Even 'safer' products require safe practices

NIOSH highlights PPE, training needs

The processor used to disinfect endoscopes was a closed system. The sterilant was a safer alternative to glutaraldehyde. So why were employees complaining of headaches, eye irritation, shortness of breath and a reduction in their sense of smell?

Based on employee complaints, industrial hygienists from the National Institute for Occupational Safety and Health (NIOSH) conducted a Health Hazard Evaluation at Kaleida Health-Buffalo (NY) General Hospital in 2006 and found opportunities for better ventilation — and additional training — in the use of the Steris Corp. system.

"The system, when it works well, does a good job of protecting the employees," says David Sylvain, MS, CIH, industrial hygienist in NIOSH's New England field office in Dartmouth, MA. Yet malfunctions or errors can occur that can lead to exposures, he cautions.

Five employees worked in the GI Lab Steris Room, separated into a dirty and clean side by a wall with a window. The Steris processors used sealed, single-use cups with the peracetic acid solution. Employees told NIOSH investigators that the room was often too warm and had poor ventilation.

NIOSH did not find detectable air concentrations of peracetic or acetic acid during its sampling. However, the NIOSH investigators did conclude that the room needed better ventilation.

Exposure, and even burns, can occur when processors leak or malfunction or when the cups are handled roughly, NIOSH said.

Meanwhile, latex gloves were the only personal protective equipment the investigators observed employees wearing, according to the Health Hazard Evaluation. Latex gloves do not provide adequate protection against a chemical hazard, and goggles and acid-resistant sleeves and aprons also should be worn, NIOSH says.

Employees also reported gaps in training. "In my opinion, training needs to be repeated periodically," says Sylvain. "We all forget our training over time and we all need a refresher.

"OSHA requires annual hazard communication training. It would mean people would be trained in the hazards of materials they're working with, how to protect themselves, how to deal with a spill or release, and what personal protective equipment would be appropriate," he says.

(Editor's note: A copy of the Health Hazard Evaluation is available at www.cdc.gov/niosh/hhe/reports/pdfs/2006-0298-3090.pdf.)