NIOSH Report Contains Interesting Information

The National Institute for Occupational Safety and Health (NIOSH) released a report in August of last year titled, “Evaluation of Worker Exposures to Peracetic Acid-Based Sterilant during Endoscope Reprocessing.” The document analyzes a 2006 visit to a hospital that requested a health hazard evaluation because of health problems being reported among employees in their sterile processing department. The report contained a few interesting things relevant to the work that is currently taking place at ChemDAQ.

First was NIOSH’s acknowledgement of the possibility of chemical spills, leaks and processor malfunctions. The report states that exposure is “unlikely”, however at the same time instructs hospital managers to “make sure that processors are inspected periodically for worn parts that can cause leaks” and urges employees to “follow standard operation procedures for processor problems, leaks, and sterilant spills.” While many manufacturers will assure their customers that continuous monitoring of sterilant gases is unnecessary because their equipment cannot malfunction, the NIOSH report makes it very clear that is not the case. According to the report, “processor malfunctions and improper handling and disposal of … containers can result in dermal or inhalation exposures”, as can what NIOSH terms “nonroutine events.”

The second is that this particular hospital had inadequate ventilation of their sterilization rooms and the employees had insufficient training. Without proper training, these workers could experience increased exposure in the event of an adverse incident, which was what prompted the NIOSH evaluation in the first place.

This report once again confirms that sterilizers can and do malfunction and that many workers have insufficient training when it comes to dealing with chemical leaks in the workplace. Without a continuous gas monitoring system, employees would have no way of knowing when chemical sterilants are in the air. This particular report mentions detection of Peracetic Acid by odor, but if you can smell it, it is too late as exposure has already occurred. Furthermore, with inadequate ventilation of the workplace, as in this case, odors from various other chemicals could be in the air, making it difficult to distinguish the harmful from the innocuous. Continuous monitoring enables immediate notification of a leak, allowing employees to exit the area quickly and safely.

To read the full report, visit:
http://www.cdc.gov/niosh/hhe/reports/pdfs/2006-0298-3090.pdf

Environmental Working Group Study

In December 2007, Environmental Working Group published a study entitled “Nurses’ Health and Workplace Exposures to Hazardous Substances”. The study was based on a survey of nurses who reported varying levels of exposure to common chemicals found in hospitals. What they found was quite remarkable, and speaks to the importance of area monitoring in the workplace. A few interesting excerpts:

“Participating nurses who were exposed frequently to sterilizing chemicals, housekeeping cleaners, residues from drug preparation, radiation, and other hazardous substances report increased rates of asthma, miscarriage, and certain cancers, as well as increases in cancers and birth defects, in particular musculoskeletal defects, in their children.”

“Asthma rates increased by up to 50 percent for nurses reporting high exposure to disinfecting and sterilizing agents (glutaraldehyde and ethylene oxide), housekeeping chemicals, and latex, relative to nurses with lower exposure to these hazards.”

“Nurses reporting high exposures to ethylene oxide and antineoplastic drugs also reported up to 20 percent higher incidence in miscarriage, on average, than nurses with lower or no exposure.”

“46 percent of nurses report feeling that the administrations at their health care facilities are not doing enough to protect them from hazardous exposures, and 37 percent do not think that occupational health is taken seriously at their place of employment.”

In light of these results, Environmental Working Group offered suggestions and recommendations to improve worker safety, saying that “(health care facilities) should monitor the air, surfaces, and even nurses’ bodies for chemicals. They should educate nurses on the hazards and safe use of chemicals and other hazardous agents. And they should not wait for these actions to be mandatory.”

We couldn’t have said it better ourselves.

To read the entire study, visit http://www.ewg.org/reports/nursesurvey.

AAMI Announces Teleconference Dates

The Association for the Advancement of Medical Instrumentation has announced dates for two important teleconferences next month in order to review remaining comments on their standards. The call for Working Group 40: Steam Sterilization Hospital Practices, will take place on Tuesday, July 20 from 10am – 2pm (EDT). The call for Working Group 61: Chemical Sterilants Hospital Practices will take place 2 days later on Thursday, July 22 from 10am – 2pm (EDT). The two documents being reviewed are ST79 and ST58, respectively.

As you might recall from an earlier post, the meetings in May were not long enough to allow discussion on many of our company’s comments concerning the standards. While we all know that exposure to chemical sterilants can be very harmful, the standards are inconsistent when it comes to how they should be monitored. Our goal is to introduce consistency in the documents on how all sterilants should be monitored, with employee safety at the forefront.

We look forward to healthy discussion via the teleconferences at the end of July.