Quality of the Air and Health Assessment of the Medical Staff Handling Disinfection Chemicals in Lithuanian Hospitals

Abstract

The use of chemical disinfectants where ventilation is insufficient can produce morbidity and allergic responses. Although disinfection is the universal tool for prevention of infections, the chemicals used can irritate the eyes and skin and may have neurotoxic and sensitising effects. The objective in the present study was to evaluate such chemical hazards, the use of personal protective equipment and the health status of those who handle disinfection chemicals in Lithuanian hospitals. Nine hospitals in Vilnius were studied in 2000-2001. Some 334 hospital employees from surgery, anaesthesiology, intensive care unit, resuscitation, nursing and endoscopy departments in contact with disinfecting chemicals were interviewed by questionnaire. Levels of several chemicals were monitored: glutaraldehyde, chlorine compounds and hydrogen peroxide were determined by a photometric method; isopropyl and ethyl alcohols were determined by gas chromatography. It was found that maximum levels of glutaraldehyde exceeded standards by 1.3 times, hydrogen peroxide by 8 times and isopropyl alcohol by 11 times. When working with the chemicals rubber latex gloves were used by 84.1% of personnel and protective face masks by 45.9%. Other personal protective equipment (goggles and respirators) were rarely used. Adverse reactíons included skin reddening and itching (57.6%; p<0.05), allergic conjunctivitis (39.5%), allergic rhinitis (36.0%), as well as frank diseases like chronic bronchitis (9.9%), allergic contact dermatitis (8.3%), allergic rhinitis (7.0%) and allergic conjunctivitis (6.4%). The study concluded that improvements were necessary in all aspects of work with chemical disinfectants containing these active components.

VOC Contamination in Hospital, from Stationary Sampling of a Large Panel of Compounds, in View of Healthcare Workers and Patients Exposure Assessment

“…In our study, the disinfection room is equipped with a general ventilation system delivering a high air flowrate (1,170 m 3 /h). Glumbakaite et al [5] reported much higher concentrations of alcohols than those measured in our study. The authors measured concentrations of alcohols before, during and after disinfection with alcohols, while in our study alcohol-based products were not used for disinfection of medical devices.…”

“…Most of the previous works have measured VOCs concentrations in disinfection rooms where medical devices are disinfecting and sterilizing with glutaraldehyde or formaldehyde. Concentrations of glutaraldehyde were widely variable between studies [6], [5], [43], [44], The difference being probably due to the type of ventilation. The highest concentrations were observed in rooms with natural ventilation [5].…”

“…Concentrations of glutaraldehyde were widely variable between studies [6], [5], [43], [44], The difference being probably due to the type of ventilation. The highest concentrations were observed in rooms with natural ventilation [5]. Aspiration hood or general ventilation decreased significantly concentrations levels [44].…”

“…Our study was designed to measure VOCs in indoor air at different locations, where various health activities are conducted. Previous studies addressing the issue of healthcare workers exposure were focused on a few activities at risk such as disinfection of medical device with glutaraldehyde or formaldehyde [5], [6], solvent handling in pathology laboratory [8], [39] or use of anesthetic gases in operating rooms [7]. In addition, air samples were collected in the morning and in the afternoon during 3 days, in order to have a first idea on the temporal variability in VOCs concentrations, and on the exposure of healthcare workers and patients.…”

“…In addition, a lower prevalence of indoor air-related symptoms were reported in hospitals, where workers perceived a good indoor air quality (IAQ) [3], [4]. Other studies have reported that exposure of HCWs to disinfectants and sterilitants (glutaraldehyde, hydrogen peroxide, alcohols) could induce allergic reactions such as conjunctivitis, rhinitis or contact dermatitis [5]. Exposure to glutaraldehyde could also be associated to occupational asthma [6].…”