Three Cases of Ortho-phthalaldehyde-induced Anaphylaxis after Laryngoscopy: Detection of Specific IgE in Serum

Suzukawa, Maho; Komiya, Akiko; Koketsu, Rikiya; Kawakami, Ayako; Kimura, Miwako; Nito, Takaharu; Yamamoto, Kazuhiko; Yamaguchi, Masao

doi:10.2332/allergolint.c-06-51

Cited by 32 publications

(31 citation statements)

References 9 publications

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“…This sample was analyzed for OPA-specific immunoglobulin E (IgE) and immunoglobulin G (IgG) antibodies [Suzukawa et al 2007] to assess past exposures to OPA. Details of the antibody analyses are included in Appendix C.…”

Section: Methodsmentioning

confidence: 99%

“…Anaphylaxis (a rapidly progressing, potentially life-threatening allergic reaction) was seen in patients who had medical procedures with endoscopes disinfected with OPA. Subsequent immunological testing indicated that OPA was the inciting agent [Suzukawa et al 2007;Cooper et al 2008;Pala and Moscato 2013]. Following reports of patient sensitization, reports of adverse occupationally related health effects surfaced.…”

Section: Ortho-phthalaldehyde and High Level Disinfectionmentioning

confidence: 99%

“…Other symptoms from inhalation of OPA may include chest and throat tightness, difficulty breathing, a stinging sensation in the nose and throat, tingling of the mouth and lips, headache, loss of smell, and dry mouth [Advanced Sterilization Products 2010]. Cases of anaphylaxis have been associated with OPA exposure after undergoing a procedure with devices cleaned with OPA that were not adequately rinsed to remove OPA residue [Sokol 2004;Suzukawa et al 2007;Cooper et al 2008]. …”

Section: Ortho-phthalaldehydementioning

confidence: 99%

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Health hazard evaluation report: evaluation of ortho-phthalaldehyde in eight healthcare facilities.

2015

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Section: Methodsmentioning

confidence: 99%

Section: Ortho-phthalaldehyde and High Level Disinfectionmentioning

confidence: 99%

Section: Ortho-phthalaldehydementioning

confidence: 99%

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Health hazard evaluation report: evaluation of ortho-phthalaldehyde in eight healthcare facilities.

2015

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“…PVC, polyurethane and siicone that tend to absorb disinfectants. While reports on the adverse effects of residual disinfectants were thought to be due to poor rinsing, the absorption by materials and toxicity related to the later release of disinfectants should not be ignored, as anaphylaxis and other sorts of allergic reactions have been reported to be due to this phenomenon Suzukawa et al, 2006;Suzukawa et al 2007;Soko, 2004;Zeiger et al, 2005 .…”

Section: Figmentioning

confidence: 99%

“…As these disinfectants are frequently used during endoscopic procedures, there have been reports on the adverse effects of their residues, especially with OPA, since it causes discoloration of the skin and mucous membranes, irritation, anaphylaxis and other allergic reactions Abdulla and Adams, 2007;Arrandale et al, 2012;Cooper et al, 2008;Miyajima et al, 2010;Suzukawa et al, 2007;Venticinque et al, 2003 . These …”

mentioning

confidence: 99%

Cytotoxicity Assessment of Residual High-Level Disinfectants

Ryu¹,

Kobayashi²,

Kawamukai³

et al. 2013

Biocontrol Sci.

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Some studies show the uptake of disinfectants on medical devices but no studies on their cytotoxicity have been reported. This study aimed to assess that cytotoxicity in a 3-dimensional culture system using HeLa cells grown in matrices composed of collagen. Plastic materials were soaked in the use solutions of the widely used high-level disinfectants, glutaraldehyde (GA), ortho-phthalaldehyde OPA and peracetic acid PAA . After being rinsed, they were allowed to dry and were embedded into the cell medium to investigate the cytotoxicity of the residual disinfectants. Cytotoxicity was observed with the polyvinyl chloride, polyurethane and silicon tubes soaked in GA and OPA, indicating that both disinfectants were absorbed in the test pieces, whereas for PAA, none was observed. As for the polytetrafluoroethylene PTFE tubes, no disinfectant displayed cytotoxicity. GA and OPA are primary irritants, having a potential to cause anaphylaxis and other forms of allergic reactions. There should be consideration not only about the toxicity of the residual disinfectant from poor rinsing, but also about the toxicity that would result from the disinfectants that were absorbed and consequently released from the medical devices or materials.

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Work‐related allergy and asthma associated with cleaning agents in health workers in Southern African tertiary hospitals

Mwanga

Baatjies

Singh

et al. 2022

American J Industrial Med

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Background: Health workers (HWs) are exposed to diverse cleaning agents in large hospitals. This study determined the prevalence of work-related symptoms, allergic sensitization, and lung function abnormalities in HWs of two tertiary hospitals in Southern Africa. Methods: A cross-sectional study of 699 HWs (South Africa: SAH, n = 346; Tanzania: TAH, n = 353) was conducted. Health outcomes were assessed using a standardized ECRHS questionnaire, immunological tests (specific IgE antibody to common aeroallergens and to occupational allergens: natural rubber latex [NRL] Hev b5 and Hev b6.02, chlorhexidine, and ortho-phthalaldehyde [OPA]), spirometry [pre-and postbronchodilator], methacholine challenge, and fractional exhaled nitric oxide (FeNO).Results: A large proportion of participants (78%) were women. Median age was 42 years, with 76% nurses, 12% cleaners, and 5% administrative workers. Current smoking was more common in SAHWs (12%) than TAHWs (1%). The overall prevalence of doctor-diagnosed asthma was 7%. Atopy was present in 43% of HWs, while 4% were sensitized to OPA, 2% to NRL, and 1% to chlorhexidine. Prevalence of work-related ocular-nasal symptoms (16%) was higher than skin (12%) and chest (7%) symptoms. TAHWs had significantly lower mean lung volumes, higher degrees of significant airflow obstruction and impaired lung function. The prevalence of bronchial hyperresponsiveness in SAHWs (14%) was high. Overall, 23% of HWs had abnormal FeNO; 6% having high (>50 ppb) levels. FeNO was positively associated with sensitization to occupational allergens, primarily OPA and NRL.Conclusions: HWs from both hospitals had similar prevalence of work-related respiratory symptoms. Sensitization to OPA and NRL appears to be contributing to allergic airway inflammation in these HWs.

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Three Cases of Ortho-phthalaldehyde-induced Anaphylaxis after Laryngoscopy: Detection of Specific IgE in Serum

Abstract: Physicians and co-medical workers need to be aware of potential allergens to which patients may be exposed during routine medical procedures.

Cited by 32 publications

References 9 publications

Health hazard evaluation report: evaluation of ortho-phthalaldehyde in eight healthcare facilities.

Health hazard evaluation report: evaluation of ortho-phthalaldehyde in eight healthcare facilities.

Cytotoxicity Assessment of Residual High-Level Disinfectants

Work‐related allergy and asthma associated with cleaning agents in health workers in Southern African tertiary hospitals

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