Effect of engineering controls and work practices in reducing ethylene-oxide exposure during the sterilization of hospital supplies.
Elliott-L; Mortimer-V; Ringenburg-V; Kercher-S; O'Brien-D
Scand J Work, Environ & Health 1988 May/Jun; 14(Suppl 1):40-42
A study of the ability of engineering controls and work practices to reduce ethylene-oxide (75218 ) exposures during sterilization of hospital supplies was conducted. In depth industrial hygiene surveys were conducted in 12 hospitals to determine ethylene-oxide exposures. Work practices and engineering controls were observed. Engineering controls in eight other hospitals were investigated to identify the best available controls for reducing exposure. Overall time weighted average (TWA) ethylene-oxide exposures ranged from nondetectable to 6.3 parts per million (ppm) for the sterilizer operators. Short term (2 to 30 minute) exposures ranged from nondetectable to 103ppm for the sterilizer operators. TWA exposures for folders and packers ranged from nondetectable to 6.7ppm. TWA ethylene-oxide exposures in hospitals with good engineering controls and good work practices were below the detection limit. TWA exposures in hospitals with good engineering controls and poor work practices were 0.16ppm. TWA exposures in hospitals with no engineering controls and good work practices were 0.46ppm. TWA ethylene-oxide exposures in hospitals with no engineering controls and poor work practices were 4.6ppm. Effective engineering controls included local ventilation above the sterilizer door and at the sterilizer drain, good general air ventilation of the sterilizer room, and additional vacuum purges. Good work practices included leaving the sterilizer room during the exhaust cycle, opening the door 2 to 5 centimeters at the end of the cycle, and limiting handling of the sterilized items. The authors conclude that engineering controls and good work practices can reduce ethylene- oxide exposures in hospitals. Engineering controls are more effective than good work practices.
NIOSH-Author; Occupational-exposure; Work-practices; Control-methods; Health-care-facilities; Air-quality-control; Ventilation-systems; Medical-personnel
National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
Scandinavian Journal of Work, Environment and Health