Health hazard evaluation report: evaluation of ortho-phthalaldehyde in eight healthcare facilities.
Chen L; Eisenberg J; Mueller C; Burton NC
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, HHE 2006-0238-3239, 2015 Jul; :1-41
Health Hazard Evaluation (HHE) Program investigators evaluated exposures to ortho-phthalaldehyde (OPA) and potential health effects among employees using this disinfectant at eight healthcare facilities across the United States. In 1999, OPA was introduced to the U.S. market as a safer alternative to glutaraldehyde for disinfecting heat-sensitive medical devices. The facilities in our evaluation used OPA manually and in automated endoscope reprocessors. We invited employees in areas where OPA was used (exposed) and not used (comparison) to participate in (1) questionnaires on work history, practices, and symptoms; (2) skin tests for allergic reactions to common allergens and OPA; (3) blood tests for antibodies to OPA; (4) skin examinations of their hands and forearms; and (5) personal air sampling. We also took surface wipe samples, evaluated ventilation systems, reviewed OPA-related training programs, and observed personal protective equipment use. We found no evidence of adverse health effects associated with exposure to OPA. The majority of participants in the exposed group used OPA in basins or containers, rather than in automated systems. About half of the participants in the exposed group reported using OPA every day. No participants had skin staining from OPA. Four participants in the unexposed group and one in the exposed group had positive allergy skin tests to OPA. No participants had OPA-specific antibodies. We found OPA in personal air samples from both the exposed and comparison groups; the average concentrations in the comparison group were lower. Areas within a facility with the highest relative surface contamination were usually around OPA basins and their lids. Ventilation systems, employee training, and personal protective equipment use varied among the facilities. Most employees wore gloves and eye protection when handling OPA. Some facilities did not have effective separation between the disinfection area and surrounding areas. To address the potential for exposure to OPA, we recommended the healthcare facilities train employees on proper use and handling, ensure employees always use proper personal protective equipment, and maintain proper ventilation. We recommended employees using OPA wear nitrile or butyl rubber gloves and eye protection, use appropriate handling procedures when pouring OPA solution and opening the containers with OPA, and report any respiratory symptoms or skin irritation when handling OPA to their supervisor and seek medical attention.
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