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Glutaraldehyde (GA) which is a form of chemical disinfection is still used in disinfection of endoscopes in Egyptian Hospitals despite of its well-known adverse health effects.
Photo of manual cleaning of an endoscope
Source: Focus for Health: Need a Colonoscopy? The one question you must ask before any endoscopic procedure [internet].2016. Available from: https://www.focusforhealth.org/need-a-colonoscopy-the-one-question-you-must-ask-before-any-endoscopic-procedure/
Glutaraldehyde is the best and most frequently used disinfectant for endoscopes as it has a broad spectrum antimicrobial activity which enables rapid disinfection as well as being economical. Studies reported that exposure to GA can cause skin, eyes and respiratory tract irritation, it also act as a sensitizer causing asthma which has been reported among health care professionals.
In a recent paper by Dr. S.A. Bolbol et al., endoscopy nurses were assessed regarding there respiratory symptoms resulting from exposure to GA accompanied with measuring of their pulmonary functions at the end of work shift.
“Because the process of disinfection is repeated many times daily and mainly through manual reprocessing techniques, duration and amount of exposure to GA among nurses are increased which put them at great risk” the authors said.
In the paper, Dr. S.A. Bolbol et al., found that exposure to GA put endoscopy nurses at risk of having respiratory health problems mainly chronic cough 52.0% and airway obstruction mainly asthma 19.0% especially in those who had poor work practices which was noticed in 67.0% of studied nurses, and those with increased work duration. Hospitals showed a defect in training system as no special training on GA usage were given to nurses.
“Regular training programs on handling hazardous substances with focus on GA as the first line of defense to protect nurses’ health along with provision of written procedures for safe working practices is mandatory” the authors recommended.
The authors continue to suggest that “Decreasing GA adverse impacts by highlighting its respiratory health problems will decrease the direct and indirect costs burden on the healthcare industry and will drew the attention of the authorities to eliminate the use of GA and to provide another less hazardous disinfectant chemical, as well as automatizing endoscopes disinfecting procedures.”
Sarah Abdelhalim Bolbol, Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Zagazig University, Zagazig, EgyptEnjy Ahmad Khorshed, Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt Naema El-Lithy Soliman, Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt Mohammed Magdy Nassef, Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
A paper about the study appeared recently in Science Journal of Public Health.