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Whether or not to use Glutaraldehyde has been a hot debate on many message boards recently. And, I must admit, I thought OSHA and the CDC outlawed Glutaraldehyde, but the truth is they have only (highly) recommended that we no longer use it. Will it be “outlawed” sometime in the future? I truly believe so and here’s why:
OSHA says; “In the years since its introduction as a disinfectant/sterilant, glutaraldehyde has been linked with a variety of health effects – ranging from mild to severe – including asthma, breathing difficulties, respiratory irritation and skin rashes.”
They claim the most serious adverse health effect documented among employees exposed to glutaraldehyde vapor is occupational asthma, a chronic condition characterized by bronchial hyperresponsiveness. Reactions can be either immediate or delayed, with a latent period ranging from a few weeks to several years from the onset of exposure.
“In addition, a few cross-sectional studies also show that an increased prevalence of irritant symptoms, including itching of the eyes with increased lacrimation (tearing), and rhinitis…”
And in addition to causing respiratory effects, glutaraldehyde acts as a contact allergen, giving rise to contact dermatitis, usually on the hands, but occasionally on the face.
Along with those symptoms, the EPA says glutaraldehyde has been linked to headaches, nosebleeds, sneezing, wheezing, hives, nausea and staining of the hands.
OK, so if that’s not enough to convince you, glutaraoldehyde is also very unstable. Most of us don’t handle it properly. Many of the “test strips” you can get to test the solution really only test to see how diluted the chemical is, not its effectiveness. Most of these are 28-day solutions; sure, your chemical might be great for the first few days, but is it still working on day 20?
Are there other chemicals that you can use? There are a few on the market, but are they as effective? They will all tell you “yes.” I will say, “Why chance it?” Holding yourself to the highest standards of patient care is essential. Infection control is the most important thing we do on a daily basis, so get it right!
The EPA is also concerned with disposal of the chemical after its use. You should never dispose of your glutaraldehyde in the sewer systems without notifying the local sewage treatment plant authority. You should always contact your local water board or regional office of the EPA. I don’t know many offices that do that.
Best practice: If you can autoclave it, do it. If you can’t, throw it away. It’s simply not worth the health risk or the all the problems associated with handling it or disposing of it. We got rid of it in our office a couple of years ago and I will admit, I was unsure at first how we would do without it. Happy to say, we haven’t missed it.
OSHA and the CDC make these guidelines based on facts, so don’t ignore them. For your safety, the safety of your patients and that of your families, I recommend (as do OSHA, the CDC and the EPA!) to get rid of it!