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[接触内镜消毒剂邻苯二甲醛的健康危害及医护人员的预防措施]

[Health hazards from exposure to ortho-phthalaldehyde, a disinfectant for endoscopes, and preventive measures for health care workers].

作者信息

Fujita Hiroshi, Sawada Yasuyuki, Ogawa Masanori, Endo Yoko

机构信息

Department of Transfusion Medicine, Tokyo Metropolitan Bokutoh Hospital, Koutoubashi, Tokyo, Japan.

出版信息

Sangyo Eiseigaku Zasshi. 2007 Jan;49(1):1-8. doi: 10.1539/sangyoeisei.49.1.

Abstract

Recently, the use of ortho-phthalaldehyde(OPA)has been increasing as an alternative to glutaraldehyde(GA)for endoscope disinfection. We detected development of bronchial asthma and contact dermatitis in health care workers(HCW)employed in an endoscopy unit. After performing health examinations and work environment measurements, we took preventative measures against development of these diseases. Seventeen of 70 HCW had experienced skin, respiratory, or eye symptoms. Contact dermatitis occurred in 4 workers, one of whom also developed asthma. OPA concentration in the air of the endoscopy unit ranged from 0.06 to 2.01 ppb. The highest OPA concentration was obtained while the cover of a bucket for dipping endoscopy instruments was opened. Dipping of instruments was then discontinued, a personal protector was provided to each HCW and local ventilation devices for auto-washers, and health education was performed for HCW. At the periodic health examination the next year, two of 83 HCW described mild eye irritation, but no contact dermatitis or bronchitis had newly developed. This study clearly revealed that despite a very low level of OPA in air, symptoms of skin and the respiratory tract can occur. Spreading use of OPA as a substitute for GA may result in serious health risks for HCW. To prevent health hazards from OPA exposure, wearing of a personal protector and use of a fully automated washing machine with a local air exhauster are required.

摘要

最近,邻苯二甲醛(OPA)作为戊二醛(GA)的替代品用于内镜消毒的情况日益增多。我们在内镜室工作的医护人员(HCW)中检测到支气管哮喘和接触性皮炎的发生。在进行健康检查和工作环境测量后,我们采取了预防这些疾病发生的措施。70名医护人员中有17人出现过皮肤、呼吸道或眼部症状。4名工作人员发生了接触性皮炎,其中1人还患上了哮喘。内镜室空气中OPA浓度在0.06至2.01 ppb之间。在内镜器械浸泡桶盖子打开时测得OPA浓度最高。随后停止器械浸泡,为每位医护人员提供了个人防护用品,并为自动清洗机配备了局部通风装置,同时对医护人员进行了健康教育。在次年的定期健康检查中,83名医护人员中有2人描述有轻度眼部刺激,但未新发生接触性皮炎或支气管炎。这项研究清楚地表明,尽管空气中OPA水平非常低,但仍可能出现皮肤和呼吸道症状。广泛使用OPA替代GA可能会给医护人员带来严重的健康风险。为防止OPA暴露带来的健康危害,需要佩戴个人防护用品并使用带有局部排气装置的全自动洗衣机。

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