Miyajima Keiko, Yoshida Jin, Kumagai Shinji
Division of Environmental Health, Department of Foods, Drugs and Environment, Osaka Prefectural Institute of Public Health, Osaka, Japan.
Sangyo Eiseigaku Zasshi. 2010;52(2):74. doi: 10.1539/sangyoeisei.b9013. Epub 2010 Feb 17.
Recently, the use of ortho-phthalaldehyde (OPA) has been increasing as an alternative to glutaraldehyde for endoscope disinfection. To better understand OPA exposure and its health effects among disinfection workers, we conducted environmental monitoring and administered a questionnaire in 17 endoscope disinfection rooms. There were 9 manual disinfection rooms using immersion vats for scope disinfection and 8 automatic rooms using automatic washers.
OPA exposure concentration during the disinfection process of scope was significantly higher in the manual group (median: 1.43ppb, range: not detected (ND-5.37ppb) than in the automatic group (median: 0.35 ppb, range: ND-0.69 ppb). Similarly, during charging and discharging the antiseptic solution, OPA levels were significantly higher in the manual group (median: 2.58 ppb, range: 0.92-10.0 ppb) than in the automatic group (median: 0.46ppb, range: ND-1.35 ppb). Time-weighted averages of OPA exposure concentration during work shifts were 0.33 to 1.15 ppb (median 0.66 ppb) in the manual group and 0.13 to 1.28 ppb (median 0.33 ppb) in the automatic group, which suggests that manual workers are exposed to OPA at higher levels. Among 80 female disinfection workers who used only antiseptic solutions containing OPA, the incidence of disinfection-related complaints were 10% skin, 9% eye, and 16% respiratory symptoms.
These findings suggest that it is desirable to introduce automatic washers to decrease OPA exposure levels among disinfection workers.
近来,邻苯二甲醛(OPA)作为戊二醛的替代品,在内镜消毒中的使用日益增加。为了更好地了解消毒工作人员接触OPA的情况及其对健康的影响,我们对17个内镜消毒室进行了环境监测并开展了问卷调查。其中有9个手动消毒室使用浸泡槽进行内镜消毒,8个自动消毒室使用自动清洗机。
手动组内镜消毒过程中OPA暴露浓度(中位数:1.43 ppb,范围:未检出(ND)-5.37 ppb)显著高于自动组(中位数:0.35 ppb,范围:ND-0.69 ppb)。同样,在防腐剂溶液装卸过程中,手动组OPA水平(中位数:2.58 ppb,范围:0.92-10.0 ppb)也显著高于自动组(中位数:0.46 ppb,范围:ND-1.35 ppb)。手动组轮班期间OPA暴露浓度的时间加权平均值为0.33至1.15 ppb(中位数0.66 ppb),自动组为0.13至1.28 ppb(中位数0.33 ppb),这表明体力劳动者接触OPA的水平更高。在仅使用含OPA防腐剂溶液的80名女性消毒工作人员中,与消毒相关的不适发生率为:皮肤10%、眼睛9%、呼吸道症状16%。
这些结果表明,引入自动清洗机以降低消毒工作人员的OPA暴露水平是可取的。