Allergic contact dermatitis from glutaraldehyde in health-care workers

Glutaraldehyde is considered the disinfectant of choice for sterilizing medical and dental equipment. Unfortunately, glutaraldehyde has many toxic side-effects, including the ability to induce allergic contact dermatitis. In a 5-year study at the University of Kansas, 468 patients were patch tested to glutaraldehyde. A comparison of results was made between those employed in a healthcare related field and those who were not. Health-care workers (HCWs) were more than 8x more likely to be allergic to glutaraldehyde than their non-health-care working peers (NHCWs). Statistically significant differences between HCWs and NHCWs were seen in their reactivity to glutaraldehyde, thimerosal, benzalkonium chloride and methyl methacrylate. A higher than expected co-reactivity between glutaraldehyde and formaldehyde was also noted among HCWs and NHCWs, which cannot fully be explained by concomitant exposure. Allergic contact dermatitis from glutaraldehyde often causes persistent dermatitis, which frequently forces patients to leave their jobs. Although the National Institute of Occupational Safety and Health has published guidelines for safe handling of glutaraldehyde, allergy appears to continue to rise, especially among those employed in health-care professions. Until a less sensitizing disinfectant is developed, it is in the best interest of those in health-care professions, and other professions exposed to glutaraldehyde, to heighten occupational safety standards and to improve methods of barrier protection.