[Strategies to improve protection from glutaraldehyde in endoscopic examination]

Safety of the working environment has emerged as an important issue in recent years. Of safe work place is a prerequisite for the practice of medicine. High level disinfection by glutaraldehyde (GAD) is the usual method for sterilizing endoscopes. But GAD is highly volatile and is an irritant. Prolonged exposure to GAD in a closed unit usually causes discomfort. Our study demonstrated that the main reasons for this are: (1) nursing staff are not sufficiently familiar with GAD, (2) high GAD concentration in the air, (3) insufficient training to use the facilities and disinfectant, (4) lack of safety precautions due to large amount of GAD in examination room. In order to diminish the dangers of unavoidable exposure, the following strategies are recommended: intensify training for the handling of GAD, decrease the amount of GAD, encourage the use of individual precautions and remove fuzzy carpets, and use appropriate disinfection facilities. Many improvements can be achieved with the introduction of these measures as, this article shows. These improvements include: (1) a 100% response rate and a 97% satisfaction rate from trainees, (2) a total reduction of 150 liters of GAD per month with atmospheric GAD markedly reduced, to 0.0054 ppm, (3) reduction in reported discomforts from between 80% and 100% to 10%, (4) a protection rate of 100% compared to the previous 10% - 30%.