The mechanics of endoscope disinfection

The decontamination of flexible fibreoptic endoscopes has considerably improved in recent years. This is mainly due to the introduction of instruments with more accessible channels, the use of automated washer disinfectors and a greater awareness of the problems associated with disinfection. Unfortunately the most widely used and effective disinfectant is 2% glutaraldehyde and this is toxic, irritant and sensitizing. With the implementation of Control of Substances Hazardous to Health legislation, strict environmental controls are required to reduce skin contact and vapour inhalation. Alcohol is probably the most suitable alternative disinfectant at present but it is flammable and cannot be used in automated systems. Other agents are either insufficiently effective or corrosive. Autoclavable or heat tolerant rigid endoscopes are now available but flexible endoscopes will not tolerate heat disinfection temperatures.