The author noted that "Occupational exposure to chemicals is common and frequent in hospitals" and went on to say that self reported exposures tend to be significantly under reported. The article looked at both respiratory and dermal exposures. Respiratory exposures arose in particular from sprayed cleaning chemicals and not only resulted in irritation but twice the rate occupational asthma compared to the general work environment. Occupational Asthma was especially prevalent among healthcare workers involved in medical instrument cleaning and exposed to general cleaning products and disinfectants. Dermal exposures mainly arose via contact with the hands due to inadequate protection.
The importance of using personal protective equipment (PPE), and receiving proper training on how to use it was emphasized including gloves, goggles and masks. Some discussion was also given to the use of alternative "Environmental Cleaning Chemicals" but efficacy concerns limit what can be used. The article summarized that there are many actions that can be taken involving different chemicals, modified work practices and better training that can have a major impact.
ChemDAQ has often stressed the importance of workers being aware of the risks of exposure to sterilant chemicals and this article shows that even common cleaning chemicals present a health risk to workers. Patient Safety is of paramount concern in healthcare, and the prevalence of hospital acquired infections has resulted in greater emphasis on disinfection and cleaning. Unfortunately, it is all too easy for hospital administrators to focus so much on patient safety that the safety of their employee gets over looked.
As the NIOSH NORA report stated "The HCSA sector is burdened by the historical and entrenched belief that patient care issues supersede the personal safety and health of workers and that it is acceptable for HCSA workers to have less than optimal protections against the risks of hazardous exposures or injuries." However, there are signs that the old ways are changing. Recent articles have discussed this issue, and more enlightened institutions know that patient safety and employee safety go hand in hand.
It almost goes without saying that any chemical used to kill a broad spectrum of microbial life is likely to have adverse effects on people exposed to it. Some of the effects will be immediate, others may take longer to become apparent. This article in Infection Control Today is valuable in informing people that occupational exposure to even every-day cleaning agents can have adverse effects. Disinfectant and cleaning chemicals provide life saving functions in healthcare, but whenever these chemicals are employed it is important to assess the risks, develop work practices to minimize exposure, provide adequate PPE, and train workers how to use these chemicals safely.