Glutaldehyde is noncorrosive to metal and does not damage rubber and plastic equipment. It retains activity in the presence of organic matter. Glutaraldehyde-based formulations are used most commonly for high-level disinfection of medical equipment such as endoscopes, transducers, dialysis systems, and anesthesia and respiratory therapy equipment (157). Due to dilution, glutaraldehyde concentrations commonly decline during use in manual and automatic baths used for endoscopes (128). Test strips are available to ensure that the glutaraldehyde concentration has not fallen below 1 to 1.5%.
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glutaraldehyde vapor at the level of 0.2 ppm is irritating ti the eyes, throat, and nose. In HCWs exposed to glutaraldehyde, allergic contact dermatitis, asthma, rhinitis, and epistaxis have been observed. Measures that may minimize employee exposure include use of tight-fitting lids on immersion baths, improved ventilation, ducted exhaust hoods or ductless fume hoods to absorb glutaraldehyde vapor, personal protective equipment, and appropriate auto mated machines for endoscope disinfection (157). Inadequate rinsing of colonoscopes after immersion in glutaraldehyde may result in proctocolitis (60). In addition, keratopathy caused by ophthalmic instruments that were not properly rinsed after soaking has been reported.
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Formaldehyde
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Formaldehyde and its condensates have been reviewed in depth elsewhere (149). Formaldehyde in aqueous solutions or as a gas has been used as a disinfectant and sterilant for many decades. Its use in the health care setting, however, gas sharply decreased for several reasons. The irritating vapors and pungent odor poduced by Formaldehyde are apparent at very low levels (<1 ppm). In addition, allergy to Formaldehyde is not uncommon. The strongest impact on banning of Formaldehyde for sterilization and disinfection processes was the actions of agencies of the U.S. federal goverment, such as OSHA, and the health and Safety Executive of Formaldehyde vapors may pose a carcinogenic risk. OSHA limits an 8-h time-weighted average exposure to a concentration of 0.75 ppm in the workplace. Elevated workers in dialysis units and gross anatomy laboratories (6). For these reasons, the use of Formaldehyde and Formalde-hyde-releasing agents in hospitals is very limited, despite its broad-spectrum microbicidal activity. The 37% (by weight) water-based solution called formalin is used to preserve anatomical, surgical, and biopsy specimens as well as for embalming purposes. Formaldehyde has been used for the disinfection of hemodialysis equipment and water dialysate distribution systems. Other disinfectants. such as chlorines, glutaraldehydes, hydrogen peroxide, and peracetic acid, may replace Formaldehyde for the reprocessing of dialysis systems. ParaFormaldehyde vaporized by heat is still used for the gaseous decontamination of biological safety cabinets.
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