The Practice >> OccMed

Hospital and Medical Facility Hazards (Part 1)
by Dr. Roy Mangubat

Hazards in the Medical facilities and their possible interventions.

Hospital and Medical Facility Hazards (Part 1) 

On most hospitals it is a rare occasion if you'll see a Safety Engineer or an Industrial hygienist among the roster of its personnel nor the presence of an MSDS/CSDS in the Lab. It is an irony that the centers for health and wellness are the one with so many hazards in its day to day operations. The Occupational Health and Safety Standards has no specific rule regarding Hospital and Health Facility OHS, DOH has some administrative orders regarding Disposal of Hospital Waste but not directly to hospital OHS. These hazards would include acute and chronic exposure to chemicals, exposure to biological agents, physical and psychosocial hazards.

 Chemical Hazards

 Formaldehyde (Formalin)

• Preservative, tissue fixative and disinfectant
• A well known skin irritant
• Also causes eye, nose, upper airway irritation and headaches
• Exposure to 50 – 100 ppm can cause pulmonary edema, inflammation and pneumonia
• Fatal level at >100 ppm exposure

 Glutaraldehyde

• An anti microbial agent
• Uses includes – in developing x rays, fixing agents and as topical treatment for the common warts
• Primary use is for medical equipment disinfection
• Skin irritation and sensitizer, can cause contact dermatitis and eczema, and occupational asthma

 Ethylene Oxides

• Sterilant for medical instruments
• Can cause nausea, headache and vomiting, weakness, drowsiness and general irritation
• Exposure to EtOH has been linked leukemia and non-Hodgkin's lymphoma
• The International Agency for the Research of Cancer (IARC) tagged it to Group Agent I
• Potential reproductive hazard

 Other Chemical Hazards

• Alcohol
• Chlorine compounds
• Hydrogen peroxide
• Iodophores
• Peracetic acid
• Phenolic acid
• quarternary ammonium compaounds

Almost all of these causes skin and respiratory irritations.

Suggested Interventions:

• always rinse preserve specimen in running water
• keeping the lids of containers containing formaldehyde and glutaraldehyde tight and well sealed
• a good ventilation system to prevent accumulations of gasses
• wearing of protective aprons, splash mask and gloves.
• Respiratory protection (PPE) as last resort

Exposure to Antineoplastic Medications

• Drugs that are use in the treatment of cancer
• Can cause mutagenicity and teratogenicity effects in the human cell structure
• Pharmacist and Nurses are the one most exposed to these agents since they are the one who mixed, prepare and administer the drugs.

Suggested Measures:

·         Protocol on safe drug preparation and drug administration (for antineoplastic medications)

·         Proper waste disposal facility

·         Use of PPEs ( protective gloves and disposable gowns)

·         A Good ventilation system

·         Use of a Biological Safety Cabinet for the preparation of these drugs.

Exposure to Nitrous Oxide and other General Anesthetics

• Anesthesiologist, OR nurses and Surgeons are the one exposed to these hazards
• Epidemiologic studies showed that exposure to these agents are linked to reproductive effects, spontaneous abortion, congenital anomalies, hepatic and renal malignancies
• Muscle weakness and numbness are also noted to those expose with these compounds

Suggested Measures:

·         Use of Anesthetic Gas Scavenging System

·         A good ventilation System

·         A good Surveillance System to detect symptoms of this type of exposure.

Latex Exposure and Allergies

• Universal use among healthcare workers
• Use of powdered gloves increase contact exposures thus increasing absorption of this type of allergen
• Nitrile Gloves and vinyl gloves can be use as a substitute for those w/ latex allergies.
• Proper hand washing after use of latex gloves is recommended to avoid transfer of allergens by direct or by indirect contact.

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The author is a diplomate of the Philippine College of Occupational Medicine (PCOM). PCOM is an accredited Occupational Health and Safety Organization of the Bureau of Working Conditions of the Department of Labor and Employment (DOLE), a subspecialty society under the Philippine Medical Association (PMA). PCOM is also affiliated with the International Commission on Occupational Health (ICOH) and the Asian Association of Occupational Health (AAOH).Lets Keep on Protecting the Health and Safety of the Filipino Workforce!

6/29/10
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