Health Effects of Chemicals used in hospitals among Healthcare Workers

Jong Uk Won

doi:10.5124/jkma.2010.53.6.474

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Won: Health Effects of Chemicals used in hospitals among Healthcare Workers

Focused Issue of This Month

Occupational Health Problems in Health Care Workers

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2010; 53(6): 474-482.

Published online: 30 June 2010

DOI: https://doi.org/10.5124/jkma.2010.53.6.474

Health Effects of Chemicals used in hospitals among Healthcare Workers

Jong Uk Won, MD

Department of Preventive Medicine, Yonsei University College of Medicine and Institute for Occupational Health, Korea.

Corresponding author: Jong Uk Won. juwon@yuhs.ac

Abstract

Healthcare workers are exposed to a variety of chemical agents used in many different areas and purposes. The chemicals could cause health problems to healthcare workers using them. Glutaraldehyde is a kind of disinfectant and used for endoscopes, catheters, and many kinds of operating apparatus. It may cause allergic contact dermatitis. Formaldehyde is another disinfectant and can be used for fixing tissues. Formaldehyde was classified to a Group 1 carcinogen by IARC and it may cause lung or nasal cancer. Ethylene Oxide gas is the most popular disinfectant these days and may be applied to many health care sets or linens. EO gas may cause allergic contact dermatitis and breast cancer or leukemia. It is also classified as Group 1 carcinogen despite limited evidence for human cancers. Anesthetics are related to genotoxicities, sister chromatid exchange, and might be related to spontaneous abortion, stillbirth or birth defects. Some of the anti-neoplastic drugs such as Busulfan, Chlorambucil, cyclophosphamide, melphalan are Group 1 carcinogens. They could cause nausea, pruritus, or decreasing leukocytes or platelets. Other miscellaneous chemical agents are heavy metals such as elementary mercury or lead and organic solvents such as toluene, xylene and acetone. Although some of these chemical agents including EO gas have occasionally exceeded to permissible level, air levels of most above chemicals in Korean hospitals were relatively low. However, we have to make every effort to reduce the exposure level of these chemicals.

Keywords: Healthcare workers, Health effects, Ethylene oxide, Anesthetic, Anti-neoplastic drug

Figures and Tables

Table 1

Carcinogenecity of anticancer drugs evaluated by IARC Working Group

References

1. Roh J, Won JU, Kim C-N, Kim U-C, Koh SB, Kim HS, et al. Study for understanding chemical usage at health care facilities and setting its control program. 2006. Seoul, Korea: Occupational Safety&Health Research Institute;135.

2. Occupational Safety&Health Research Institute. 2004 Survey of Occupational Health Service status of Health Care Facilties. 2005.

3. Kiec-Swierczynska M, Krecisz B. Occupational skin diseases among the nurses in the region of Lodz. Int J Occup Med Environ Health. 2000. 13:179–184.

4. Shaffer MP, Belsito DV. Allergic contact dermatitis from glutaraldehyde in health-care workers. Contact Dermatitis. 2000. 43:150–156.

5. Ravis SM, Shaffer MP, Shaffer CL, Dehkhaghani S, Belsito DV. Glutaraldehyde-induced and formaldehyde-induced allergic contact dermatitis among dental hygienists and assistants. J Am Dent Assoc. 2003. 134:1072–1078.

6. Kim CW, Song JS, Ahn YS, Park SH, Park JW, Noh JH, Hong CS. Occupational asthma due to formaldehyde. Yonsei Med J. 2001. 42:440–445.

7. Gannon PF, Bright P, Campbell M, O.H'ickey SP, Burge PS. Occupational asthma due to glutaraldehyde and formaldehydein endoscopy and x ray departments. Thorax. 1995. 50:156–159.

8. Donovan J, Skotnicki-Grant S. Allergic contact dermatitis from formaldehyde textile resins in surgical uniforms and nonwoven textile masks. Dermatitis. 2007. 18:40–44.

9. Formaldehyde, 2-butoxyethanol and 1-tert-butoxypropan-2-ol. IARC Monogr Eval Carcinog Risks Hum. 2006. 88:1–478.

10. Minstry of Labor. Threshold Limit Values for Chemical Substances and Physical Agents. 2008.

11. Kim JH, Kim DJ, Kim HW. A Study on exposure-Worker to Formaldehyde in the Endoscopy Unit of Hospitals. Korean Ind Hyg Assoc J. 2009. 19:195–201.

12. Jeong K-H, Ha A-L, Lee Y-H. Formaldehyde Concentrations in Air of Histopathology Laboratories of Some Hospitals. Kosim J Health Sci. 2002. 12.

13. ACGIH. Threshold Limit Values for Chemical Substances and Physical Agents and Biological Exposure Indices. Cincinnati: 2099.

14. Kerre S, Goossens A. Allergic contact dermatitis to ethylene oxide. Contact Dermatitis. 2009. 61:47–48.

15. Rom WN, editor. Environmental and Occupational Medicine. 2006. 4th ed. Philadelphia: Lippincott-Raven.

16. Grosse Y, Baan R, Straif K, Secretan B, El Ghissassi F, Bouvard V, Altieri A, Cogliano V. WHO International Agency for Research on Cancer Monograph Working Group. Carcinogenicity of 1,3-butadiene, ethylene oxide, vinyl chloride, vinyl fluoride, and vinyl bromide. Lancet Oncol. 2007. 8:679–680.

17. IARC monographs on the evaluation of carcinogenic risks to humans. Volume 97. 1,3-butadiene, ethylene oxide and vinyl halides (vinyl fluoride, vinyl chloride and vinyl bromide). IARC Monogr Eval Carcinog Risks Hum. 2008. 97:3–471.

18. Hagmar L, Mikoczy Z, Welinder H. Cancer incidence in Swedish sterilant workers exposed to ethylene oxide. Occup Environ Med. 1995. 52:154–156.

19. Lucas LJ, Teta MJ. Breast cancer and ethylene oxide exposure. Int J Epidemiol. 1996. 25:685–686.

20. Steenland K, Stayner L, Deddens J. Mortality analyses in a cohort of 18 235 ethylene oxide exposed workers: follow up extended from 1987 to 1998. Occup Environ Med. 2004. 61:2–7.

21. Jeong MH, Lee YW. Hematologic Effects in Workers Exposed to Ethylene Oxide. J Korean Public Health Assoc. 1997. 23:117–127.

22. Seo SO, Paik NW. A Study on Worker Exposure to Ethylene Oxide in Central Sterilizing Room of Hospital. Korean Ind Hyg Assoc J. 1995. 5:68–86.

23. Eroglu A, Celep F, Erciyes N. A comparison of sister chromatid exchanges in lymphocytes of anesthesiologists to nonanesthesiologists in the same hospital. Anesth Analg. 2006. 102:1573–1577.

24. Choi Y-S, Kim H-s, Kang K. A Study on the Effect of Waste Anestheic Gases on the Sister Chromatid Exchanges of Peripheral Lymphocytes in Operating Room Personnel. Korean J Anesthesiol. 1990. 23:879–883.

25. Boivin JF. Risk of spontaneous abortion in women occupationally exposed to anaesthetic gases: a meta-analysis. Occup Environ Med. 1997. 54:541–548.

26. Rowland AS, Baird DD, Weinberg CR, Shore DL, Shy CM, Wilcox AJ. Reduced fertility among women employed as dental assistants exposed to high levels of nitrous oxide. N Engl J Med. 1992. 327:993–997.

27. Cohen EN, Gift HC, Brown BW, Greenfield W, Wu ML, Jones TW, Whitcher CE, Driscoll EJ, Brodsky JB. Occupational disease in dentistry and chronic exposure to trace anesthetic gases. J Am Dent Assoc. 1980. 101:21–31.

28. Guirguis SS, Pelmear PL, Roy ML, Wong L. Health effects associated with exposure to anaesthetic gases in Ontario hospital personnel. Br J Ind Med. 1990. 47:490–497.

29. McGregor DG. Occupational exposure to trace concentrations of waste anesthetic gases. Mayo Clin Proc. 2000. 75:273–277.

30. Irwin MG, Trinh T, Yao CL. Occupational exposure to anaesthetic gases: a role for TIVA. Expert Opin Drug Saf. 2009. 8:473–483.

31. Vellore AD, Drought VJ, Sherwood-Jones D, Tunnicliffe B, Moore VC, Robertson AS, Burge PS. Occupational asthma and allergy to sevoflurane and isoflurane in anaesthetic staff. Allergy. 2006. 61:1485–1486.

32. Cha JY, Paek DM, Paik NW. Employee Exposures to Waste Anesthetic Gases in Hospital Operating Rooms. Korean Ind Hyg Assoc J. 2006. 16:193–201.

33. Rosenstock L, editor. Textboopk of Clinical Occupational and Environmental Medicine. 2005. 2nd ed. Philadelphia: Elsevier Saunders.

34. Stucker I, Caillard JF, Collin R, Gout M, Poyen D, Hemon D. Risk of spontaneous abortion among nurses handling antineoplastic drugs. Scand J Work Environ Health. 1990. 16:102–107.

35. Valanis B, Vollmer WM, Steele P. Occupational exposure to antineoplastic agents: self-reported miscarriages and stillbirths among nurses and pharmacists. J Occup Environ Med. 1999. 41:632–638.

36. Valanis B, Vollmer W, Labuhn K, Glass A. Occupational exposure to antineoplastic agents and self-reported infertility among nurses and pharmacists. J Occup Environ Med. 1997. 39:574–580.

37. McDonald AD, McDonald JC, Armstrong B, Cherry NM, Côté R, Lavoie J, Nolin AD, Robert D. Congenital defects and work in pregnancy. Br J Ind Med. 1988. 45:581–588.

38. Fuchs J, Hengstler JG, Jung D, Hiltl G, Konietzko J, Oesch F. DNA damage in nurses handling antineoplastic agents. Mutat Res. 1995. 342:17–23.

39. Undeger U, Basaran N, Kars A, Guc D. Assessment of DNA damage in nurses handling antineoplastic drugs by the alkaline COMET assay. Mutat Res. 1999. 439:277–285.

40. Ursini CL, Cavallo D, Colombi A, Giglio M, Marinaccio A, Iavicoli S. Evaluation of early DNA damage in healthcare workers handling antineoplastic drugs. Int Arch Occup Environ Health. 2006. 80:134–140.

41. Sasaki M, Dakeishi M, Hoshi S, Ishii N, Murata K. Assessment of DNA damage in Japanese nurses handling antineoplastic drugs by the comet assay. J Occup Health. 2008. 50:7–12.

42. Grosse Y, Baan R, Straif K, Secretan B, El Ghissassi F, Bouvard V, Benbrahim-Tallaa L, Guha N, Galichet L, Cogliano V. WHO International Agency for Research on Cancer Monograph Working Group. A review of human carcinogens-Part A: pharmaceuticals. Lancet Oncol. 2009. 10:13–14.

43. Skov T, Maarup B, Olsen J, Rorth M, Winthereik H, Lynge E. Leukaemia and reproductive outcome among nurses handling antineoplastic drugs. Br J Ind Med. 1992. 49:855–861.

44. Shin H-S, Lee S-H. A Study on the Handling Patterns of Anticancer Drugs and Related Symptoms in Nurses. Korean J Occup Environ Med. 1996. 8:228–238.

45. Kim SJ, Lee SE, Chung HW. Chromosome Aberrations and Sister Chromatid Exchanges in Peripheral Lymphocyte of Nurses Handling Anticancer Drungs. Korean J Environ Health Soc. 1995. 21:67–76.

46. Choi JS, Kim YH, Gong SH, Jun MH, Park JS, Kim MJ. Level of Knowledge and Compliance on Guidelines for Safe Handling of Cytotoxic Drugs by Career and Work Units in Clinical Nurses. Clinical Nursing Research. 2004. 9:6–17.

47. Hong S-Y, Cho E-J, Yoo Y-S. Effects of Education for Safe Handling of Cytotoxic Drugs on Knowledge and Practice in Oncology Nurses. J Korean Oncol Nurs. 2006. 6:47–53.

48. Uveges RE, Grimwood RE, Slawsky LD, Marks JG Jr. Epidemiology of hand dermatitis in dental personnel. Mil Med. 1995. 160:335–338.

49. Strauss RM, Gawkrodger DJ. Occupational contact dermatitis in nurses with hand eczema. Contact Dermatitis. 2001. 44:293–296.

50. Hwang JI, Suh MJ. Adverse Reaction to Surgical Latex Gloves. J Korean Acad Adult Nurs. 1997. 9:199–208.

51. Choi BM, Kim YG, Jung JT, Doggo YC. Clinical Study of Allergic Reaction to Latex Gloves in Hospital Personnel. Pediatr Allergy Respir Dis. 1994. 4:30–37.

52. Lee BJ, Kim YK, Min KU, Kim YY. A case of occupational asthma induced by latexin a hospital personnel. J Asthma Allergy Clin Immunol. 1998. 18:510–517.

53. Song IH, Kim YO. Hazardness of Workplace in General Hospital (3). Chonnam Med J. 1986. 33:297–300.

54. Song KH, Kim DH, Lee JY. Mercury contents in Scalp Hair of Dentists and in their Dental Office. Korean J Occup Environ Med. 1991. 3:21–31.

55. Hwang YS, Jung KC. Mercury Contents in Hair of Korea Den-tal Hygienists. J Korean Acad Oral Health. 1996. 20:75–86.

56. Kiec-Swierczynska M, Krecisz B. Allergic contact dermatitis in a dental nurse induced by methacrylates. Int J Occup Med Environ Health. 2003. 16:73–74.

57. Geukens S, Goossens A. Occupational contact allergy to (meth)acrylates. Contact Dermatitis. 2001. 44:153–159.

58. Villar RN, Johnston FG, Scott PM. Occupational asthma due to methyl methacrylate bone cement. Br Med J (Clin Res Ed). 1986. 292:1597.

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