Transcript Mercury Exposure

Mercury Exposure
Healthcare employee exposure to mercury from accidental
spills that can occur during repair of broken thermometers,
sphygmomanometers, or during sterilization and
centrifugation of thermometers in maintenance areas. Mercury
can also be found in esophageal dilators, dental amalgam,
laboratory reagents, and in some pressure-sensing
instruments (e.g., barometers and sensors in machine rooms),
as well as in electronic equipment, and in some older medical
devices. When mercury is exposed to the air, as in the case of
a spill, it slowly vaporizes.
Mercury Vacuum Cleaner
Mercury Spill Kit
Exposure to mercury occurs through inhalation or through skin contact. If spills are not promptly cleaned up,
mercury may accumulate on surfaces and then vaporize and be inhaled by unaware workers.
Acute exposure: Acute inhalation of mercury vapor may result in toxicity including chills, nausea, general malaise,
tightness in the chest, chest pains, dyspnea, cough, stomatitis, gingivitis, salivation, and diarrhea (ACGIH 1991;
Hathaway et al.1991). Short exposure to high levels of mercury can cause severe respiratory irritation, digestive
disturbances, and marked renal damage.
Chronic exposure: Chronic exposure to mercury may result in weakness, fatigue, anorexia, weight loss, and
disturbance of gastrointestinal function.
Use mercury spill kits to help clean up small spills of 25ml or less. Kits should contain gloves, protective
glasses, Hg absorb powder, mercury sponges, and a disposal bag.
Glutaraldehyde Exposure
Healthcare workers can be exposed to Glutaraldehyde, a toxic chemical
that is used as a cold sterilant to disinfect and clean heat-sensitive
medical, surgical and dental equipment. It is found in products such as
Cidex, Aldesen, Hospex, Sporicidin, Omnicide, Matricide, Wavicide and
others. Specific applications include use as a disinfecting agent for
respiratory therapy equipment, bronchoscopes, physical therapy
whirlpool tubs, surgical instruments, anesthesia equipment parts, x-ray
tabletops, dialyzers, and dialysis treatment equipment.
Acute effects: Contact with glutaraldehyde liquid and vapor can severely irritate the eyes, and at higher
concentrations burns the skin. Breathing glutaraldehyde can irritate the nose, throat, and respiratory tract, causing
coughing and wheezing, nausea, headaches, drowsiness, nosebleeds, and dizziness.
Chronic effects: Glutaraldehyde is a sensitizer. This means some workers will become very sensitive to
glutaraldehyde and have strong reactions if they are exposed to even small amounts. Workers may get sudden
asthma attacks with difficult breathing, wheezing, coughing, and tightness in the chest. Prolonged exposure can
cause a skin allergy and chronic eczema, and afterwards, exposure to small amounts produces severe itching and
skin rashes.
Wear gloves which are impervious to glutaraldehyde such as those made of Butyl Rubber, Nitrile, and Viton ® which
have been shown to provide full shift protection from glutaraldehyde. Wear splash proof goggles and/or full-face
shields when working with glutaraldehyde to protect eyes.
Store glutaraldehyde products in closed containers, in well ventilated areas. Post signs to remind staff to replace
lids after using product.
Use glutaraldehyde products in rooms that are well ventilated and large enough to ensure adequate dilution of
vapor, with a minimum air exchange rate of 10 air changes per hour.
Formaldehyde Exposure
Healthcare workers can be exposed to Formaldehyde (FAH), since it has a variety of uses in hospitals including:
1. tissue preservatives and in embalming fluids in autopsy rooms and the pathology department; 2. in kidney
dialysis units and central supply as a sterilizing agent; 3. in operating rooms as a disinfectant. It is classified as a
human carcinogen and is linked to nasal and lung cancer, and with possible links to brain cancer and leukemia.
Formaldehyde (FAH) is a colorless, flammable gas with a strong, pungent odor. It is widely used in hospitals, in
disinfectants, in carpet and furniture glues, and in a large number of other products.
Special Precautions - Formaldehyde is flammable and explosive but only in higher concentrations. Formaldehyde
should NEVER be stored near or used with hydrochloric acid because the two chemicals combine to form (bis)
Chloromethyl Ether (BCME), a very powerful cancer-causing agent.
Acute Effects - Low Exposure Levels (0.1-5 parts per million): Burning, tearing of eyes; skin irritation. Moderate
Exposure Levels (10-20 ppm): Burning of eyes, nose and trachea; severe coughing; severe difficulty in breathing;
and intense tearing of the eyes. High Exposure Levels (50-100 ppm): Tightening in the chest; irregular heartbeat;
severe headache; pulmonary edema (fluid in the lungs); inflammation of the lungs; possibly even death.
Chronic Effects – Eczema (flaking and itching skin), which may involve the eyelids, neck, hands, arms, armpits and
scrotum. Dermatitis, it may range from simple reddening of the skin to severe cracking and blistering. Prolonged
exposure may cause the fingernails to turn soft and brown-colored. Cancer, nasal cancer and may be associated
with other respiratory cancers and cancer of the brain. Reproductive System, it can damage the genetic make-up of
certain cells, which means it may cause birth defects.
Medical Surveillance - when employees are exposed to levels above the STEL. Housekeeping - survey for leaks or
spills (including visual inspections), proper maintenance of equipment, spill clean-up procedures, and waste
disposal methods. Respiratory Protection - to be worn in work situations where engineering and work practice
controls do not reduce exposure to below the STEL. Protective Clothing and Equipment - clothing which is
impervious to formaldehyde, gloves, safety goggles, face shields, and other personal protective equipment may be
necessary.
Toluene, Xylene and Acryl Amide Exposure
Healthcare workers can be exposed to hazardous chemicals such as Toluene,
Xylene and Acrylamide. Toluene and Xylene are solvents used to fix tissue
specimens and rinse stains. They are primarily found in the histology,
hematology, microbiology, and cytology laboratories. Acrylamide a resin,
usually found in research labs, is used to make gels for biochemical
separations.
Toluene and Xylene Exposure:
Acute Effect: Eye and respiratory irritation can result form exposure to the liquid and vapor forms. Severe
abdominal pains, nausea, vomiting and possible loss of consciousness could occur, if ingested in large amounts.
Chronic Effect: High concentration of vapor inhaled for long periods can cause laryngitis, bronchitis or bronchial
pneumonia. Prolonged exposure may cause conjunctivitis. Nasal tumors have been reported in animals.
Acryl Amide Exposure:
Acute Effect: Eye and skin irritation.
Chronic Effect: Central nervous system disorders, i.e., polyneuropathy. Acrylamide is a suspected carcinogen, and
mutagen.
1 - Skin contact with chemicals should be avoided at all times.
2 - Avoid underestimation of risk. One should assume that any mixture will be more toxic than its most toxic
component and that all substances of unknown toxicity are toxic.
3 - Provide adequate ventilation. The best way to prevent exposure to airborne substances is to prevent their escape
into the working atmosphere by use of hoods and other ventilation devices.
4 - Follow the Chemical Hygiene Program in place.
5 - Observe the PELs, TLVs.
Antineoplastic and Other Hazardous Drugs
Both clinical and non-clinical workers may be exposed to
hazardous drugs when they create aerosols, generate dust,
or touch contaminated surfaces during the preparation,
administration, or disposal of hazardous drugs.
Examples of manipulations that can cause splattering, spraying, and aerosolization include: 1 - Withdrawal of
needles from drug vials. 2 - Drug transfer using syringes and needles or filter straws. 3 - Breaking open of
ampoules. 4 - Expulsion of air from a drug-filled syringe.
Drugs are classified as hazardous if studies in animals or humans indicate that exposures to them
have a potential for causing cancer, developmental or reproductive toxicity, or harm to organs. The number of
workers who may be exposed to hazardous drugs exceeds 5.5 million. These workers include shipping and
receiving personnel, pharmacists and pharmacy technicians, nursing personnel, physicians, operating room
personnel, environmental services personnel, and workers in veterinary practices where hazardous drugs are used.
Although the potential therapeutic benefits of hazardous drugs outweigh the risks of side effects for ill patients,
exposed healthcare workers risk these same side effects with no therapeutic benefit. Occupational exposures to
hazardous drugs can lead to:
Acute Effects: skin rashes
Chronic effects: including adverse reproductive events
Protection from hazardous drug exposures depends on safety programs established by employers and followed
by workers. Factors that affect worker exposures include the following: 1 - Drug handling circumstances
(preparation, administration, or disposal). 2 - Amount of drug prepared. 2 - Frequency and duration of drug
handling. 3 - Potential for absorption. 4 - Use of ventilated cabinets. 5 – PPE. 6 - Work practices.
The likelihood that a worker will experience adverse effects from hazardous drugs increases with the amount and
frequency of exposure and the lack of proper work practices.
Be Safe!
Tony Soares, Safety Director
Compensation Solutions, Inc.
[email protected]
Tel: 1-888-201-5680 Ext. 192