In the hospitals, health care, mostly hospitals but you find it in some nursing homes too, The chemicals that you might find are formaldehyde, xylene, glutaraldehyde. You got the Waste Anesthetic Gases in the operating rooms. You got the Chemotherapy and now, there are hazardous drugs. Pinpoint the most common mistakes that cause medical facilities to fall into non-compliance with this expert healthcare training article.
And of course, then you have the myriad of disinfectant Cleaners -- phenolics, quaternary ammonium compounds, all of your bleaches. And that's all covered under the hazard communication rights. No standard with them (is the F sheet). But still, those are the chemical hazards in hospitals.
Our expert provides information in a healthcare event on how do you comply with some of these chemical standards. Because they're all very similar. They all say that you need to do monitoring, initial monitoring of employee’s exposure. And you get a new employee or a new process, a new chemical. You got to do initial monitoring. And then you find out where you're at with the standards.
There's usually a eight-hour limit. That's the PEL, Permissible Exposure Limited to eight hours. There's a STEL which is the Show Term Exposure Limit. Those are usually 15 minutes, although some are 30 minute.
And so, when you get your results, you compare those and if you're over the PEL or the STEL, well then, you got to do certain things. And then usually, the action level is half of that limit. And when you're over the action level, you're not in violation but it does trigger program requirements. And all the healthcare rules or standards are little different.
So you do initial monitoring, find out where you're at. And institute your program and then based on that, you generally would have to repeat monitoring if you're over. If you're below, action level or these PELs and STELs, normally, you can just continue monitoring. But you discontinue monitoring until such time as you have a new employee or you have a change in work practice.
Well, who doesn’t? You know, after a year or two, you're bound to have something like that. So it's not a good idea to just completely discontinue monitoring. It is usually recommended maintaining a once a year monitoring at least.
A little bit specific on perhaps formaldehyde. We've got – find formaldehyde in laboratory, surgery, morgue. Used to find it in Renal Dialysis for disinfecting artificial kidneys but they’ve gotten away from that. And you see those specimen containers a lot of places around the hospital. Well, when you've got that, there's some requirements that are triggered. For instance, in a histology lab counter, you have got all those – the large specimen containers with tissue samples in the formaldehyde solution.
There's a cardboard box there with a spigot. That's a (cardboard) of 10% formalin. So all that is in the (well, and) if you have a large amount of these things, let's say you have a room of containers of these tissues, well, in general, you might find some that are these lids aren’t completely sealed. So you're going to have a hazard from just leaking vapors and it might stink. So it is always recommended to keep the lids covered for any of these containers and then also have good ventilation.
Healthcare Conference Update: One of the OSHA requirements is if you got a formalin in greater than 10th of a percent, it's you need an eyewash station. And if you have it greater than 1% solution of formaldehyde, you need drench the shower. So a lot of these places will have eyewash stations and drench showers.
You have to monitor and, you know, formaldehyde is a carcinogen. It causes like nasal cancer and other things. It's got a strong odor and strong concentrations. It will make your eyes water. So because of the strong odor, we don’t – people usually respect it and try to keep it in under control.
One the OSHA healthcare guidelines is to have everything properly labeled. And all of those tissue samples have to have a little formaldehyde labeling unless they're all in a cabinet and you labeled the door of the cabinet.
And what is the label? “Danger Formaldehyde Irritant and Potential Cancer Hazard”. And then if it's a door, it's “It's Authorized Personnel Only”. So labeling, that's a good example of labeling requirements for formaldehyde.
A lot of people don’t realize that the formaldehyde standard does have an annual formaldehyde training requirement.. So don’t forget, you know, once a year, you know, either on some computer or whatever to get your lab people or all the people that work with formaldehyde to get their training.
Glutaraldehyde does not have a current OSHA standard but some states do. And Michigan’s one example where it was – there is a requirement for maintaining permissible exposure limit. And for example, NIOSH recommends the .02 ceiling limit and that's pretty much what other people have adopted although they've lowered it.
Like there's another group called the ACGIH, American Conference of Government Industrial Hygienist. And oftentimes, they're limit is even lower than NIOSH limit. Those are both recommended limits so if you don’t have a law in your state on it, you would look to the recommended limit and try to meet those.
Glutaraldehyde, in the next, the Cidex, the (wave at side, beyond the side), that's usually 2% Glutaraldehyde. That's where you see it in endoscopy, they soak the endoscopes in it to disinfect them. And you see them in these blue side-X tubs whatever.
Healthcare Training Tip: Again, a best way to handle that is to keep those lids covered, keep the employees trained, make sure they don’t get it splashed on them and avoid because those are sensitizers. And when you get it on your skin, you can develop rashes, and then overtime working with it, you get sensitized to it so even the slightest bit of exposure would set off a rash.
You don’t want employees developing sensitization because then you have to move them to a different part of the hospital or, you know, they lose their career. So that's – it's a tricky thing and again, there's no OSHA standard on it.
Now, Johnson & Johnson actually has developed a new product called Cidex OPA which is not Glutaraldehyde, it is Ortho-Phthalaldehyde. It's doesn’t have that odor problem but it's still an aldehyde, you still have to avoid skin contact. The MSDS still thin air changes in hour.So please don’t think that just because you switched to Cidex OPA, you're in the clear. It still has a hazard and NIOSH is actually currently studying the health effects.
Now, in radiation oncology, that's where you have these mold, they call it the molds room. And the lead cadmium alloy is melted and then put into star foam molds where it's shaped to exact size and shape for when they're doing the radiation oncology to shield the part of the body that don’t need their radiation and then to concentrate the radiation into other parts of the body. People are getting away from this fortunately because the newer radiation machines are – can pinpoint the beam so much better.
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