In addition to infectious disease, ergonomic, and workplace violence issues, workers in healthcare settings encounter a number of other workplace hazards. These include chemicals (e.g., sterilants), hazardous drugs (e.g., antineoplastic drugs), materials that cause allergic reactions (e.g., latex), and physical agents (e.g., radiation). Several common examples of these "other hazards" are discussed below.
Ethylene oxide (EtO) is a flammable, colorless gas at temperatures above 51.3 ºF (10.7 ºC) that smells like ether at toxic levels. It can be found in fumigants and sterilants and presents an opportunity for healthcare worker exposure during operations such as EtO sterilization of surgical equipment.
Appendix A, Substance safety data sheet for ethylene oxide (Non-mandatory)
Appendix B, Substance technical guidelines for ethylene oxide (Non-mandatory)
Appendix C, Medical surveillance guidelines for ethylene oxide (Non-mandatory)
Appendix D, Sampling and analytical methods for ethylene oxide (Non-mandatory)
OSHA's Small Business Guide for Ethylene Oxide (PDF*). OSHA Publication 3359, (2009, April). Provides guidance to help employers understand the EtO standard, with particular emphasis on how to monitor the quality of the air in workplaces where EtO is processed, used, or handled. Air monitoring is an important activity that can help alert employers when unsafe levels of EtO are present in the air so they can take steps to reduce employee exposure.
Reducing Ethylene Oxide and Glutaraldehyde Use (PDF). Environmental Protection Agency (EPA) fact sheet, (2002, November). This fact sheet provides background information on the uses and hazards of both chemicals, describes environmentally preferable alternatives, and provides detailed case study and cost information to help evaluate alternatives to EtO and glutaraldehyde.
Formaldehyde can be used as a disinfectant or a sterilant. It is often found mixed in water and referred to as formalin. Formaldehyde can be used to prepare viral vaccines; as an embalming agent; as a tissue fixative; and in the sterilization of medical equipment (e.g., surgical instruments, hemodialyzers). Paraformaldehyde (a solid polymer of formaldehyde) can be heat vaporized for the gaseous decontamination of laminar flow biologic safety cabinets.
Controlling Formaldehyde Exposures During Embalming. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication Number 98-149 (Hazard Control 26), (1998, October). Discusses a local exhaust ventilation system that can be used to reduce exposures during embalming.
Formaldehyde (PDF*). OSHA Fact Sheet, (2011, April). Provides an brief overview of formaldehyde, its harmful effects, routes of exposure, and some provisions of OSHA's formaldehyde standard.
Glutaraldehyde is a colorless, oily liquid with a pungent odor. It is often mixed with water for use. Exposure can occur in healthcare facilities when glutaraldehyde is used in operations such as cold sterilization / high-level disinfection; tissue fixing / preservation (e.g., for microscopy, histology); and in the processing of x-rays.
Glutaraldehyde: Occupational Hazards in Hospitals. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication Number 2001-115, (2001, May). A brochure that discusses glutaraldehyde health effects, worker exposure, and control measures.
Reducing Ethylene Oxide and Glutaraldehyde Use (PDF). Environmental Protection Agency (EPA) fact sheet (2002, November). This fact sheet provides background information on the uses and hazards of both chemicals, describes environmentally preferable alternatives, and provides detailed case study and cost information to help evaluate alternatives to EtO and glutaraldehyde.
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 other organ system damage. Hazardous drugs, such as those used for cancer chemotherapy, antiviral treatments and hormone regimens, pose a serious hazard to healthcare workers. These effects can be irreversible even with low-level exposures.
Waste anesthetic gases include nitrous oxide and various halogenated anesthetics (e.g., halothane, enflurane, isoflurane, desflurane). Exposure to these gases can occur through leakage of the patient's anesthetic breathing circuit during delivery of anesthetic and through exhalations of patients recovering from anesthesia.
During the provision of emergency response care, healthcare workers may be exposed to chemical, biological, physical, or radioactive hazards. These hazards could be encountered singly or in combination with other hazards, could be a hazard that has never been or is rarely seen by the healthcare provider (e.g., anthrax), and could involve a large number of affected individuals that stresses available resources.
Emergency Department (ED) module: Terrorism. Potential hazards and solutions for healthcare emergency department workers exposed to biological agents, chemical agents, and mass causalities as a result of terrorist attacks or events.
Ionizing radiation has enough energy to remove an electron from an atom (creating an ion). The main types of ionizing radiation are alpha particles, beta particles, gamma rays, and x-rays. Sources of ionizing radiation in healthcare include x-ray machines, radioactive isotopes, and radio nucleotides.
Non-ionizing radiation does not have enough energy to remove an electron from an atom, but may cause an atom to vibrate or move around in a molecule. Examples of non-ionizing radiation include microwaves, infrared radiation, and visible light. A source of non-ionizing radiation in healthcare is a laser.
Lasers produce an intense, highly directional beam of light. In healthcare, lasers may be used as scalpels, probes, or in certain imaging techniques. Hazards may be associated with the laser beam (e.g., burns due to absorption of laser energy), the equipment (e.g., high voltage), or products produced during laser use (e.g., laser plume).
Latex, also known as rubber or natural latex, is derived from a milky fluid found in rubber trees. Latex allergy is a reaction to certain proteins found in natural latex. Latex allergy may cause allergic reactions ranging from sneezing or a runny nose to anaphylaxis, a potentially life-threatening condition. Healthcare workers exposed to rubber gloves and other latex-containing medical devices are at risk of developing latex allergy.
Home Healthcare Workers: How to Prevent Latex Allergies (PDF). US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication Number 2012-119, (2012, February). Latex products are made from natural rubber, and sensitivity can develop after repeated exposure. Limiting exposure to latex can help prevent allergic reactions for both home healthcare workers and their clients.
All other documents, that are not PDF materials or formatted for the web, are available as Microsoft Office® formats and videos and are noted accordingly. If additional assistance is needed with reading, reviewing or accessing these documents or any figures and illustrations, please also contact OSHA's Directorate of Technical Support and Emergency Management at (202) 693-2300.
**eBooks - EPUB is the most common format for e-Books. If you use a Sony Reader, a Nook, or an iPad you can download the EPUB file format. If you use a Kindle, you can download the MOBI file format.
U.S. Department of Labor | Occupational Safety & Health Administration | 200 Constitution Ave., NW, Washington, DC 20210 Telephone: 800-321-OSHA (6742) | TTY www.OSHA.gov
Thank You for Visiting Our Website
You are exiting the Department of Labor's Web server.
The Department of Labor does not endorse, takes no responsibility for, and exercises no control over the linked organization or its views, or contents, nor does it vouch for the accuracy or accessibility of the information contained on the destination server. The Department of Labor also cannot authorize the use of copyrighted materials contained in linked Web sites. Users must request such authorization from the sponsor of the linked Web site. Thank you for visiting our site. Please click the button below to continue.