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Other Hazards

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.

Chemicals

Ethylene Oxide

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.

Formaldehyde

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.

Glutaraldehyde

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.

Additional Resources

Hazardous Drugs

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

  • 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.
  • Anesthetic Gases: Guidelines for Workplace Exposures. OSHA, (2000, May 18). Provides guidelines and controls to help reduce occupational exposure to waste anesthetic gases.
  • Waste Anesthetic Gases - Occupational Hazards In Hospitals. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2007-151 (2007, October). Discusses exposures, health effects, and control measures.
  • For additional information, see OSHA's Waste Anesthetic Gases Safety and Health Topics Page.
Emergency Response Hazards

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.

Radiation

Ionizing (e.g., x-rays, nuclear medicine)

Hazardous Chemicals

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 (e.g., lasers)

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 Allergies

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.


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