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withdrawal of the OES will mean that all exposures to glutaraldehyde will

have to be adequately controlled and that exposures meeting the OES will

be deemed no longer to be adequate control.

COSHH obliges the employer to make a systematic assessment of risk to staff of

exposure to glutaraldehyde and to institute measures to deal effectively with

exposure. The action which should be taken is shown in Tables 1 and 2. There

are several aspects of COSHH regulations which create problems for endoscopy

units and operating theatres.

Table 1

COSHH Regulations for Hazardous Substances

1. Remove the hazardous substance by substituting a safer material or

changing the process.

2. When this is impractical exposure should be controlled by enclosing the

process, using extraction and ventilation equipment, and adopting safer

working and handling procedures. Personal protective equipment may be

used to achieve adequate control when other measures are not

reasonably practicable, or as an addition to other measures to achieve

adequate control.

3. Ensure that control measures are properly used, maintained and tested.

Local exhaust ventilation systems installed as a control measure must be

examined and tested at least every 14 months.

4. Monitor staff exposure and perform health surveillance.

5. Educate staff on the risks and appropriate precautions to be taken.

Table 2

Personnel Protection in Endoscopy

1. Wear disposable waterproof aprons. These should be discarded if soiled

with disinfectant.

2. Use nitrile gloves which are long enough to protect the forearms from

splashes. These should be changed regularly because they absorb


3. Goggles prevent conjunctival irritation and protect the wearer from


4. Disposable charcoal-impregnated face masks may reduce inhalation of

vapour from disinfectants, but experience with them is not yet widespread.

5. An HSE-approved vapour respirator should be available in case of spillage

or other emergencies. It should be stored away from disinfectants as the

charcoal adsorbs fumes and respirators should be regularly replaced.

1. Some units still use open baths or semi-automated systems for cleaning

and disinfection with no facilities for removal or containnment of toxic

vapour. This practice must be discontinued.

2. In reality ventilation is often far from ideal and the use of

ventilation/extraction systems to protect the cleaning area is not universal.

Glutaraldehyde should be activated, used and discharged within the

influence of a containment or local exhaust system.

3. Some enclosed automated cleaning/disinfection machines require manual

filling and emptying of disinfectant, exposing staff to direct contact or to

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