The possibility of splashing by blood, bodily fluids and hazardous substances is not necessarily predictable and all those likely to encounter splashing should wear PPE.
It is also important to use work practices that can minimise the likelihood of splashing and the production of aerosols.
Fluid repellent gowns that provide full skin protection for arms and legs should be worn when reprocessing flexible endoscopes and accessories. They should be changed if soiled.
The relevant Australian Standards are:
For handling hazardous substances, where splashing of the concentrated solution may occur, chemical safety goggles should be used.
For handling small quantities of dilute solutions, chemical safety spectacles with side shields may suffice.
When reprocessing endoscopes, face shields should be used to protect from exposure to biological hazards as well as hazardous substances.
The selection and use of eye protection should be in accordance with the Australian Standards:
As aerosol production or splattering is likely, a face shield should be worn when reprocessing flexible endoscopes and accessories.
Bronchoscopy should be avoided wherever possible in patients with known or suspected tuberculosis. Where this is unavoidable, close-fitting, disposable, particulate filter respirators should be worn. In the absence of an Australian Standard it is recommended in Infection Control Guidelines Section 13.4 that respirators which meet the United States N95 standard be used. The Australian equivalent is a P2 respirator.
In case of spills of hazardous substances where respiratory protection is required a half-face respirator with organic vapour cartridge should be available. Cartridges should be replaced at regular intervals in accordance with the manufacturer's recommendations.
The relevant Australian Standards are:
Gloves used when reprocessing endoscopes must be impervious to the cleaning agents and biocides being used. If single use gloves are not used then the reusable gloves should be washed in soapy water, rinsed and dried after use, otherwise they may become permeable. They should be stored dry after use and replaced if torn, cracked, peeling or showing signs of deterioration.
The permeability of different gloves to increasing concentrations of glutaraldehyde has been assessed by permeation tests. PVC and neoprene gloves have been found to retain or absorb glutaraldehyde on extended exposure. Nitrile rubber or butyl rubber provide the best protection. Latex gloves provide protection for approximately 45 minutes. However, the issue of latex allergy will impact on the choice of gloves.
Latex allergies are an increasing occupational health and safety problem and can vary from mild to very severe. For more information about latex allergy go to the CDC website. As aerosolisation of latex particles is a major route of sensitisation the use of powder free gloves is advisable.
For latex sensitive individuals gloves made from alternative products such as nitrile, butyl rubber, vinyl and neoprene are available. However, consideration needs to be given to the suitability of the material for use with the biocides and cleaning agents used for reprocessing.
The Australian Standards for gloves are:
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© The State of Queensland (Queensland Health) 2008.
