NIOSH: Key steps to reduce respiratory risk
Steps include conducting OSHA hazard training, assessment
September 1, 2015 3 minutes read
Most of the chemical and disinfecting products used in healthcare do not have specific occupational exposure limits, but all hazardous chemicals are covered by the Hazard Communication Standard of the Occupational Safety and Health Administration. That requires a written hazard communication program that provides for a list of all known hazardous chemicals in the workplace, proper labeling, employee access to safety data sheets, and employee training. Training also must occur whenever a new product is introduced (www.osha.gov/dsg/hazcom/).
In its report published in the American Journal of Infection Control,1 the Cleaning and Disinfecting in Healthcare Working Group of the National Institute for Occupational Safety and Health’s National Occupational Research Agenda offered the following advice about reducing respiratory hazards related to cleaning and disinfection in hospitals:
- Follow the manufacturers’ instructions for the selection and use of cleaning and disinfection products. Avoid using products that provide a higher level of disinfection than needed for a particular application.
- Use cleaning and disinfection products that are less harmful to human health and the environment, when possible.
- Use automated diluting systems that reduce direct personal contact (respiratory and dermal) with concentrated products and meter correct dispensing proportions, when possible.
- Use the manufacturers’ recommended amount of product and contact times to accomplish the level of cleaning and disinfection needed. Exceeding the recommended amount of product does not lead to increased effectiveness for removing microorganisms and may pose health risks to healthcare workers, patients, and other building occupants.
- Choose chemical application methods that minimize aerosol production. Spraying usually generates higher airborne exposures than wiping and can lead to skin and respiratory health risks. The toxicological category of the substance should be considered; therefore, spraying of more toxic substances is especially discouraged.
- Use ventilation when cleaning and disinfecting products are applied in small rooms, such as a single-patient bathroom, examination room, or utility closet where products may be mixed.
- Conduct an occupational hazard assessment of cleaning and disinfecting tasks. When chemicals are used in the workplace, employers should conduct a hazard assessment to evaluate the cleaning needs of the facility, the safest cleaning chemical options, and alternative, safer cleaning methods. As in all work environments, appropriate PPE must be provided to workers. PPE may include gloves, eye protections, face shields, protective clothing, or respirators. Guidelines for PPE usage and the proper time table to replace them depend on the physical and chemical properties of the cleaning and disinfecting products, routes of exposure, intensity of exposure, duration of exposure, and frequency of PPE use.
- Educate and train users effectively. Cleaning and disinfecting chemicals can have a spectrum of health impacts, and education and training needs to be done so that employers and workers can be actively engaged to develop and apply a critical-thinking process to select the appropriate cleaning and disinfecting chemicals, practices, and technologies that both prevent infection and chemical exposures. OSHA requires worker training under the OSHA Hazard Communication Standard. Workers without this training should not use these products.
- Ensure that the OSHA hazard communication training has been completed in the language of the employees using the products, automated dilution systems are demonstrated, and different products for different uses are well-labeled.
Reference
- Quinn MM, Henneberger PK, and members of the National Institute for Occupational Safety and Health National Occupational Research Agenda Cleaning and Disinfecting in Healthcare Working Group. Cleaning and disinfecting environmental surfaces in healthcare: Toward an integrated framework for infection and occupational illness prevention. Am J Infect Control 2015;43:424-434.
The Cleaning and Disinfecting in Healthcare Working Group of NIOSH’s National Occupational Research Agenda offered advice about reducing respiratory hazards related to cleaning and disinfection in hospitals.
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