Cidex (glutaraldehyde) Johnson & Johnson Warning chemical hazard to Health Care Workers, United Kingdom U.K. withdraws use, Brunswick New Jersey

THE DAILY TELEGRAPH

18 april 2000

by Nigel Bunyan



Nurse wins 157,000 for job that made her ill

A THEATRE nurse who developed asthma while working with a chemical used to sterilize instruments was awarded 157,000 compensation yesterday.



Fostina Brobbey, 58, had to retire through ill health in September 1996, 20 years after first coming into contact with the strong-smelling disinfectant Cidex.



Her award is one of the largest even for asthma and included damages for pain and suffering, past and future less of earnings, loss of pension and loss of congenial employment because she loved her job so much.



Manchester country court heard how in the five or six minutes it took Mrs. Brobbey to prepare Cidex for sterilization, her eyes would water, her throat become dry and her breathing laborious.



Once she became so unwell that she had to go home but in general she put up with the discomfort as it was "part of the job".



The North Manchester General Hospital NHS Trust had contested her claim for damages for personal injury and losses, but at the end of a four-day bearing was ordered to pay both compensation and costs.



Fortina Brobbey



she loved her work

Judge Holman ruled that the hospital had exposed Mrs. Brobbey to the risk of injury from Cidex, partly because she was given no warning to keep the lid down on the equipment used to prepare the disinfectant for use, called a Safescope. This rendered the function of the Safescope "largely if not totally, ineffective".



Furthermore, the equipment had not been regularly serviced, masks which might have offered protection from fumes were not provided, and senior staff failed to monitor the effects of short-term exposure to Cidex. The latter indicated "a failure to appreciate and act on important safety information".



Mrs. Brobbey, a mother of five, from Ancoats, Manchester, said: "I am pleased with the ruling, but I really didn't want to give up work, I would go back tomorrow if I could."



The former nurse said she eventually linked her suffering to the preparation of Cidex and, in particular, to contact with one of its constituents, glutaraldehyde.



"I would start to feel better, but then when I went back to work it would start again," she said. I have to carry inhalers with me all the time.



"The worst thing about it is that I can't really plan to do things I want to because I never know when I'm going to have an asthma attack."



Hugh Robertson, head of health and safety for Unison, the union that backed Mrs. Brobbey's action, claimed: "There is no safe level of exposure to glutaraldehyde.



It is well known that it can irritate the skin, eyes, throat and lungs. In the very rare circumstances where it has to be used, it should be in sealed containers."



Mrs. Brobbey's solicitor, Judith Gledhill, said a number of similar claims involving glutaraldehyde were being prepared.



Nick Grimshaw, director of human resources at North Manchester Healthcare NHS Trust, apologized to Mrs. Brobbey yesterday.



He added: "In recent years we have limited the use of glutaraldehyde wherever possible, but it is still used where, in the clinical judgment of experts in infection control, it is the best way of protecting patients from cross-infection. That is why it is still used regularly throughout the NHS."

Hospital disinfectant withdrawn amid safety fears

18/02/02 10:52:27



A hospital disinfectant that has been blamed for causing skin and lung problems is being withdrawn from use in the UK by its manufacturers.



The disinfectant glutaraldehyde, which is marketed as Cidex by Johnson & Johnson, has been in use in UK hospitals since the 1960s and is used to kill bacteria and viruses on sensitive medical equipment.



But from May 1, glutaraldehyde will no longer be used in the health service after it was found to have induced a range of adverse health effects, including asthma, headaches and skin irritation.



In April 2000, a Manchester theatre nurse was awarded 157,000 in damages after developing asthma following exposure to glutaraldehyde.

Mr Roger Leicester, a colorectal surgeon and director of endoscopy services at St George's Hospital in south-west London, said the withdrawal of glutaraldehyde was great news.



It is extremely toxic and people did not understand how dangerous it was, he said.



Mr Leicester said nothing was known about the disinfectant's potential to cause ill health in the early days of its use, and the levels at which exposure is dangerous are difficult to measure. As a result, people were handling it without gloves, and often in units that were not properly ventilated, he said.



Alternatives to glutaraldehyde will put greater financial pressure on hospitals. A unit performing up to 9,000 endoscopies a year paid just 3,600 for its supply of glutaraldehyde. Other disinfectants, such as chlorine dioxide, peracetic acid and super-oxidised water, range from 9,400 to 67,400.



However, A recent report by the Trades Union Congress found that work related asthma is costing UK industry billions of pounds in lost staff, lower productivity and high compensation payouts because employers are failing to substitute asthma-causing substances in their workplaces.

Workers Against Senseless Toxic Exposure

(US Medical Personnel Injuried by Glutaraldehyde)

http://www.ncchem.com/waste.htm



WASTE is a national support group comprising well over 100 individuals within the medical community who have been injured by the toxic chemical called Glutaraldehyde.



MISSION STATEMENT: Maintain current information through our newsletter and website, share health concerns with other interested parties and provide emotional support.

------------------

There are thousands of people that have been injured by Toxic Chemicals used in the Health Care Enviroment.



W.A.S.T.E. should open its membership and resources to other injured health care professionals. I say this because I tried to contact you without any success.



What is the sense in having an organization such as W.A.S.T.E. if it is not helping all Health Care workers?

Cidex (Glutaraldehyde) Disinfectant withdrawn over safety fears

BBC News 22jan02

The product is used to disinfect fragile surgical instruments



A commonly used disinfectant in the NHS is to be withdrawn after staff reported skin problems and asthma. Cidex, made by Johnson and Johnson, is to be taken off the UK market on May 1 this year.



Cidex is one of the brand names for Glutaraldehyde, a toxic colourless, oily liquid also available as an aqueous solution. Glutaraldehyde is harmful if inhaled or swallowed and irritating to eyes and respiratory tract. It can also cause severe damage to the skin and eyes.



Exposure limits



Cidex is used by most NHS hospitals to kill viruses on surgical instruments which are too fragile to be heat-treated.



It is used in decontamination units throughout the country and is the most commonly used disinfectant in endoscopy departments.



But the UK's Health and Safety Executive (HSE) raised concerns over the use of the disinfectant after the reports of health problems from staff exposed to it during the decontamination process.



In 1999, the HSE published guidance limiting how much Glutaraldehyde workers should be exposed to.



The chemical hit the headlines 14 months ago when thousands of people were called for medical tests after possible exposure to a faulty batch.



'Good for nurses'



Jon Richards, of the health workers union Unison said the move was good news for nurses' health.



He said: "Too many nurses have been lost to the NHS and many valuable years of experience wasted, because of exposure to glutaraldehyde.



"There is no 'safe' level of exposure and no place for it in hospitals today.



"It is well known that it can irritate the skin, eyes, throat and lungs. I am delighted to hear that it will be withdrawn from hospitals."



He said Unison had campaigned for years to get the substance banned.



"We have taken many claims for compensation for nurses who have had their careers needlessly cut short and their lives blighted by asthma and other health problems, through working with glutaraldehyde in operating theatres."



GLUTARALDEHYDE

Chemical Formula: C5H8O2 Molecular Weight: 100.13

Synonyms: 1,3-Diformylpropane; glutaral; glutardialdehyde; glutaric dialdehyde; 1,5-pentanedial; 1,5-pentanedione; potentiated acid glutaraldehyde

Trade names: Cidex; Sonacide



Glutaraldehyde is used in large volume in a variety of industries as a disinfectant, preservative, fixative and cross-linking agent, and as a chemical intermediate in the synthesis of pharmaceuticals and pesticides. Glutaraldehyde was nominated by the National Cancer Institute, the Occupational Safety and Health Administration, and the National Institute of Environmental Health Sciences for carcinogenicity studies because of potential occupational exposure.

http://www.vidyya.com/vol4/v4i23_4.htm

I was first introduced to Cidex in Ohio in 1970.



The salesperson was great at conveying what a good germicide solution this was. He told my Department Head and I that although gloves could be used, the solution was so mild that gloves were not necessary.



This happened in Toledo, Ohio. As a health care professional in 1970, I had my focus on good patient care.



Safety precautions in handling Cidex took lower priority. This was in part due to being told that this material although powerful enough to kill viruses was supposedly mild and non-irritating to skin. Rashes on my forearms and neck resulted.



This was a time when hexachlorophene was used to wash infants. Procedures like using the one syringe and changing just the needle between patients still existed. Thank God, they do not do that anymore.



Red rubber catheters were used by Nursing personal on a patient and then put back into a phenol solution only to be used repeatedly. We know better than to do this now.



I became seriously ill in 1982 and no obvious reason was found. I never thought about the soaking tub with hot water holding plastic tubing adjacent to a tub filled with glutaraldehyde sitting within 10 feet of my desk as a possible cause.



However, although ill with chronic muscle pain and bouts of breathlessness I worked until 1989. Chest pain, fatigue and memory problems remain constant reminders of something gone awry.



Further, ethylene oxide which was used on patient care tubing and parts was wrapped in a plastic that would cause employees eyes to water when they were removing it from the sterilizer. It took days before the smell dissipated from the plastic wrap. By then, the equipment was already being used on patients.



In November 2002, I came across an article, which stated the United Kingdom was removing glutaraldehyde as a liquid sterilization agent.



Ignorance is not bliss. Even the ventilation system in many hospitals was not set up correctly to lower the risk of high air concentrations. Airflow hoods should be used to draw fumes away from workers that use this material.



The United States in it's rush to find cost effective ways to reclean patient care items put dangerous materials in the hands of trusting Health Care workers. Many including myself became ill and have no explanation or recourse.



To date I know of no legal action being taken in behalf of injured Medical Professionals subjected to toxic materials.



I contacted the Department of Health and Human Services after trying to contact legal authorities in the United States and the United Kingdom. I was sent a great deal of written professional papers from the 1989-1992 period. Did all the studies stop?



Where was this information when I needed it?



I wrote to a physician at Univ. CA Davis. Although he seemed knowledgeable, he was not able to direct me to any specific studies in the United States.



'Unfortunately this is not a case that Russell Jones & Walker are able to deal with now. Unfortunately we are based in the UK and do not cover American Law. "Rebecca Bell" R.A.Bell@rjw.co.uk



Health Care workers are not safe from these Toxic Materials.