The Processing Room: Handling Chemical Odor

As a former assistant manager of an operating room, the last thing I expected was to be involved in a discussion of, “what are we going to do about the smell in the endoscopy department?” I was asked to visit the sterile processing staff to observe as they were reprocessing the flexible endoscopes. There were only a few minor adjustments that needed to be made to their process, which was good news.

But I did notice that the staff kept the door open to the reprocessing area. Their explanation was that the smell from the glutaraldehyde was too strong for them and they felt sick with the door closed. The department was equipped with a good ventilation system, but it was not being used correctly. I asked why they were not using an orthopthalaldehyde product to decrease the noxious fume issue and they explained that since they also reprocess the urology scopes, they couldn’t use that because of “the bladder tumor issue.”

Why would we continue to use a dialdehyde-based high-level disinfectant (HLD) when we knew about the employee and patient safety concerns, the environmental hazards of disposal, and the protein-binding effect of dialdehydes that could possibly bind residual protein to our scopes? I am sure that many nurse managers have experienced something similar to this scenario and didn’t feel they had other chemistry options at the time.