Substitution of glutaraldehyde with a solution of peracetic acid and hydrogen peroxide as a disinfectant of medical equipment.

Number

107-EN

Section

General Section

Use

Sector

Health services

Function

Biocide
Cleaning agent

Process

Manual activities involving hand contact

Product category

Biocidal products
washing ad cleaning products

Application

Disinfecting of medical equipment in washing mashines

Abstract

Glutaraldehyde has previously been used to disinfect heat-sensitive medical equipment in dishwashers. It was found that glutaraldehyde could be substituted with a solution of peroxyacetic acid and hydrogen peroxide.

Substituted substances

Glutaraldehyde

CAS No. 111-30-8 EC No. 203-856-5 Index No. 605-022-00-X

Chemical group

Aldehyde

Classification: hazard statements

H330 Fatal if inhaled
H301 Toxic if swallowed
H335 May cause respiratory irritation
H314 Causes severe skin burns and eye damage
H334 May cause allergy or asthma symptoms or breathing difficulties if inhaled
H317 May cause an allergic skin reaction
H400 Very toxic to aquatic life
H411 Toxic to aquatic life with long lasting effects

Alternative Substances

Peracetic acid

CAS No. 79-21-0 EC No. 201-186-8 Index No. 607-094-00-8

Chemical group

Peroxides

Classification: hazard statements

H226 Flammable liquid and vapour
H242 Heating may cause a fire
H332 Harmful if inhaled
H312 Harmful in contact with skin
H302 Harmful if swallowed
H314 Causes severe skin burns and eye damage
H400 Very toxic to aquatic life

Hydrogen peroxide

CAS No. 7722-84-1 EC No. 231-765-0 Index No. 008-003-00-9

Chemical group

Peroxides

Classification: hazard statements

H271 May cause fire or explosion; strong oxidiser
H332 Harmful if inhaled
H302 Harmful if swallowed
H314 Causes severe skin burns and eye damage

Reliability of information

Evidence of implementation: there is evidence that the solution was implemented and in use at time of publication

Reason substitution

skin/respiratory sensitizing
sensitizing
ecotoxicity

Hazard Assessment

Substance to be substituted: The substituted substance is in the database of hazardous substances according to SUBSPORTplus screening criteria (SDSC).. Glutaraldehyde is also fatal if inhaled, is toxic if swallowed, causes severe skin burns and eye damage, is very toxic to aquatic life, is toxic to aquatic life with long lasting effects, may cause an allergic skin reaction, may cause allergy or asthma symptoms or breathing difficulties if inhaled and may cause respiratory irritation. Alternative substances: The alternative substances peracetic acid and hydrogen peroxide are not listed in the database of hazardous substances according to SUBSPORTplus screening criteria (SDSC). The alternatives hold similar hazard statements as glutaraldehyde except that glutaraldehyde is also a known allergen.

Description of Substitution

Glutaraldehyde is used as a disinfectant to clean heat-sensitive medical equipment in dishwashers. Since the compound is a known allergy-causing substance a substitution to something less hazardous would be good from a workplace environment perspective. One solution which has been implemented stepwise since 2003 at Uppsala University Hospital is to substitute glutaraldehyde with a solution of peracetic acid and hydrogen peroxide. Unfortunately this substitution is not as simple as exchanging the chemicals. The dishwashers need to be converted or exchanged in order for the method to work correctly. It is therefore useful to plan the substitution several years in advance so that when equipment needs to be replaced, it can be replaced with equipment compatible with the substitution. The advantages of this substitution is mainly a decreased risk for personnel handling the dishwashers, the limitation is as previously stated that the dishwashers need to be replaced. It is also important to note that peracetic acid and hydrogen peroxide are toxic and should still be handled with care. Also, peracetic acid is only sold as a 45% mix with 10% hydrogen peroxide. (Otherwise it is too unstable).

Case/substitution evaluation

The advantage of this substitution is that staff is no longer exposed to an allergenic substance. The substances in the alternative mixture are less hazardous, but still need to be handled carefully and should be replaced in the future.

State of implementation

Full capacity

Date and place of implementation

2003

Enterprise using the alternative

All county councils in Sweden.

Availability ofAlternative

On the market

Type of information supplier

User

Contact

Environmental Chemist Environment and Chemistry Unit, Uppsala Country Council.

Date, reviewed

December 11, 2020