Proteolytic enzymes are a recognised risk for respiratory and dermal allergy. Cases of asthma have been identified in health care workers using cleaning solutions containing these enzymes to decontaminate endoscopes and surgical equipment. An assessment was made of three hospitals using enzyme products to clean endoscopes. Air samples showed that approximately a third of the personal and a half of the static air samples contained protease activity at levels that may pose risk for allergic sensitisation. Wipe samples demonstrated protease on surfaces where manual pre-cleaning of endoscopes was undertaken but lower levels were present elsewhere in these rooms. A risk factor for increased levels of surface and air contamination was a lack of awareness that enzymes were present in the cleaning solutions and posed a risk for respiratory sensitisation. A contributory factor to the lack of awareness was that the enzymes are not required to be identified on material safety data sheets because the concentration of enzymes were less than 1%. A a result there were deficiencies in the application of control measures although the surface contamination levels were much lower at one hospital where regular cleaning of surfaces was undertaken throughout the day.
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