RR445 - An evaluation of chemical disinfecting agents used in endoscopy suites in the NHS

This research report looks at alternatives to glutaraldehyde for the disinfection of endoscopes. It highlights their benefits and limitations.

The work was commissioned because of the historically high number of cases of occupational asthma caused by glutaraldehyde.

There is no single system for disinfection and no single most appropriate disinfectant. Many users are moving away from glutaraldehyde towards other products, some of which are regarded as potential asthmagens.

The report presents the control approaches for disinfecting agents based on HSE's COSHH Essentials. This is summarised as follows:

Chemical Base Example of Product COSHH Essentials Hazard Group COSHH Essentials Control Approach
Chlorine base Sterilox A (low hazard) 1 (general ventilation)
Chlorine base Tristel A (low hazard) 1 (general ventilation)
Peroxygen Virkon S (1% liquid) A (low hazard)* 1 (general ventilation)
Peracetic Acid Nu-Cidex/Aperlan C (medium hazard)* 3 (containment)
Ortho-phthalaldehyde Cidex-OPA C (medium hazard)* 3 (containment)
2% Glutaraldehyde Cidex E (special case) 4 (special case)

*Cidex-OPA is subject to requirement for self-classification within EU legislation. This assessment is based on manufacturer data.

This report and the work it describes were funded by the Health and Safety Executive (HSE). Its contents, including any opinions and/or conclusions expressed, are those of the author alone and do not necessarily reflect HSE policy.

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Updated 2021-04-20