Download PDF
Endoscopy 2001; 33(6): 529-532
DOI: 10.1055/s-2001-14956
Short Communication

© Georg Thieme Verlag Stuttgart · New York

Determination of Glutaraldehyde Residues on Flexible Endoscopes after Chemothermal Treatment in an Endoscope Washer-Disinfector

B. Dietze1 , H. Neumann1 , U. Mansmann2 , H. Martiny1
  • 1 Universitätsklinikum Benjamin Franklin - Technical Hygiene, Fachbereich Humanmedizin, Free University of Berlin, Berlin, Germany
  • 2 Medical Informatics, Statistics and Epidemiology, Fachbereich Humanmedizin, Free University of Berlin, Berlin, Germany
Further Information

Publication History

Publication Date:
31 December 2001 (online)

Also available at
    Permissions and Reprints

Background and Study Aims: Although there are several cases of glutaraldehyde-induced colitis following colonoscopy there is only one study on residues after disinfecting. Our report describes the determination of water-soluble glutaraldehyde residues after processing endoscopes with a glutaraldehyde-containing disinfectant.

Materials and Methods: A gastroscope and a colonoscope were processed in a washer-disinfector and then immersed in 20 l of NaCl solution. Glutaraldehyde was determined by high performance liquid chromatography in 84 samples. Samples were taken after immersing the endoscopes for 5 h and 24 h with and without rinsing the channels.

Results: After 5 h and with the channels having been rinsed, the median for colonoscopes was only 0.409 mg/l. The highest level of glutaraldehyde was 0.846 mg/l.

Conclusions: After endoscopes have been processed in the washer-disinfector there is no risk of a glutaraldehyde-induced colitis, proctitis or diarrhoea.

References

  • 1 Gorse G J, Messner R L. Infection control practices in gastrointestinal endoscopy in the United States: a national survey.  Infect Control Hosp Epidemiol. 1991;  12 289-296
    CrossrefPubMedSearch in Google Scholar
  • 2 Rutala W A, Clontz E P, Weber D J, Hoffmann K K. Disinfection practices for endoscopes and other semicritical items.  Infect Control Hosp Epidemiol. 1991;  12 282-288
    PubMedSearch in Google Scholar
  • 3 Reynolds C D, Rhinehart E, Dreyer P, Goldmann D A. Variability in reprocessing policies and procedures for flexible fiberoptic endoscopes in Massachusetts hospitals.  Am J Infect Control. 1992;  20 283-290
    CrossrefPubMedSearch in Google Scholar
  • 4 Ayliffe G AJ. Principles of cleaning and disinfection. Which disinfectant?.  Gastrointest Endosc Clin N Am. 1993;  3 411-429
    PubMedSearch in Google Scholar
  • 5 Cox H M, Cheung K, Fletcher A J, et al. Glutaraldehyde concentration in the sterilization of endoscopes.  Pathology. 1995;  27 362-364
    PubMedSearch in Google Scholar
  • 6 Ellet M L, Mikels C A, Fullhart J W. SGNA endoscopic disinfectant survey.  Gastroenterol Nurs. 1995;  18 2-10
    PubMedSearch in Google Scholar
  • 7 Orsi G B, Filocamo A, Di Stefano L. Tittobello A. Italian national survey of digestive endoscopy disinfection procedures.  Endoscopy. 1997;  29 732-740
    Thieme ConnectPubMedSearch in Google Scholar
  • 8 British Society for Gastroenterology Endoscopy Committee Working Party . Cleaning and disinfection of equipment for gastrointestinal endoscopy: report of a Working Party of the British Society of Gastroenterology Endoscopy Committee.  Gut. 1998;  42 585-593
    PubMedSearch in Google Scholar
  • 9 Akamatsu T, Tabata K, Hironaga M, Uyeda M. Evaluation of the efficacy of a 3.2 % glutaraldehyde product for disinfection of fibreoptic endoscopes with an automatic machine.  J Hosp Infect. 1997;  35 47-57
    CrossrefPubMedSearch in Google Scholar
  • 10 Ryan C K, Potter G D. Editorial: disinfectant colitis. Rinse as well as you wash.  J Clin Gastroenterol. 1995;  21 6-9
    PubMedSearch in Google Scholar
  • 11 Le Moan G, Chaigneau M, Chastagnier M, Chuong P H. La persistance de résidus au cours du traitement du matériel médico-chirurgical par le glutaraldehyde.  Ann Fals Exp Chim. 1983;  76 463-473
    PubMedSearch in Google Scholar
  • 12 Dolcé P, Gourdeau M, April N, Bernard P -M. Outbreak of glutaraldehyde-induced proctocolitis.  Am J Infect Control. 1995;  23 34-39
    CrossrefPubMedSearch in Google Scholar
  • 13 Caprilli R, Viscido A, Frieri G, Latella G. Acute colitis following colonoscopy.  Endoscopy. 1998;  30 428-431
    PubMedSearch in Google Scholar
  • 14 Castelli M, Qizilbash A, Seaton T. Post-colonoscopy proctitis.  Am J Gastroenterol. 1986;  81 887
    PubMedSearch in Google Scholar
  • 15 Qizilbash M D, Castelli M D, Seaton T. Post-colonoscopy chemical proctitis.  Lab Invest. 1986;  54 51A
    PubMedSearch in Google Scholar
  • 16 Jonas G, Mahoney A, Murray J, Stanford G. Chemical colitis due to endoscope cleaning solutions: a mimic of pseudomembranous colitis.  Gastroenterology. 1988;  95 1403-1408
    PubMedSearch in Google Scholar
  • 17 Abemayor E, Falkenstein D B, Rotterdam H, Raicht R F. Glutaraldehyde colitis: confirmation in a rat model.  Am J Gastroenterol. 1990;  85 1269
    PubMedSearch in Google Scholar
  • 18 Durante L, Zulty J C, Israel E, et al. Investigation of an outbreak of bloody diarrhea: association with endoscopic cleaning solution and demonstration of lesions in an animal model.  Am J Med. 1992;  92 476-480
    CrossrefPubMedSearch in Google Scholar
  • 19 Rozen P, Somjen G J, Baratz M, et al. Endoscope-induced colitis: description, probable cause by glutaraldehyde, and prevention.  Gastrointest Endosc. 1994;  40 547-553
    PubMedSearch in Google Scholar
  • 20 Birnbaum B, Gordon R B, Jacobs J E. Glutaraldehyde colitis: radiologic findings.  Radiology. 1995;  195 131-134
    PubMedSearch in Google Scholar
  • 21 West B, Kuan S -F, Bennick M, Lagarde S. Glutaraldehyde colitis following endoscopy: clinical and pathological features and investigations of an outbreak.  Gastroenterology. 1995;  108 1250-1255
    CrossrefPubMedSearch in Google Scholar
  • 22 Beaufort P, Chassagne P, Larrey D, Michel H. Colite au glutaraldehyde compliquant une endoscopie: une nouvelle observation.  Presse Med. 1996;  27 1257
    PubMedSearch in Google Scholar
  • 23 Ledinghen de V, Goujon J -M, Mannant P -R, et al. Recité aprés coloscopie: attention au rinc|,age du coloscope!.  Gastroenterol Clin Biol. 1996;  20 215-216
    PubMedSearch in Google Scholar
  • 24 Coche G, lzet T, Descombes P, Duchman J C, et al. Colite chimique au glutaraldehyde.  J Radiol. 1997;  78 215-217
    PubMedSearch in Google Scholar
  • 25 Burtin P, Ruget 0, Petit R, Boyer J. Glutaraldehyde-induced proctitis after endorectal ultrasound examination: a higher risk of incidence than expected?.  Gastrointest Endosc. 1993;  39 859-860
    PubMedSearch in Google Scholar
  • 26 Catalano O, Cusati B, Lapiccirella G. Colite da glutaraldeide: un caso studiato con clisma con doppio mezzo di contrasto e tomografia computerizzata.  Radiol Med. 1998;  96 126-127
    PubMedSearch in Google Scholar
  • 27 Zissin R, Gayer G, Maor-Kendler Y. CT findings of glutaraldehyde colitis: a report of two cases.  Clin Radiol. 1999;  54 123-125
    CrossrefPubMedSearch in Google Scholar
  • 28 Lynch D A, Parnell P, Porter C, Axon A TR. Patient and staff exposure to glutaraldehyde from Keymed Auto-Disinfector endoscope washing-machine.  Endoscopy. 1994;  26 359-361
    PubMedSearch in Google Scholar
  • 29 Russell A D. Glutaraldehyde: current status and uses.  Infect Control Hosp Epidemiol. 1994;  15 724-733
    PubMedSearch in Google Scholar
  • 30 Bardazzi F, Melino M, Alagna G, Veronesi S. Glutaraldehyde dermatitis in nurses.  Contact Dermatitis. 1986;  14 319-320
    PubMedSearch in Google Scholar
  • 31 Corrado O J, Osman J, Davies R J. Asthma and rhinitis after exposure to glutaraldehyde in endoscopy units.  Hum Toxicol. 1986;  5 325-327
    PubMedSearch in Google Scholar
  • 32 Jachuck S J, Bound C L, Steel J, Blain P G. Occupational hazard in hospital staff exposed to 2 percent glutaraldehyde in an endoscopy unit.  J Soc Occup Med. 1989;  39 69-71
    PubMedSearch in Google Scholar
  • 33 Wiggins P, McCurdy S A, Zeidenberg W. Epitaxis due to glutaraldehyde exposure.  J Occup Med. 1989;  31 854-856
    PubMedSearch in Google Scholar
  • 34 Hansen K S. Glutaraldehyde occupational dermatitis.  Contact Dermatitis. 1983;  9 81-82
    PubMedSearch in Google Scholar
  • 35 Gonc|,alo S, Branda|~o F M, Pecegueiro M, et al. Occupational contact dermatitis to glutaraldehyde.  Contact Dermatitis. 1984;  10 183-184
    PubMedSearch in Google Scholar
  • 36 Anonymous: Deutsche Gesellschaft für Hygiene und Mikrobiologie . Richtlinien für die Prüfung und Bewertung chemischer Desinfektionsverfahren.  Zbl Bakt Hyg I Abt Org B. 1981;  122 534-562
    PubMedSearch in Google Scholar
  • 37 Beauchamp R, St Clair M BG, Fennell T R, et al. A critical review of the toxicology of glutaraldehyde.  Crit Rev Toxicol. 1992;  22 143-174
    PubMedSearch in Google Scholar
  • 38 Ballantyne B, Myers R C, Blaszcak D L. Influence of alkalization of glutaraldehyde biocidal solution on acute toxicity, primary irritancy, and skin sensitization.  Vet Hum Toxicol. 1997;  39 340-346
    PubMedSearch in Google Scholar
  • 39 Anonymous .Glutardialdehyd. In: Henschler D, Greim H (eds). Gesundheitsschädliche Arbeitsstoffe. Toxikologisch-arbeitsmedizinische Begründungen von MAK-Werten.  Weinheim; VCH, 1994 Lieferung 20: 1-21
    Search in Google Scholar
  • 40 Gannon P FG, Bright P, Campbell M, et al. Occupational asthma due to glutaraldehyde and formaldehyde in endoscopy and x-ray departments.  Thorax. 1995;  50 156-159
    PubMedSearch in Google Scholar
  • 41 Farina A, Fievet M -H, Plassart F M, et al. Residual glutaraldehyde levels in fiberoptic endoscopes: measurement and implications for toxicity.  J Hosp Infect. 1999;  43 293-297
    CrossrefPubMedSearch in Google Scholar

B. Dietze, M.D.

Freie Universität Berlin, Fachbereich Humanmedizin
Universitätsklinikum Benjamin Franklin - Technische Hygiene

Hindenburgdamm 27
12203 Berlin
Germany


Fax: Fax:+ 49-30-84454490

Email: E-mall:martiny@medizin.fu-berlin.de