St Elizabeth Health Care Cidex ® OPA Handling Safety Guidelines

1. 2012 St Elizabeth Health Care Cidex® OPA Handling Safety Guidelines Tia Gonnella 2012

2. This module is applicable to managers/supervisors, Cidex OPA® users, and any employee in the work area of area that may see, be exposed or encounter a Cidex OPA® spill Tia Gonnella 2012

3. Uses of Cidex® OPA • A high-level disinfectant • To high level disinfect endoscopic instruments and endocavity ultrasound probes, thermometers, rubber or plastic equipment which cannot be heat sterilized Tia Gonnella 2012

4. Chemical Description • Synonyms– OPA, orthophthalaldehyde • Clear, pale blue liquid • Chemical similarity to gluteraldehyde • Lower inhalation/exposure risk than Cidex® Plus • Contains only .55% of active ingredient (compared to Cidex® Plus at 3.2% gluteraldehyde) • Less time to decontaminate (12 minutes vs. 20 minutes for Cidex® Plus) Tia Gonnella 2012

5. Hazardous Component • The active ingredient is ortho-phthalaldehyde • Mild irritant • Can produce asthma-like symptoms with heavy inhalation exposure • Active ingredient interacts with proteins and can stain mucous membranes • Excessive soak times can damage instrument and increase potential for staining Tia Gonnella 2012

6. Hazard information • Target organ effects: • None • Reproductive effects: • Not a reproductive effector. • Mutagenic effects: • Not mutagenic in the Ames assay. • Sensitization: • May cause sensitization. Tia Gonnella 2012

7. Routes of Exposure • Oral: • Not anticipated to be a significant route of occupational exposure. • Eye contact: • May cause eye irritation and redness. • Skin contact: • May cause skin irritation. Repeated exposure may cause skin dryness or cracking. Exposure to skin may cause temporary staining. • Ingestion: • Ingestion may cause gastrointestinal irritation, nausea, vomiting and diarrhea. Exposure can irritate and discolor the tissues of the mouth, esophagus and other tissues of the digestive tract • OSHA 2012 retrieved 7/26/2012 from http://www.osha.gov/Publications/glutaraldehyde.pdf Tia Gonnella 2012

8. How employees can reduce exposure • Use local exhaust ventilation • GUS STATION • Keep Cidex® OPA solution containers under GUS hood AND keep cap/cover on container • Use only enough OPA to perform the required disinfecting procedure • Avoid skin contact: use PPE Advanced sterilization products (2012) retrieved 7/26/2012 from http://www.aspjj.com/us/products/cidex-opa/features-and-benefits Tia Gonnella 2012

9. How employees can reduce exposure (cont.) • Wash gloved hands after handling Cidex® OPA • Wear goggles and face shields when handling ortho-phthalaldehyde • Cover all containers holding ortho-phthalaldehyde solutions • Attend training classes in safety awareness about use of and exposure to ortho-phthalaldehyde Tia Gonnella 2012

10. Protective Work Clothing and Equipment • Non-latex gloves (or doubled up latex) • Splash-proof safety goggles • Impervious Gown • Mask • Will stain clothing/shoes Advanced sterilization products (2012) retrieved 7/26/2012 from http://www.aspjj.com/us/products/cidex-opa/features-and-benefits Tia Gonnella 2012

11. CidexOPA®Stain This type of stain can occur on any contact surface including probes, skin, hair, nails, and clothing. PPE protects against staining. Tia Gonnella 2012

12. CidexOPA®Stain This type of stain can occur on any contact surface including probes, skin, hair, nails, and clothing. PPE protects against staining. Tia Gonnella 2012

13. Spills and Leaks • Follow SPIL procedure: • SECURE area: stop the spill with absorbent material • PROTECT yourself and others from the spilled material • INFORM security and your supervisor of spill • LEAVE clean-up for trained personnel (that will be you) Tia Gonnella 2012

14. Spills and Leaks • Locate the Spill Kit • Put on PPE • Gown, Gloves, Mask, Eye Protection • Apply Glute-Out® to spill • Start at edges of spill and work inward • Wait Five Minutes for Cidex® OPA to be neutralized Advanced sterilization products (2012) retrieved 7/26/2012 from http://www.aspjj.com/us/products/cidex-opa/features-and-benefits Tia Gonnella 2012

15. Spills and Leaks (cont.) • Flush down drain and run water • Sweep up any remaining glute-out crystals into container, tie top and place in trash container • Wipe down all areas with soap and water/general cleaner Tia Gonnella 2012

16. Contact with Cidex® OPA • If skin contact has occurred • Immediately wash area of contact with soap and water • Hold affected area under running water for 15 minutes • Seek medical advice through employee health (ER after hours) Tia Gonnella 2012

17. Contact with Cidex® OPA • If eye contact has occurred • Eye wash station: • wash eyes under running water • Allow water to run for 15 minutes • Seek medical advice through employee health Tia Gonnella 2012

18. Contact with Cidex® OPA • If contact with clothing occurs • remove clothing • Wash affected area with soap and water • Allow water to run over area for 15 minutes • Place in air tight bag for washing later • Seek medical advice through employee health Tia Gonnella 2012

19. Contact/Exposure Cidex® OPA • If direct inhalation occurs • go to well ventilated area immediately • If discomfort or breathing difficulty occurs, seek medical advice through employee health Tia Gonnella 2012

20. Contact/Exposure • Ingestion: • Do not induce vomiting. Rinse mouth followed by drinking a large quantity of water • Seek medical advice through employee health • OSHA 2012 retrieved 7/26/2012 from http://www.osha.gov/Publications/glutaraldehyde.pdf Tia Gonnella 2012

21. Contact with Cidex® OPA • If you have questions or concerns about Cidex OPA® • Contact your supervisor or the Safety Director If you have concerns about exposure to Cidex OPA® • Contact Employee Health • Refer to MSDS on intranet/compliance 360 Tia Gonnella 2012

22. Storage • Keep original bottle tightly closed • Store unused Cidex® OPA in a secure area –outside of patient care areas • Place soak stations in low traffic areas, keep it secured, and cap containers that are not in use • Store at room temperature between 59-86oF • Do not store in original bottle past expiration date of 75 days (or original date, whichever is earlier) Advanced sterilization products (2012) retrieved 7/26/2012 from http://www.aspjj.com/us/products/cidex-opa/features-and-benefits Tia Gonnella 2012

23. Secondary ContainersRecognizing Cidex® OPA in the workplace • Labels: • The name of the chemical (without abbreviations or symbols) • The activation date • The expiration date • The hazard class • Warning • OSHA 2012 retrieved 7/26/2012 from http://www.osha.gov/Publications/glutaraldehyde.pdf • Warning: • High Level Disinfectant Tia Gonnella 2012

24. Disposal • Unused Cidex® OPA can be poured down drain without neutralization • Cidex® OPA spills -after neutralizing all contact surfaces with Glute-Out® sweep into receptacle and place in bag, tie top prior to placing in trash can. Tia Gonnella 2012

25. Safety tips • Become familiar with and be able to recognize sources of ortho-phthalaldehyde exposure • In case of skin or eye contact, wash with water at eye station immediately and contact employee health or ER • Clean up spills immediately, use PPE, Follow REST plan • Refer to MSDS for more information • OSHA 2012 retrieved 7/26/2012 from http://www.osha.gov/Publications/glutaraldehyde.pdf Tia Gonnella 2012

26. ReferencesOSHA (2006) Best Practices for the Safe Use of Glutaraldehyde in Health Care. Retrieved from www.osha.gov/Publications/glutaraldehyde.pdf Tia Gonnella 2012