St Elizabeth Health Care Cidex® OPA Handling Safety Guidelines /1/12 Tia Gonnella 2012

4/1/12 Tia Gonnella 2012 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

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 4/1/12 Tia Gonnella 2012

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) 4/1/12 Tia Gonnella 2012

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 4/1/12 Tia Gonnella 2012

Hazard information  Target organ effects:  None  Reproductive effects:  Not a reproductive effector.  Mutagenic effects:  Not mutagenic in the Ames assay.  Sensitization:  May cause sensitization. 4/1/12 Tia Gonnella 2012

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 4/1/12 Tia Gonnella 2012

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 opa/features-and-benefits 4/1/12 Tia Gonnella 2012

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 4/1/12 Tia Gonnella 2012

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 4/1/12 Tia Gonnella 2012

Cidex OPA®Stain This type of stain can occur on any contact surface including probes, skin, hair, nails, and clothing. PPE protects against staining. 4/1/12 Tia Gonnella 2012

Cidex OPA®Stain This type of stain can occur on any contact surface including probes, skin, hair, nails, and clothing. PPE protects against staining. 4/1/12 Tia Gonnella 2012

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) 4/1/12 Tia Gonnella 2012

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 and-benefits 4/1/12 Tia Gonnella 2012

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 4/1/12 Tia Gonnella 2012

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) 4/1/12 Tia Gonnella 2012

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 4/1/12 Tia Gonnella 2012

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 4/1/12 Tia Gonnella 2012

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 4/1/12 Tia Gonnella 2012

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 4/1/12 Tia Gonnella 2012

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 4/1/12 Tia Gonnella 2012

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 o F  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 4/1/12 Tia Gonnella 2012

Secondary Containers Recognizing 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 df 4/1/12 Tia Gonnella 2012

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. 4/1/12 Tia Gonnella 2012

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 4/1/12 Tia Gonnella 2012

References OSHA (2006) Best Practices for the Safe Use of Glutaraldehyde in Health Care. Retrieved from www. osha.gov/Publications/glutaraldehyde.pdf 4/1/12 Tia Gonnella 2012