by Andrea Tritschler
As patients we expect our hospitals to make us feel better, fix our injuries, and send us on our way. Health care workers help to care for the sick and injured and keep the hospitals functioning smoothly. And whether we are patient or employee, we all expect our hospitals to be safe and clean and to look after our well-being.
Keeping a hospital clean and germ-free is a delicate balancing act. The cleaning chemicals have to be strong, so as to kill spores and other bacteria, yet be safe and gentle enough to use around patients and workers.
A local hospital recently began using Ecolab Oxycide, a daily-use, non-bleach disinfectant. In the few months since the switch, health care workers have been complaining about burning eyes, irritated noses and troubled breathing, a source who only spoke on the condition of anonymity said:
“Everyone complains. The smell lingers and it’s strong. Someone was cleaning and I walked into the room, and after two minutes or so it burned my eyes so bad and smelled so bad, I had to leave.”
Oxycide Daily Disinfectant Cleaner is approved by the Food and Drug Administration and is registered with the Environmental Protection Agency. According to Ecolab’s Director of Global Communication, Roman Blahoski, Oxycide has undergone rigorous testing for use in healthcare settings.
Mostly used in hospitals, Oxycide is designed to stop the spread of infection, including Clostridium Difficile (C. diff), a bacterium that causes diarrhea and other intestinal conditions such as colitis. According to the Center for Disease Control, approximately 1.7 million people acquire hospital-associated infections (HAI’s) annually, resulting in 150,000 deaths, and of those, C. diff infections are linked to 29,000 deaths each year.
Treating C. diff infections is costly. A recent study conducted by the Journal of the American Medical Association Internal Medicine found the healthcare industry incurs an annual cost of $1.5 billion, or about $11,285 per case, to treat infections like C. diff. Disinfectants like Oxycide provide greater efficiency at a lower cost.
“The department leads say that [Oxycide] is preventing C. diff and that the switch of disinfectants was to keep HAI’s down. I really think it’s about cost. But since using it for patient care, it’s been keeping the rates of infection down I guess. It’s not making the patients sick, but it’s making the staff sick,” our source said.
And the hospital administration is adamant that the maintenance department use Oxycide, despite the complaints or objections of its staff. According to our source one of the neurological nurse managers didn’t want Oxycide used in that unit, but supervisors told her they had to use it.
“This girl is pregnant and she was working in the area and was supposed to use oxycide, but said it was making her sick. The leadership told her she needed a doctor’s note, or she had to continue using the product.”
Hospitals are looking to Oxycide as a more desirable disinfectant, being both more environmentally friendly and safer for employees to handle. Oxycide requires no manual mixing, like other disinfectants, instead the product is dispensed from a container that dilutes the chemical solution with water. But even in the diluted state in which it’s used, Oxycide requires proper ventilation, something that our source says the local hospital doesn’t have.
“I hear we have a poor ventilation system, even some of the doctors have told me so. I sneeze a lot at work because I have allergies. but the doctors tell me it’s probably because the ventilation is poor.”
The main component in Oxycide is Peracetic acid (PAA), a colorless liquid formed by the reaction of hydrogen peroxide and acetic acid. Known to be one of the strongest oxidizing agents, PAA doesn’t leave behind any harmful residue on surfaces and decomposes into benign hydrogen, water and acetic acid, making it a more environmentally friendly chemical than bleach disinfectants.
Peracetic acid is a widely used chemical, yet there is little information about the health effects. When Oxycide was released in 2013, there was even less known about the recommended exposure levels and there was no occupational exposure limit set. To date OSHA doesn’t have an accurate way to test PAA levels and there are no limits as to how much exposure is acceptable.
Pressure groups have requested investigations to study the serious health affects associated with PAA. In Spring of 2014 The American Conference of Governmental Industrial Hygienists set new short term exposure limits on Peracetic acid that confirmed the dangers of Peracetic acid in the workplace.
A 2014 report from the San Francisco Department of the Environment links PAA to asthma, but many long term effects are still unknown. Peracetic acid is still a relatively new chemical, but already it is widely used both in and beyond the healthcare industry.
“Hospitals across the country are finding that OxyCide is a key component of their programs to battle healthcare-acquired infections,” Blahowski said in an email.
Healthcare workers nationwide have experienced similar symptoms associated with the disinfectant including hospitals in Vermont and Minnesota. Last year, over 200 healthcare workers at the University of Pittsburgh Medical Center filed a complaint with the Occupational Safety and Health Administration, complaining of adverse health effects.
According to Pittsburgh City Paper, the complaint was investigated by OSHA and closed without issuing any violations, which could be due to flawed testing. With no exposure limit yet established, OSHA has been using the levels for hydrogen peroxide and acetic acid, both of which have OSHA limits to evaluate exposure. The article goes on to say the problem with that method of testing is that hydrogen peroxide and acetic acid are not as harmful as when they are combined.
When employees at the University of Vermont Medical Center began complaining of running noses, headaches and burning sensations the administration decided to stop using the product, without inquiry. The Mayo Clinic saw similar issues and had the levels of Peracetic Acid measured by ChemDAQ, a company that ensures the safe use of biocidal chemicals in protecting patients from HAIs and foodborne illness. The results have yet to be released.
ChemDAQ does free environmental analysis upon request and works with chemical and equipment suppliers as well as employers and workers who rely on biocidal chemicals. They found that continued exposure of PAA can result in liver and kidney problems, pulmonary edemas and circulatory problems that could go undetected for months or years.
“So many people have been complaining about this and they do nothing. I’m invisible here, no one is listening. So I don’t use it even though I’m supposed to, and I’m looking for a new job where I don’t have to use this product.”