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Precautionary Measures Lacking for High Level Disinfectants: Results of a Survey of Healthcare Workers Who Disinfect Medical and Dental Devices

January 14, 2015
NIOSH Update:

Press Contact: Nura Sadeghpour (202) 245-0673

Findings from a survey conducted by the National Institute for Occupational Safety and Health (NIOSH) show that precautionary measures to minimize worker exposure to high-level disinfectants (HLDs) are not always used. The study results were recently published in the journal Infection Control and Hospital Epidemiology.

The recent release is one of a series of reports detailing results from the 2011 Health and Safety Practices Survey of Healthcare Workers, the largest federally-sponsored survey of healthcare workers in the U.S. Eligible respondents included those who chemically disinfect medical or dental devices using one or more of the following HLDs during the past week: glutaraldehyde, orthophthaldehyde (OPA), peracetic acid, and/or hydrogen peroxide. Information on various exposure controls and impediments to using personal protective equipment (PPE) was assessed.

Findings suggest that recommended practices are not always used by healthcare workers. The following describes examples of practices that may increase exposure risk:

  • 17% never received training on safe handling of HLDs.
  • 19% reported that safe handling procedures were unavailable.
  • 44% did not always wear water-resistant gown or outer garment.
  • 9% did not always wear protective gloves.
  • ‘Exposure was minimal’ was the most frequently reported reason for not wearing PPE.
  • 12% reported skin contact with HLDs during the past week.
  • Workers reporting skin contact were 4 times more likely to report not always wearing protective gloves.

When precautionary practices are not followed, workers handling HLDs are at risk of exposure. Ensuring proper precautionary measures are utilized requires diligence on the part of both employers and healthcare workers. Employers who provide a safety culture that demonstrates a strong commitment to health and safety of their workers ensure that adequate resources and safety equipment are available. Workers, in turn, are encouraged to seek out training, understand and follow safety procedures, and feel free to report any safety concerns.

The findings from this survey are expected to help NIOSH, partners, employers, and healthcare providers better understand current health and safety practices relative to working with hazardous chemical agents, identify gaps in current knowledge about those practices, and design further research for addressing those gaps. To access the research paper online, visit:

NIOSH is the federal agency that conducts research and makes recommendations for preventing work-related injuries, illnesses and deaths. To learn more about healthcare safety and health, visit: More information can be found at


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