www.osha.gov

Best Practices for the 

Safe Use of Glutaraldehyde 

in Health Care

OSHA 3258-08N 2006
Employers are responsible for providing a safe and

healthful workplace for their employees. OSHA’s

role is to assure the safety and health of America’s

employees by setting and enforcing standards;

providing training, outreach and education; establishing partnerships; and encouraging continual

improvement in workplace safety and health. 

This handbook provides a general overview of a

particular topic related to OSHA standards. It does

not alter or determine compliance responsibilities in

OSHA standards or the Occupational Safety and

Health Act of 1970. Because interpretations and enforcement policy may change over time, you should

consult current OSHA administrative interpretations

and decisions by the Occupational Safety and Health

Review Commission and the Courts for additional

guidance on OSHA compliance requirements.

This publication is in the public domain and may be

reproduced, fully or partially, without permission.

Source credit is requested but not required.

This information is available to sensory impaired

individuals upon request. Voice phone: (202) 693-

1999; teletypewriter (TTY) number: (877) 889-5627.
U.S. Department of Labor

Occupational Safety and Health Administration

OSHA 3258-08N

2006

Best Practices for the 

Safe Use of

Glutaraldehyde 

in Health Care
2

Contents

Introduction . . . 4

Summary of Health Effects . . . 4

Occupational Exposure Limits for Glutaraldehyde . . . 6 

GLUTARALDEHYDE USE AS A HIGH-LEVEL 

DISINFECTANT . . . 6

Engineering Controls . . . 10

Alternatives to Glutaraldehyde for 

High-Level Disinfection . . . 17

GLUTARALDEHYDE USE AS A TISSUE FIXATIVE . . . 18

GLUTARALDEHYDE USE IN X-RAY PROCESSING . . . 20

GENERAL RECOMMENDATIONS APPLICABLE TO 

ALL USES OF GLUTARALDEHYDE IN HEALTH CARE . . . 23

Additional Resources . . . 32

OSHA Assistance . . . 38

OSHA Regional Offices . . . 43
This best practices booklet is not a standard or regulation, and 

it creates no new legal obligations. The document is advisory in

nature, informational in content, and is intended to assist

employers in providing a safe and healthful workplace. The

Occupational Safety and Health Act (OSH Act) requires employers

to comply with hazard-specific safety and health standards. In

addition, pursuant to Section 5(a)(1), the General Duty Clause of

the Act, employers must provide their employees with a workplace

free from recognized hazards likely to cause death or serious

physical harm. Employers can be cited for violating the General

Duty Clause if there is a recognized hazard and they do not take

reasonable steps to prevent or abate the hazard. However, failure

to implement these recommendations is not, in itself, a violation of

the General Duty Clause. Citations can only be based on standards,

regulations, and the General Duty Clause. 

OSHA standards that may apply in exposure scenarios similar to

those described in this publication include Hazard Communication

(29 CFR 1910.1200) and Personal Protective Equipment, General

Requirements (29 CFR 1910.132); Eye and Face Protection (29

CFR 1910.133); Respiratory Protection (29 CFR 1910.134.); and

Hazardous Waste Operations and Emergency Response (29 CFR

1910.120(q)). Scenarios where these OSHA standards may apply are

identified in the text of this document.

Mention of any company or product is for informational

purposes only and does not constitute an endorsement by OSHA.

3
Introduction

This document describes best practices for the safe use of glutaraldehyde in health care facilities. Glutaraldehyde is used widely

as a cold sterilant to disinfect a variety of heat-sensitive

instruments, such as endoscopes, bronchoscopes, and dialysis

equipment (NIOSH, 2001). In addition, health care employees

may be exposed to glutaraldehyde in its uses as a hardener in x-ray

developing and as a tissue fixative in histology and pathology labs. 

Glutaraldehyde’s properties as a chemical sterilant were initially

recognized in the early 1960s as the health care industry searched

for a safer alternative to formaldehyde, which is regulated by OSHA

as a carcinogen (29 CFR 1910.1048). In the years since its introduction as a disinfectant/sterilant, glutaraldehyde has been linked with

a variety of health effects – ranging from mild to severe – including

asthma, breathing difficulties, respiratory irritation, and skin rashes

(Pryor, 1984; Crandall, 1987). 

The purpose of this document is to provide information that can

be used by health care employers and employees to understand

and control exposures to glutaraldehyde. This document describes

engineering controls, work practices, and facility design considerations that will help reduce employee exposure to glutaraldehyde.

This document also includes recommendations for personal

protective equipment, employee training, exposure monitoring,

disposal practices, and spill and cleanup procedures. The use of

alternatives to glutaraldehyde is also addressed. 

Note: The term “health care facilities” is intended to encompass

the broad range of health care facility types and sizes, including

hospitals, clinics, freestanding surgical centers, physician offices,

and dental clinics, as well as nursing homes and other residential

health care facilities.

Summary of Health Effects 

The most serious adverse health effect documented among

employees exposed to glutaraldehyde vapor is occupational

4
asthma, a chronic condition characterized by bronchial hyperresponsiveness. Reactions can be either immediate or delayed, with

a latent period ranging from a few weeks to several years from

the onset of exposure. Human studies on the effects of glutaraldehyde exposure consist of many case reports in the

published literature, some identified by both American and British

health surveillance systems, and symptom surveys of American

health care employees, all of which document an association

between exposure to glutaraldehyde and the development of

asthma. (Gannon et al., 1995; Rosenman et al., 1997; Keynes et al.,

1996; Di Stefano et al., 1999). 

In addition, a few cross-sectional studies also show that an

increased prevalence of irritant symptoms, including itching of the

eyes with increased lacrimation (tearing), and rhinitis, is reported

by health care employees who are exposed to short-term (15-

minute) concentrations well below 0.2 parts-per-million (ppm) in

air, predominantly in the range of about 0.005 to 0.050 ppm

(Norback, 1988; Pisaniello et al., 1995). 

In addition to causing respiratory effects, glutaraldehyde acts as

a contact allergen, giving rise to contact dermatitis, usually on the

hands but occasionally on the face. Skin sensitization from contact

with glutaraldehyde has been documented in endoscopy nurses,

dental assistants, x-ray technicians, hospital maintenance and

cleaning staff, and funeral service employees (Marzulli and

Maibach, 1974; Fowler, 1989; Nethercott et al., 1988; Maibach and

Prystowsky, 1977; Nethercott and Holness, 1988; Ballantyne and

Berman, 1984; Waters et al., 2003). Individuals who have become

sensitized to glutaraldehyde can develop dermatitis after

contacting solutions containing as little as 0.1 percent glutaraldehyde. In contrast, simple skin irritation typically occurs on

contact with solutions containing more than 2 percent glutaraldehyde (HSE, 1997). In one study of health care employees who had

developed allergic contact dermatitis from glutaraldehyde, ten

employees who were followed for six months after initial diagnosis

continued to have persistent hand eczema, although five of these

employees had left their jobs because of this health problem

(Nethercott et al., 1988).

5
Occupational Exposure Limits

for Glutaraldehyde

The Federal Occupational Safety and Health Administration

(OSHA) does not have a Permissible Exposure Limit for glutaraldehyde. The National Institute for Occupational Safety and Health

(NIOSH) established a Recommended Exposure Limit (REL) of 0.2

ppm in 1989 (http://www.cdc.gov/niosh/npg/npgd0301.html). Other

organizations that have occupational exposure limits include the

American Conference of Governmental Industrial Hygienists (ACGIH),

which currently recommends a Threshold Limit Value (TLV) of 0.05

ppm in air, measured as a ceiling concentration, and the United

Kingdom Health and Safety Executive which also has established

a 0.05 ppm Workplace Exposure Limit (WEL) averaged over both 8

hours and 15 minutes.

The occupational exposure limits discussed above were current

at the time this document was published. However, it is essential

that health care personnel keep informed of current Federal, state,

and local regulations applicable to glutaraldehyde, as well as with

professional guidelines.

GLUTARALDEHYDE USE AS

A HIGH-LEVEL DISINFECTANT

Primary Sources of Glutaraldehyde Exposure

Glutaraldehyde-based agents are used to disinfect medical

equipment that cannot be subjected to steam sterilization, specifically heat-sensitive, lensed devices typically requiring high-level

disinfection between patient uses (ANSI/AAMI, 1996).

Glutaraldehyde-based products may be used in a variety of

locations within a facility, such as surgery, endoscopy, and

respiratory therapy. Trade names of glutaraldehyde-based

products include, but are not limited to, Cidex®, Sonacide®,

Sporicidin®, Hospex®, and Omnicide® (NIOSH, 2001).

6
Definitions:

Sterilant: Physical or chemical agent(s) or process which

completely eliminates or destroys all forms of life, particularly

microorganisms.

Disinfectant: An agent that destroys pathogens by physical or

chemical means. Disinfection processes do not ensure the same

margin of safety associated with sterilization processes and can

vary in their extent of microorganism elimination. This variation

leads to subcategories, the first of which is high-level disinfection.

High-Level Disinfection: A process utilizing a sterilant under less

than sterilizing conditions. The process kills all forms of microbial

life except for large numbers of bacterial spores.

Disinfection activities range from simple soaking of small

instruments to automated processing of complex lensed instruments, such as endoscopes. Exposure to glutaraldehyde as a highlevel disinfectant occurs primarily during the following activities:

■ activating and pouring glutaraldehyde solution into or out of a

cleaning container system (e.g., soaking basin in manual disinfecting operations and reservoir in automated processors);

■ opening the cleaning container system to immerse instruments

to be disinfected;

■ agitating glutaraldehyde solution;

■ handling of soaked instruments; 

■ removing instruments from the container system;

■ rinsing the channels of instruments containing residual glutaraldehyde solution;

■ flushing out instrument parts with a syringe;

■ drying instrument interiors with compressed air;

■ disposing of “spent” glutaraldehyde solutions to the sanitary

sewer;

■ performing maintenance procedures, such as filter or hose

changes on automated processors that have not been pre-rinsed

with water.

Measurements of health care employee exposure to glutaraldehyde vapor during high-level disinfection have been reported to

7
range from none detected to 0.20 ppm or greater (Naidu et al.,

1995; Pisaniello et al., 1997). NIOSH has documented levels as

high as 0.5 ppm (NIOSH, 1985); 0.48 ppm (NIOSH, 1987); and 0.08

ppm (NIOSH, 1991) during disinfection procedures at health care

facilities. A recent study (Waters et al., 2003) documented

exposures of up to 0.15 ppm in endoscopy disinfection. Exposure

levels will vary depending on a number of factors such as the

concentration of the glutaraldehyde solution, type of process

(manual versus automatic), ventilation conditions, site-specific

factors, as well as the duration of the sampling period (e.g., peak,

15-minute short-term, or full task duration). 

Manual operations with inadequate or ineffective controls result

in higher exposures. Pisaniello et al. (1997) reported on exposures

in operating theaters and endoscopy areas with and without local

exhaust ventilation (LEV). In endoscopy units, the mean geometric

exposure of 14 samples without LEV was 0.093 ppm, and 0.022

ppm with LEV. Figure 1 presents some exposure data for specific

operations with and without exposure controls.

8

Figure 1. Glutaraldehyde Exposures with and without

Local Exhaust Ventilation 

0.1

0.09

0.08

0.07

0.06

0.05

0.04

0.03

0.02

0.01

0

ppm

Sources: NIOSH, 1991; NJDOHSS, 1998; Naidu et al., 1995. All exposures 

are personal breathing zone samples.

A. Manual Sterilization, 

Poor Ventilation and 

Work Practices

B. Manual Sterilization

Under Local Exhaust

Ventilation

C. Automatic Sterilization,

Poor Ventilation

D. Automatic Sterilization,

Proper Ventilation

E. Solution Handling, No

Local Exhaust Ventilation

F. Solution Handling, Local

Exhaust Ventilation

A B C D E F

•

•

•

•

•• •

••

•

••

•

•

•

•

•

•

•

•

•

••

•••

•

•

•

•
Recommended Exposure Controls

A variety of engineering controls, facility design considerations,

and work practices are available to minimize exposure to

glutaraldehyde during its use as a disinfectant and sterilant. In

good industrial hygiene practice such methods are to be used to

control employee exposure, and if they prove to be insufficient to

protect employees, respirators and other personal protective

equipment are to be used. Employees required by their employer to

wear respirators must receive training and a medical evaluation

to determine their fitness to use the equipment. Fit testing of

the respirator is also required. For details on fit testing and

other requirements for employee use of respirators see OSHA’s

Respiratory Protection standard (29 CFR 1910.134). Employees

whose employers do not require them to wear respirators but who

choose to do so must obtain certain information concerning the

safe use of respirators (Appendix D to Part 1910.134). Respirators

protect only the user, and others in the area may be overexposed to

glutaraldehyde vapor if it is not adequately controlled at the source

of the release.

Other forms of personal protective equipment (PPE), such as

gloves, safety eyewear, and isolation gowns, lab coats, or aprons

(plus sleeve protectors) should be worn and may be required

whenever there is the potential for skin or eye contact with glutaraldehyde. See the following OSHA standards: Personal

Protective Equipment, General Requirements (29 CFR 1910.132); Eye

and Face Protection (29 CFR 1910.133); Respiratory Protection

(29 CFR 1910.134) and Hand Protection (29 CFR 1910.138), and

ANSI/AAMI, 1996. Such PPE should always be used in combination with effective engineering controls. 

Studies have documented the effectiveness of controls in

reducing exposure to gluataraldehyde in disinfecting. Butt et al.

(1999) documented exposures during sterilization and mixing over

a 5-month period, while changes to ventilation, equipment and

work practices were made. During this time, exposures to glutaraldehyde during mixing decreased from a high of 0.96 ppm

down to 0.04 ppm. The authors indicated that the changes that

appeared to have the most impact on reducing mixing exposures

were the addition of a waste pump and new filters in the hood. 

9
This section describes recommended engineering controls and

work practices to reduce glutaraldehyde exposures to safe levels

during disinfection activities. This section also summarizes the

most recent information concerning possible substitutes for glutaraldehyde. Employers should consider whether for a particular

use of glutaraldehyde there is an effective substitute that has

reduced risks to employees. 

See General Recommendations section of this publication at

page 23 for additional information on the selection and use of

personal protective equipment, employee information and training,

exposure monitoring, disposal of glutaraldehyde solutions, and

spill and cleanup procedures applicable to the use of glutaraldehyde as a high-level disinfectant.

Engineering Controls

The goal of engineering controls is to keep glutaraldehyde vapor

from entering the workroom and the employee’s breathing zone

by containing and removing it at the source of release. As

described above, the primary sources of employee exposure to

glutaraldehyde during disinfection/sterilant activities include

pouring glutaraldehyde solutions into container systems, opening

soaking basins or reservoirs, and handling instruments containing

residual glutaraldehyde. Engineering controls tailored for these

exposure sources include ventilation, both general exhaust

ventilation and local exhaust systems (such as laboratory chemical

hoods), process automation, and isolation (e.g., basins with tightfitting covers, dedicated centralized storage and use areas). 

General Room Ventilation

The American National Standards Institute, Inc., in collaboration

with the Association for the Advancement of Medical Instrumentation, recommends that rooms where glutaraldehyde disinfection/

sterilization is performed be large enough to ensure adequate

dilution of vapor and have a minimum air exchange rate of 10 air

exchanges per hour (ANSI/AAMI, 1996). Some agencies recommend even higher air exchange rates, e.g., 15 air exchanges per

10
hour, to ensure dilution of vapor. There are no national standards

that apply specifically to glutaraldehyde usage areas; however, local

codes may apply. The air exchange rate recommended by ANSI/

AAMI is consistent with the American Institute of Architects’ guidelines for health care facilities (ANSI/AAMI, 1996).

Local Exhaust Ventilation

ANSI/AAMI ST58 recommends that local exhaust ventilation also

be installed at the point of release of glutaraldehyde vapors. The

health care facility must ensure that the ventilation system is

operating properly and is not obstructed or disturbed by drafts

from sources such as fans, supply air diffusers, open windows

and doors, and heavily traveled aisles.

Local exhaust ventilation located at the level of vapor discharge

is the preferred method of reducing glutaraldehyde vapor concentrations because it captures and removes vapor at the source

before it can escape into the general work environment. Local

exhaust ventilation systems for glutaraldehyde-based activities may

include a local exhaust hood (such as a laboratory fume hood) and

the associated ductwork and fan; or, a self-contained, freestanding,

recirculating exhaust ventilation system (i.e., ductless fume hood).

Local Exhaust Hood

The purpose of a local exhaust hood is to capture glutaraldehyde

vapor during processing and conduct it into the exhaust system

(via the hood). The capture and control of glutaraldehyde vapor

is achieved by the inward airflow created by the exhaust hood.

The minimum hood-induced air velocity necessary to capture and

convey glutaraldehyde vapor into the hood is called the “capture

velocity. ” Pryor (1984) recommends a minimum capture velocity of

at least 100 feet per minute to prevent exposure to glutaraldehyde

vapor.

The average velocity of the air drawn through the face (opening)

of the hood is called the “face velocity. ” The face velocity of a

hood greatly influences the containment efficiency of the hood (i.e.,

the hood’s ability to contain hazardous air contaminants) (National

Research Council, 1995). The American Industrial Hygiene

11
Association recommends an average face velocity of 80 to 120 feet

per minute for laboratory exhaust hoods (AIHA, 1992 in ANSI/AAMI,

1996).

Once glutaraldehyde vapor is collected inside a suitable exhaust

hood, it is transported through a duct system and then discharged

to the outside via a fan. 

Ductless Fume Hoods

Ductless fume hoods are ventilated enclosures that have their

own exhaust fan that draws air out of the hood, passes it through

an air cleaning filter and then discharges the cleaned exhaust air

back into the workplace. Ductless fume hoods are “recirculating”

exhaust systems used for contaminant control and use a variety

of filters for air cleaning purposes, depending on the air contaminant(s). For glutaraldehyde, a filter containing activated charcoal or

other suitable sorbent material must be used to effectively capture

vapors. Because the collection efficiency of these filters decreases

over time, a preventive maintenance program in accordance with

the manufacturer’s recommendations must be implemented to

ensure optimum performance of the system and effective employee

protection.

Ductless fume hoods may also come equipped with a variety of

features as specified in the American National Standards for

Recirculation of Air from Industrial Process Exhaust Systems

(ANSI/AIHA, 1998). These safety features are designed to prevent

inadvertent exposure in the workplace and include continuous

monitoring devices equipped with alarms to alert operators to

potential filter break through, and backup air cleaning devices. 

Transfer Procedures

Reducing the release of glutaraldehyde vapor during transfer

operations can be accomplished by the use of automated and

enclosed equipment. For example, the transfer of glutaraldehyde

from drums into process containers can be automated using

pumps and closed transfer lines. Such automated equipment can

help employees avoid glutaraldehyde exposure (OSHA “Hospital

12
e-Tool;” http://www.osha.gov/SLTC/etools/hospital/index.html);

(AFSCME, 2001).

The use of a “safety nozzle” for pouring reduces the potential

for splashing and “glugging” during initial pouring of glutaraldehyde solutions. When using a “safety nozzle, ” be aware that

droplets may remain inside the nozzle and take care to avoid

spraying droplets into the atmosphere when removing (unscrewing)

it from one container and screwing it onto another container.

Automated Disinfection

The use of automated processing equipment to disinfect

instruments can significantly reduce the glutaraldehyde exposures

of employees performing disinfection procedures, as well as of

other employees and non-employees in the vicinity. However,

exposure is still possible, especially when poor work practices are

used or the equipment is poorly designed or improperly installed.

The ANSI/ AAMI ST58 standard contains detailed guidelines (Figure

2, below) for the purchase and installation of automated equipment

which is now widely used in health care facilities that perform highvolume disinfection.

Figure 2. Guidelines for the Purchase and Installation of 

Automated Glutaraldehyde Processing Equipment

Automated processing equipment encloses the glutaraldehyde

disinfection/sterilizing operations and can significantly reduce

the release of glutaraldehyde vapor into the workroom air

(compared with manual disinfection operations). However, the

equipment must be properly designed and installed in order to

control glutaraldehyde vapor effectively. The ANSI/AAMI ST58

standard contains detailed guidelines for the purchase and

installation of such equipment. Key points include the following: 

1. Purchase automated processing equipment only from a manufacturer who can provide documentation (i.e., exposure

monitoring data) of its effectiveness in controlling glutaraldehyde vapor releases.

13
14

(Figure 2. continued)

2. Other purchase considerations include: space needs, accessibility, safety features, mid-cycle inspection capability, and

means of changing and disposing of glutaraldehyde

solutions.

3. Following installation, the equipment performance should

be evaluated before it is put into actual use at the facility.

Exposure monitoring should be conducted to ensure that

all equipment is performing properly.

Note: Properly installed ventilation is still necessary even with

the use of automated glutaraldehyde processing equipment.

For example, ventilation is needed to control exposure when

glutaraldehyde is poured into the machine’s reservoir and

whenever the machine is opened to observe or troubleshoot the

equipment. Ductless enclosure hoods are available in a variety

of sizes, including custom designs, for automated processing

equipment (freestanding and countertop units) from select

medical/laboratory equipment suppliers.

Mobile Disinfecting Stations

Mobile disinfecting soaking stations designed specifically for

manual high-level disinfecting provide an enclosed area for

sterilizing trays, protecting employees from splashes and spills,

and controlling exposure to vapor from glutaraldehyde and other

disinfectants. Mobile disinfecting stations utilize ductless fume

hoods for vapor control and may have different types of filters

available depending on the disinfectant to be used. 

Facility Design 

The health care facility should designate central areas for disinfection and sterilization using glutaraldehyde so that specific

controls can be utilized (ANSI/AAMI, 1996). Specific engineering

controls are more difficult to implement in facilities that permit

the widespread use of glutaraldehyde throughout the site. The

centralized location should be large enough to permit freedom of
movement (a crowded work space creates the potential for spills),

and have limited access. Posting warning signs at the entrance to

the centralized location and limiting access to only trained

personnel designated to perform operations involving the use of

glutaraldehyde will contribute to reducing exposure at the facility. 

Recommended Work Practices

Poor work practices can contribute significantly to an employee’s

glutaraldehyde exposure. The health care facility should evaluate

each glutaraldehyde-using operation and observe employees’

work practices to determine all potential sources of exposure.

Developing procedures for safe work practices may be useful for

training and communication purposes. These procedures should

emphasize prevention of employee contact with glutaraldehyde

solution or vapors. Only trained, designated personnel should be

responsible for handling glutaraldehyde. The following sections

provide general recommendations for safe work practices

addressing the transportation, storage, use, spill control, cleanup,

and disposal of glutaraldehyde. Individual facilities should tailor

their work practices to the specific glutaraldehyde operations in

place at their work sites.

Transportation and Storage of Glutaraldehyde

■ Transport glutaraldehyde solution only in closed containers

with tight-fitting lids to minimize the potential for spills (NICNAS,

1994).

■ Designate centralized locations for using glutaraldehyde to

reduce the potential for spills during transport.

■ Store unused glutaraldehyde solutions in tightly covered

containers in a cool, secured, and properly labeled area

(NICNAS, 1994; ANSI/AAMI, 1996). 

■ Dispose of outdated solutions properly.

Use and Handling Procedures

■ When transferring glutaraldehyde to soaking basins and

reservoirs, pour the liquid carefully and minimize splashing.

15
Minimize splashing and agitation of glutaraldehyde solutions by

careful placement and removal of instruments (NSW Health

Department, 1993).

■ When transferring and pouring glutaraldehyde solutions, use

safety nozzles designed with a flexible spout and shut-off valve,

when available (http://www.kemmed.com). 

■ Keep covers on soaking basins closed as much as possible and

use appropriately-sized, tight-fitting lids for containers.

■ Use appropriately-sized soaking basins designed to minimize

surface area (e.g., narrow, deep container) (ANSI/AAMI, 1996).

■ Keep automatic washer doors closed at all times except when

necessary for loading or unloading of instruments to be disinfected.

■ Rinse soaked instruments under gently running water as close

as possible to the soaking tray or washer to contain solution and

minimize dripping on other surfaces (NSW Health Department,

1993).

■ Use adequate ventilation if using compressed air to dry instruments rinsed with ethyl or isopropyl alcohol rinses. See

discussion on Engineering Controls at page 10 in this section.

■ Use glutaraldehyde only in designated areas where traffic and

ventilation can be controlled.

■ Ensure that the ventilation system is operating prior to handling

glutaraldehyde solutions. (Consult your facilities department for

help on how to check the operation of your ventilation system.)

NOTE: The odor threshold of glutaraldehyde has been reported

to be 0.04 parts per million (ppm), and odor detection is a

potential indicator that the engineering controls are inadequate.

However, you cannot always rely on odor detection because

some formulations may contain a perfume to mask the odor of

glutaraldehyde (ANSI/AAMI, 1996). Additionally, individuals vary

in their ability to detect odors; thus, the lack of an odor does not

necessarily mean that exposures are adequately controlled.

■ Follow recommended ACGIH procedures for proper use of

laboratory hoods (see Figure 3 at page 19).

16
■ Close workroom doors to ensure the effectiveness of any

available general dilution ventilation (NJDOHSS, 1998).

■ Do not store food, eat, drink, smoke, or apply cosmetics in any

area where glutaraldehyde is stored or used.

■ Clean up small glutaraldehyde spills and releases immediately.

In the case of large spills or delayed response, employees

should be encouraged to close doors, alert others and activate

the HazMat spill response team.

Alternatives to Glutaraldehyde for

High-Level Disinfection

When an alternative to glutaraldehyde is available which is at

least as effective as an FDA-approved high-level disinfectant, consideration should be given to whether the alternative is safer for

employees. Prior to selecting a specific glutaraldehyde alternative,

in addition to process and product considerations, consideration

should be given to the following: the toxicity of the glutaraldehyde

alternative (e.g., there may be limited knowledge regarding the

potential health effects of the alternative); disposal, ventilation,

personal protective equipment (PPE) and air monitoring requirements. 

Health care facilities that would like to eliminate or reduce their

dependence on glutaraldehyde as a high-level disinfectant have

two options: (1) use a different (drop-in) liquid chemical disinfectant (e.g., Cidex OPA, Compliance, Sporox II, and Sterilox); or (2)

invest in new enclosed equipment technologies that do not utilize

glutaraldehyde (e.g., Sterrad and Steris) (Sustainable Hospitals,

2001). Current alternatives to glutaraldehyde for high-level disinfection and/or sterilization can be found on the Food and Drug

Administration’s (FDA) website at www.fda.gov.cdrh/ode/germlab.

html. Material Safety Data Sheets (MSDSs) for each product can be

obtained directly from the manufacturer.

17
18

Selection and Use of Personal Protective Equipment

See the General Recommendations section of this publication at

page 23 for additional information on the selection and use of

personal protective equipment to control employee exposures to

glutaraldehyde. General information on employee training, exposure

monitoring, disposal of glutaraldehyde solutions, and spill and

cleanup procedures applicable to the use of glutaraldehyde as a

high-level disinfectant is also included.

GLUTARALDEHYDE USE AS

A TISSUE FIXATIVE

Primary Sources of Glutaraldehyde Exposure

Glutaraldehyde is used in some health care facilities as a fixative in

electron and light microscopy and as a tissue preservative.

Laboratory personnel may be exposed to solutions containing up

to 50% glutaraldehyde during the preparation of fixative solutions

for use in microscopy and histology, and to very small quantities

of working strength solutions (3-6%) during tissue fixation. If the

use is regular and exposure controls are lacking or ineffective,

adverse health effects may occur. Eye, skin, and respiratory

irritation have been reported for laboratory personnel engaged

in tissue fixing (NICNAS, 1994, NIOSH, 1986). The more serious

effects, such as skin/respiratory tract sensitization and asthma,

may occur in some exposed individuals. 

NIOSH has measured and reported air concentrations of glutaraldehyde as high as 1.5 mg/m3 (0.36 ppm) during tissue fixing

operations evaluated during maintenance procedures (NIOSH,

1984). The following activities are the primary sources of glutaraldehyde exposure during its use as a tissue fixative:

■ preparing glutaraldehyde solution from concentrate to fill

enclosed fixing basin;

■ draining and cleaning of fixing basin;

■ removing and adding materials (e.g., tissue sample) to the

fixing basin;

■ handling materials fixed in the basin;
19

■ handling tissue samples for refrigeration;

■ rinsing tissue samples in a buffer;

■ slicing tissue samples onto slides (NIOSH, 1986).

Recommended Exposure Controls

The use of a properly operating laboratory hood is the recommended method of controlling the exposures of laboratory

employees who use glutaraldehyde to prepare slides of tissue

samples. As discussed above, for employees who perform

instrument disinfection using glutaraldehyde, respirators should

not be the primary means of controlling exposure during these

laboratory operations. Appropriate PPE, such as gloves and

safety eyewear, should always be used in combination with the

laboratory hood. Guidelines for the proper use of laboratory

hoods are presented in Figure 3, below. These guidelines were

developed by the American Conference of Governmental

Industrial Hygienists (ACGIH). 

Figure 3. Recommended Work Practices for Laboratory Hoods

1. Keep all equipment at least 6 inches inside the hood.

2. Keep your head outside of the hood during all operations

involving hazardous chemicals.

3. Do not store chemicals or laboratory equipment inside the hood.

4. Keep the hood sash closed as much as possible.

5. Do not allow equipment to obstruct the air exhaust slots

inside the hood.

6. Avoid turbulence at the hood face by minimizing activity in

the vicinity of the hood.

7. Keep doors and windows closed when the hood is operating

(exception: where laboratories are designed to keep doors open).

8. Keep the hood sash at the proper operating height. Site Safety

and Health or Facilities personnel can provide assistance in

evaluating the hood to determine the hood sash location that

ensures optimum operation.

Source: ACGIH Industrial Ventilation, 2001.
Selection and Use of Personal Protective Equipment

See the General Recommendations section of this publication at

page 23 for additional information on the selection and use of

personal protective equipment to control exposures to glutaraldehyde. General information on employee training, exposure

monitoring, disposal of glutaraldehyde solutions and spill and

cleanup procedures applicable to the use of glutaraldehyde as a

tissue fixative is also included.

GLUTARALDEHYDE USE IN

X-RAY PROCESSING

Primary Sources of Glutaraldehyde Exposure

Health care facilities employees who develop x-rays may be

exposed to glutaraldehyde during such operations. Glutaraldehyde is used in developing solutions as a hardening agent to

shorten the drying cycle in film processing. X-ray developers are

typically supplied as a concentrate containing 30-50% weight-toweight ratio glutaraldehyde and are diluted to working strength

solutions containing less than 1-2% glutaraldehyde. Automatic

mixers are generally used to mix and dispense developing solutions;

however, smaller radiology units may still use manual methods.

The primary sources of glutaraldehyde exposure during x-ray

processing are as follows:

■ mixing glutaraldehyde developer solutions;

■ adding solutions to tanks and processors;

■ processing x-rays;

■ removing incompletely dried processed x-rays;

■ cleaning rollers and tanks on x-ray machines;

■ emptying tanks and processors;

■ fugitive emissions from open tanks and leaky 

hoses and equipment; and

■ automatic processor exhaust.

(Source: NICNAS, 1994.)

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Measurements of health care employee exposure to glutaraldehyde during x-ray film processing generally show glutaraldehyde levels below recommended exposure standards,

especially with automatic mixing and processing operations.

Efforts to minimize or eliminate occupational exposure are

recommended because glutaraldehyde is a potential sensitizer,

health effects may occur at levels lower than current standards,

and the effects of simultaneous exposure to multiple chemicals

used in developer and fixer solutions are not clearly understood

(NICNAS, 1994; Teschke et al., 2002).

Recommended Exposure Controls

As described for previous operations, the primary method of

exposure control is enclosing the operation and installing local

exhaust ventilation. The following sections describe methods of

exposure control during x-ray processing.

Alternative Processes

A good method of glutaraldehyde exposure control is substitution with a safer process that does not require the use of glutaraldehyde. There are commercially available processes that do

not require glutaraldehyde as a hardener (Thunthy et al., 1994).

Digital x-ray processors are also a viable substitute.

Engineering Controls

Where alternative processes cannot be implemented, engineering

controls should be implemented to minimize glutaraldehyde

exposure during film processing operations. Examples of engineering controls include:

■ installing automatic mixers and processors equipped with

local exhaust ventilation that is discharged to outdoors;

■ conducting manual mixing and processing within laboratory

fume hoods;

■ using sealed containers and dispensing units for automatic

transfer of glutaraldehyde solutions to processors;

■ maintaining glutaraldehyde work areas under slight negative
pressure to prevent glutaraldehyde emissions from escaping

into surrounding areas; 

■ keeping darkroom and processing temperatures as low as

possible to minimize glutaraldehyde evaporation.

(Source: NICNAS, 1994.)

Recommended Work Practices

Safe work practices for the use and handling of glutaraldehyde in

x-ray film processing include the following:

■ regular inspection and maintenance of auto mixers and

processors to prevent vapor releases due to leaks and

overheating;

■ placement and use of mixing tanks and glutaraldehyde

solutions in laboratory fume hoods or other enclosed, well

ventilated areas;

■ careful mixing and handling procedures to minimize vapor

release, splashing, spillage, and skin contact; 

■ use of tight-fitting lids on mixing tanks;

■ use of adequately-sized and properly located washing

receptacles for cleaning processor equipment and tanks;

■ limited handling of wet films; and

■ immediate cleanup of small glutaraldehyde spills and

releases. See the paragraph on large spills in the General

Recommendations section of this document at page 31.

(Source: NICNAS, 1994.)

Selection and Use of Personal Protective Equipment

See the General Recommendations section of this publication,

below, for additional information on the selection and use of

personal protective equipment. General information on employee

training, exposure monitoring, disposal of glutaraldehyde solutions

and spill and cleanup procedures applicable to the use of glutaraldehyde in x-ray processing is also included. 

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23

GENERAL RECOMMENDATIONS

APPLICABLE TO ALL USES OF

GLUTARALDEHYDE IN HEALTH CARE

The following recommendations apply to all health care operations

involving glutaraldehyde use, and cover:

■ selection and use of personal protective equipment;

■ employee information and training;

■ exposure monitoring;

■ disposal of glutaraldehyde solutions; and

■ spill control and cleanup procedures.

Selection and Use of Personal Protective Equipment

Employees must wear personal protective equipment (PPE)

designed to protect skin and eyes from contact with glutaraldehyde solutions (29 CFR 1910.132 and 1910.133). Contact with

clothing should also be prevented. The health care facility should

develop and implement a written program outlining the facility’s

policies and procedures for PPE selection and use, including a

hazard assessment and written certification that the hazard assesment has been performed (pursuant to the requirements of 29 CFR

1910.132) to determine the nature of the hazards requiring PPE.

Skin Protection

Employers must select and require employees to use appropriate

hand protection when employees' hands are exposed to potential

skin absorption of substances such as glutaraldehyde (29 CFR

1910.138). Gloves impervious to glutaraldehyde are required to be

worn to prevent contact with glutaraldehyde solutions. Elbowlength gloves or protective sleeves made of glutaraldehydeimpervious material should be worn to protect the hands and

forearms (ANSI/AAMI, 1996). The gloves used will depend on the

type of work to be done, the duration of contact, and the concentration of glutaraldehyde. Among the chemical-protective materials,

butyl rubber, nitrile and Viton® are the most impervious to 50%

glutaraldehyde solutions and have been shown to provide full

shift protection against glutaraldehyde permeation (Jordan et al.,
1996; Forsberg and Keith, 1999). For shorter exposures, gloves

made of polyethylene and styrene-butadiene/styrene-isoprene

copolymers (i.e., Allergard Synthetic Surgical Gloves) provide

protection for several hours with dilute (2% to 3.4%) glutaraldehyde solutions (Jordan et al., 1996; Ansell Health Care, 2003). 

Latex examination gloves may not provide adequate skin

protection against glutaraldehyde. Although one author reports a

breakthrough time of 45 minutes with latex examination gloves and

standard 2% to 3.4% glutaraldehyde solutions, other materials are

available that provide a greater margin of safety. Therefore, latex

gloves are not recommended for use with glutaraldehyde. 

Polyvinyl chloride (PVC) and neoprene gloves do not provide

adequate protection and should not be used with glutaraldehyde

solutions because they may retain or absorb glutaraldehyde

(Jordan et al., 1996). 

If the required hazard assessment (29 CFR 1910.132) indicates a

need for additional protection for skin and clothing, it can be

provided through the use of isolation gowns, lab coats, or aprons

(plus sleeve protectors) that are made of glutaraldehyde-impervious

material such as polyethylene-coated, spun-bond polypropylene.

Protective clothing that has become saturated should be removed

quickly and laundered prior to reuse. If skin contact with glutaraldehyde occurs, the skin should be washed thoroughly with soap and

water for at least 15 minutes (ANSI/AAMI, 1996).

Eye Protection

Splashproof goggles or safety glasses with full face shields must be

worn wherever there is potential for glutaraldehyde solution to

contact the eyes (29 CFR 1910.133). Suitable emergency eyewash

equipment must be immediately available for quick drenching or

flushing of the eyes (for at least 15 minutes) in all glutaraldehyde

usage locations. It is recommended that emergency eyewash units

be accessible and located within a 10 second travel time of all

affected areas. For additional details, consult American National

Standard Z358.1-1998, Emergency Eyewash and Shower Equipment. 

If an eyewash and a shower are required, a combination unit

should be considered.

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25

Respiratory Protection

Respirators should not be used as a substitute for installing

effective engineering controls. When effective engineering controls

are not feasible, or while they are being implemented, appropriate

respirators may be used to control employee exposure to glutaraldehyde vapor (29 CFR 1910.134(a)(1)).

All personnel who may be required to wear a respirator for

routine or emergency use must be included in a written respiratory

protection program that meets the requirements of OSHA’s

Respiratory Protection standard (29 CFR 1910.134). Such a program

must have written site-specific procedures for selecting, using, and

maintaining respirators; medical evaluations; fit testing; employee

training; and routine program evaluation.

Employers must select appropriate respirators based on an

exposure assessment or a reasonable estimate of employee

exposures to glutaraldehyde vapor during routine and/or emergency work procedures. For protection against exposures to glutaraldehyde vapor during routine procedures, employers may

provide air-purifying respirators (i.e., a half-face or full-face airpurifying respirator with organic vapor cartridges), or air-supplying

respirators.

If air-purifying respirators are provided, employers must

implement a change-out schedule for air-purifying canisters and

cartridges to ensure that they are changed before the end of their

service life. Change-out schedules must be developed by consulting

the respirator manufacturer cartridge or canister test data and

evaluating workplace conditions such as estimated glutaraldehyde

concentrations, temperature, relative humidity, and employee

breathing rate. Cartridge or canister service life calculation formulas

are also available on the OSHA website, www.osha.gov. 

Air-supplied respirators should be used when exposures may be

reasonably anticipated to be higher and for unknown exposures,

such as emergency spill situations. 

All respirators used must be certified by the National Institute

for Occupational Safety and Health (NIOSH) and must be appropriate for use with glutaraldehyde (29 CFR 1910.134(d)(1)(i) and (ii)).

The disposable air-purifying particulate respirators (filtering face-
pieces) are not effective against organic vapors, and must not be

used for glutaraldehyde protection.

Employees who voluntarily choose to wear respirators, but

who are not required by their employers or OSHA to wear a

respirator, must still receive the information in Appendix D to 29

CFR 1910.134. See OSHA’s Respiratory Protection standard, 29

CFR 1910.134, for further details regarding the requirements for

employee use of respirators.

Employee Information and Training

All employers with glutaraldehyde solutions or other hazardous

chemicals in their workplaces must develop and implement a

written hazard communication program that meets the requirements of OSHA’s Hazard Communication standard, 29 CFR

1910.1200. Such a program must include provisions for employee

access to material safety data sheets (MSDSs), container labeling,

and training for all potentially exposed individuals. 

Employees who use, handle, or may have potential exposure

(e.g., accidental or possible) to glutaraldehyde solutions must be

provided information and training prior to their initial work assignment. Employees must be provided information regarding the

requirements of the Hazard Communication standard; operations

in their work area where glutaraldehyde solutions (and other

hazardous chemicals) are present; and the location and availability

of the written hazard communication program and material safety

data sheets (MSDSs).

Employee training must include, at a minimum, the following

elements (29 CFR 1910.1200):

■ methods and observations that may be used to detect the

presence or release of glutaraldehyde in the workplace;

■ the physical and health hazards of glutaraldehyde;

■ the measures employees can take to protect themselves,

including specific procedures the employer has implemented

to protect employees from exposure to glutaraldehyde, such

as appropriate work practices, emergency procedures, and

personal protective equipment; and

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27

■ an explanation of the material safety data sheet, the employer’s

labeling system, and how employees can obtain and use the

appropriate hazard information.

Exposure Monitoring

Workplace exposure monitoring should be conducted to ensure a

safe work environment and to compare monitoring results with

recommended occupational exposure limits for glutaraldehyde.

Monitoring should be conducted after initiating use of glutaraldehyde solutions; whenever there is a significant change in protocol,

work practices, caseload, or workplace ventilation systems; and

after major equipment (e.g., endoscope washers or other automated equipment) repairs (ANSI/AAMI, 1996). Exposure monitoring should also be conducted if employees have complaints or

symptoms of glutaraldehyde exposure.

Monitoring should be conducted in all glutaraldehyde use areas

as well as in the breathing zone of each employee using or handling

glutaraldehyde solutions. Special attention should be given to shortterm tasks that may have elevated exposures such as pouring,

mixing or otherwise agitating glutaraldehyde solutions.

Several air sampling methods are available for monitoring

glutaraldehyde exposures. These methods include active and

passive sampling techniques as well as the use of a directreading instrument. Active air sampling uses battery-powered

personal sampling pumps and treated filters or sorbent tubes for

sample collection. Passive sampling uses small, lightweight,

easy-to-use badge assemblies that rely on natural air movement

rather than pumps for sample collection. After sampling, the filters

or sorbent tubes and passive monitors should be sent to a laboratory for analysis. Accredited laboratories have demonstrated

their ability to meet performance standards and are preferred. The

OSHA website at www.osha.gov/dts/sltc/methods/organic/org064/

org064.html and NIOSH at www.cdc.gov/niosh/nmam/pdfs/

2532.pdf may be consulted for additional information regarding

validated sampling and analytical methods for glutaraldehyde. In

addition, the American Industrial Hygiene Association

(www.aiha.org) may be consulted for a listing of consultants and

accredited industrial hygiene laboratories. 
A direct-reading, handheld, easy-to-use, portable instrument

called the “Glutaraldemeter” may also be used to compare

monitoring results with recommended glutaraldehyde exposure

limits as well as to determine concentrations resulting from spills

and other emergencies.

Active air sampling methods require sampling expertise and

special sampling supplies and should be performed by an industrial

hygienist or other qualified professional trained in industrial hygiene

air sampling strategies and techniques. Passive monitors and the

Glutaraldemeter do not necessarily require sampling expertise

and can be used by health care personnel to evaluate workplace

exposures. Proper use of passive monitors may be determined by

consulting the manufacturer’s instructions and/or the laboratory

that will conduct the analyses. Proper use and maintenance of the

Glutaraldemeter may be determined by consulting the equipment

manufacturer (e.g., MSA or PPM Technology). 

Active sampling methods are more sensitive and reliable than

passive monitors/badges and the Glutaraldemeter. Quantitative

limits of detection (LOD) for the active methods are in the range

of 0.44 ppb (parts per billion), while the reliable LOD for passive

methods and the Glutaraldemeter are in the range of 20-100 ppb.

Disposal of Glutaraldehyde Solutions

Dispose of glutaraldehyde solutions in accordance with local,

state, and Federal regulations. Check with your local Publicly

Owned Treatment Works (POTW) to determine if glutaraldehyde

solutions can be disposed of in the sanitary sewer system. Some

POTWs may prohibit the disposal of glutaraldehyde solutions in

the sanitary sewer system or may require neutralization prior to

disposal. If there are no disposal restrictions, glutaraldehyde

solutions may be disposed of, along with copious amounts of cold

water, into a drain connected to the sanitary sewer system. Do not

discard glutaraldehyde solutions (including neutralized solutions)

into septic systems. Unlike municipal sewage treatment systems,

septic systems are not diluted by other waste streams. Consequently, glutaraldehyde concentrations entering the system may be

28
29

higher and have an adverse effect on the microorganisms that are

necessary for proper functioning of the septic system. Dispose of

empty glutaraldehyde containers according to product label instructions.

Spill Control and Cleanup Procedures

All glutaraldehyde spills have the potential to create vapor concentrations that exceed recommended exposure limits. Vayas et

al. (2000) measured airborne concentrations during two spills

that occurred during their study. The TWA exposures to glutaraldehyde were 0.27 mg/m3 (0.06 ppm) for a spill of about one

liter in an unventilated room, and 0.439 mg/m3 (0.11 ppm) for a

spill greater than 5 liters in a positive pressure theater. Niven et al.

(1997) also reported on glutaraldehye monitoring results (as high as

1.4 ppm) from various spill scenarios. Consequently, a suitable

plan of action with procedures for handling glutaraldehyde spills

should be developed and implemented by knowledgeable and

responsible individuals at the facility. In the development of this

plan, consideration should be given to the physical characteristics of the area(s) where glutaraldehyde solutions are used (e.g.,

type and effectiveness of ventilation, room size and temperature)

as well as the quantity and concentration(s) of the solution(s).

The spill control plan should incorporate the following key

elements (ANSI/AAMI, 1996):

■ designation of individuals responsible for managing spill

cleanup;

■ evacuation procedures for nonessential personnel, if

necessary;

■ medical treatment procedures for exposed individuals;

■ site-specific reporting requirements (e.g., site safety and

health personnel);

■ cleanup procedures, the location of spill control supplies, and

required personal protective equipment;

■ location and availability of material safety data sheets (MSDSs)

for glutaraldehyde-based sterilants/disinfectants and manufacturer recommendations for emergency response;
■ employee training requirements;

■ air exchange rate(s) within the areas of use and procedures to

prevent the dispersal of glutaraldehyde vapor to other areas of

the facility through the general ventilation system; and

■ respiratory protection program requirements pertaining to

glutaraldehyde.

General Procedures

All spills should be cleaned up immediately, regardless of size.

All necessary spill cleanup equipment (e.g., sponges, towels,

absorbent mats/wipes, spill pillows, mop and bucket, plastic dustpan and trash bags) and personal protective equipment (i.e., eye,

hand, body and respiratory protection) should be readily available.

Whether or not a spill can be cleaned up safely without the use of

neutralizing chemicals and/or a respirator will depend on a number

of factors such as the glutaraldehyde concentration and the amount

spilled, the temperature of the room and the solution, and the

effectiveness of the ventilation in the spill area. (ANSI/AAMI,

1996). Any spill larger than a drip or a splash may need to be

neutralized; and, when vapor concentrations are unknown, airsupplied or atmosphere-supplying respirators are appropriate.

Neutralizing Chemicals

Before using any type of glutaraldehyde-based product, review the

manufacturer’s recommendations for spill cleanup. Several

chemicals can be used to lower the glutaraldehyde concentration in

solutions and/or the ambient vapor level during a spill. Examples

include household ammonia, ammonium carbonate powder, dibasic

ammonium phosphate, and sodium bisulfite. Glycine is also used

as a neutralizer, and may be less hazardous than others. There are

also commercially available products for this purpose (ANSI/AAMI,

1996), including powders, solutions, and salts.

Drips and Splashes

A reusable or disposable sponge, towel, or mop may be used to

quickly clean up small spills. Glutaraldehyde solutions can also

be neutralized with an appropriate chemical agent before wiping

30
31

up with a sponge, towel, or mop. Cleanup supplies should be

thoroughly rinsed with large amounts of water prior to reuse.

Rinse water and disposable cleanup supplies should be discarded

according to applicable regulations as well as the procedures

outlined in the facility spill control plan (ANSI/AAMI, 1996). 

Drips and splashes may also be cleaned up with commercially

available spill control kits that contain mats/wipes to absorb and

neutralize small spills. The absorbed medium should be disposed

of according to local, state and Federal regulations. 

Large Spills

Any glutaraldehyde spill larger than small drips or splashes

should be cleaned up by properly trained and equipped spill

response personnel. Certain larger spills of glutaraldehyde are

covered by the requirements of OSHA’s Hazardous Waste

Operations and Emergency Response standard (29 CFR 1910.120(q)). 

Pre-planning for spills is a critical piece of the facility exposure

control plan. Personnel should understand the necessity to

evacuate until the spill is cleaned up and the worksite is safe for

reentry of employees. Appropriate spill-response equipment

placed outside the affected area for access after the area is

evacuated will facilitate compliance with the emergency spill

response plan. Supplied air respirators are an important

component of a spill-response kit. Appropriate training on the use of

the respirators is an important piece of the pre-spill planning, so that

spill responders are adequately equipped and trained. 

Large spills should be contained and neutralized or contained

and collected for disposal. Once contained, spills may be

neutralized with an appropriate chemical agent such as sodium

bisulfite (2-3 parts (by weight) per part of glutaraldehyde solution)

with a contact time of 5 minutes at room temperature, using a mop

or other tool to thoroughly blend in the deactivation compound.

A less hazardous neutralizer, glycine, can be used in a ratio of 25

grams per gallon of 2.4% glutaraldehyde solution to neutralize in

5 minutes. Depending on the size of the spill and site conditions,

heat and vapor may be liberated by the reaction with the neutral-
izing chemicals (ANSI/AAMI, 1996). Commercially available spill

pillows and booms may also be used to easily contain, absorb,

and/or neutralize large glutaraldehyde spills. 

After the glutaraldehyde solution is removed, the spill area

and the cleanup supplies/tools should be thoroughly rinsed with

large amounts of cold water. Rinse water, disposable cleanup

supplies and absorbent medium (if used) should be disposed of

according to applicable regulations and the procedures outlined

in the facility spill control plan (ANSI/AAMI, 1996).

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National Institute for Occupational Safety and Health (NIOSH).

2001. Glutaraldehyde: occupational hazards in hospitals. Online

at http://cdc.gov/niosh/2001-115html

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Sustainable Hospitals. 2001. The Lowell Center for Sustainable

Production. Sustainable Hospitals Project. Glutaraldehyde control in

hospitals. Available online at http://www.sustainablehospitals.org/

HTMLSrc/IP_Glutcontrol.html

Stern, M.L., et al. Contact hypersensitivity response to glutaraldehyde in guinea pigs and mice. Toxicol Ind Health, 5(1):31-

43, 1989. 

Teschke, K., Chow, Y., Brauer, M., Chessor, E., Hirtle, B.,

Kennedy, S.M., Yeung, M.C. and H.D. Ward. 2002. Exposures

and their determinants in radiographic film processing. Am Ind

Hyg Assoc J, 63:11-21.

Thunthy, K.H., Yeadon, W.R. and R.Winberg. 1994.

Sensitometric and archival evaluation of Kodak RA films in dental

automatic processing. Oral Surg Oral Med Oral Pathol, 77(4):

427-430. 

University of North Carolina-Chapel Hill Health and Safety

Manual. http://www.ehs.unc.edu/manuals/HSMManual/

Chapter5html/h5-03.htm

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Vyas, A., Pickering, C.A., Oldham, L.A., Francis, H.C., Fletcher,

A.M., Merrett, T., and R. M. Niven. 2000. Survey of symptoms,

respiratory function, and immunology and their relation to glutaraldehyde and other occupational exposures among endoscopy

nursing staff. Occup Environ Med, 57:752-759.

Waters, A., Beach, J., and M. Abramson. 2003. Symptoms

and lung function in health care personnel exposed to glutaraldehyde. Am J Ind Med, 43:196-203.
OSHA Assistance

OSHA can provide extensive help through a variety of programs,

including technical assistance about effective safety and health

programs, state plans, workplace consultations, voluntary protection programs, strategic partnerships, training and education,

and more. An overall commitment to workplace safety and health

can add value to your business, to your workplace and to your life.

Safety and Health Program Management Guidelines

Effective management of employee safety and health protection is

a decisive factor in reducing the extent and severity of work-related

injuries and illnesses and their related costs. In fact, an effective

safety and health program forms the basis of good employee

protection and can save time and money (about $4 for every

dollar spent) and increase productivity and reduce employee

injuries, illnesses and related workers’ compensation costs.

To assist employers and employees in developing effective

safety and health programs, OSHA published recommended Safety

and Health Program Management Guidelines (54 Federal Register

(16): 3904-3916, January 26, 1989). These voluntary guidelines

apply to all places of employment covered by OSHA.

The guidelines identify four general elements critical to the

development of a successful safety and health management

program:

■ Management leadership and employee involvement.

■ Work analysis.

■ Hazard prevention and control.

■ Safety and health training.

The guidelines recommend specific actions, under each of 

these general elements, to achieve an effective safety and health

program. The Federal Register notice is available online at

www.osha.gov 

State Programs

The Occupational Safety and Health Act of 1970 (OSH Act) encourages states to develop and operate their own job safety and

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health plans. OSHA approves and monitors these plans. Twentyfour states, Puerto Rico and the Virgin Islands currently operate

approved state plans: 22 cover both private and public (state and

local government) employment; Connecticut, New Jersey, New

York and the Virgin Islands cover the public sector only. States and

territories with their own OSHA-approved occupational safety and

health plans must adopt standards identical to, or at least as

effective as, the Federal standards. 

Consultation Services

Consultation assistance is available on request to employers who

want help in establishing and maintaining a safe and healthful

workplace. Largely funded by OSHA, the service is provided at no

cost to the employer. Primarily developed for smaller employers

with more hazardous operations, the consultation service is delivered by state governments employing professional safety and

health consultants. Comprehensive assistance includes an appraisal

of all mechanical systems, work practices and occupational safety

and health hazards of the workplace and all aspects of the employer’s present job safety and health program. In addition, the

service offers assistance to employers in developing and implementing an effective safety and health program. No penalties are

proposed or citations issued for hazards identified by the consultant. OSHA provides consultation assistance to the employer

with the assurance that his or her name and firm and any information about the workplace will not be routinely reported to OSHA

enforcement staff.

Under the consultation program, certain exemplary employers

may request participation in OSHA’s Safety and Health

Achievement Recognition Program (SHARP). Eligibility for participation in SHARP includes receiving a comprehensive consultation

visit, demonstrating exemplary achievements in workplace safety

and health by abating all identified hazards and developing an

excellent safety and health program.

Employers accepted into SHARP may receive an exemption

from programmed inspections (not complaint or accident investigation inspections) for a period of one year. For more information

concerning consultation assistance, see the OSHA website at

www.osha.gov
Voluntary Protection Programs (VPP)

Voluntary Protection Programs and on-site consultation services,

when coupled with an effective enforcement program, expand

employee protection to help meet the goals of the OSH Act. The 

three levels of VPP are Star, Merit, and Star Demonstration

designed to recognize outstanding achievements by companies

that have successfully incorporated comprehensive safety and

health programs into their total management system. The VPPs

motivate others to achieve excellent safety and health results in the

same outstanding way as they establish a cooperative relationship

between employers, employees and OSHA.

For additional information on VPP and how to apply, contact the

OSHA regional offices listed at the end of this publication.

Strategic Partnership Program

OSHA’s Strategic Partnership Program, the newest member of

OSHA’s cooperative programs, helps encourage, assist and

recognize the efforts of partners to eliminate serious workplace

hazards and achieve a high level of employee safety and health.

Whereas OSHA’s Consultation Program and VPP entail one-on-one

relationships between OSHA and individual worksites, most

strategic partnerships seek to have a broader impact by building

cooperative relationships with groups of employers and employees. These partnerships are voluntary, cooperative relationships between OSHA, employers, employee representatives and

others (e.g., labor unions, trade and professional associations, 

universities and other government agencies). 

For more information on this and other cooperative programs,

contact your nearest OSHA office, or visit OSHA’s website at

www.osha.gov

Alliance Programs

The Alliance Program enables organizations committed to

workplace safety and health to collaborate with OSHA to prevent

injuries and illnesses in the workplace. OSHA and the Alliance 

participants work together to reach out to, educate and lead the

nation’s employers and their employees in improving and advancing workplace safety and health. 

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Groups that can form an Alliance with OSHA include employers,

labor unions, trade or professional groups, educational institutions

and government agencies. In some cases, organizations may be

building on existing relationships with OSHA that were developed

through other cooperative programs. 

There are few formal program requirements for Alliances and

the agreements do not include an enforcement component. However, OSHA and the participating organizations must define, implement and meet a set of short- and long-term goals that fall into

three categories: training and education; outreach and communication; and promoting the national dialogue on workplace safety and

health. 

OSHA Training and Education

OSHA area offices offer a variety of information services, such as

compliance assistance, technical advice, publications, audio-visual

aids and speakers for special engagements. OSHA’s Training

Institute in Arlington Heights, IL, provides basic and advanced

courses in safety and health for Federal and state compliance

officers, state consultants, Federal agency personnel, and private

sector employers, employees and their representatives.

The OSHA Training Institute also has established OSHA Training

Institute Education Centers to address the increased demand for its

courses from the private sector and from other Federal agencies.

These centers are nonprofit colleges, universities and other organizations that have been selected after a competition for participation

in the program.

OSHA also provides funds to nonprofit organizations, through

grants, to conduct workplace training and education in subjects

where OSHA believes there is a lack of workplace training. Grants

are awarded annually. Grant recipients are expected to contribute

20 percent of the total grant cost.

For more information on grants, training and education, contact

the OSHA Training Institute, Office of Training and Education, 2020

South Arlington Heights Road, Arlington Heights, IL 60005, (847)

297-4810 or see “Training” on OSHA’s website at www.osha.gov.

For further information on any OSHA program, contact your

nearest OSHA area or regional office listed at the end of this

publication.
Information Available Electronically

OSHA has a variety of materials and tools available on its website

at www.osha.gov. These include e-Tools such as Expert Advisors,

Electronic Compliance Assistance Tools (e-cats), Technical Links;

regulations, directives and publications; videos and other

information for employers and employees. OSHA’s software programs and compliance assistance tools walk you through challenging safety and health issues and common problems to find the best

solutions for your workplace.

A wide variety of OSHA materials, including standards, interpretations, directives, and more, can be purchased on CD-ROM from

the U.S. Government Printing Office, Superintendent of Documents,

phone toll-free (866) 512-1800.

OSHA Publications

OSHA has an extensive publications program. For a listing of

free or sales items, visit OSHA’s website at www.osha.gov or

contact the OSHA Publications Office, U.S. Department of Labor,

200 Constitution Avenue, NW, N-3101, Washington, DC 20210.

Telephone (202) 693-1888 or fax to (202) 693-2498. 

Contacting OSHA

To report an emergency, file a complaint or seek OSHA advice,

assistance or products, call (800) 321-OSHA or contact your nearest

OSHA regional or area office listed at the end of this publication.

The teletypewriter (TTY) number is (877) 889-5627.

You can also file a complaint online and obtain more information on OSHA Federal and state programs by visiting OSHA’s

website at www.osha.gov

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OSHA Regional Offices

* These states and territories operate their own OSHA-approved job

safety and health programs (Connecticut, New Jersey, New York and the

Virgin Islands plans cover public employees only). States with approved

programs must have standards that are identical to, or at least as effective

as, the Federal standards.

Note: To get contact information for OSHA Area Offices, OSHAapproved State Plans and OSHA Consultation Projects, please visit us

online at www.osha.gov or call us at 1-800-321-OSHA.

Region I

(CT,* ME, MA, NH, RI, VT*) 

JFK Federal Building, Room E340

Boston, MA 02203

(617) 565-9860

Region II

(NJ,* NY,* PR,* VI*)

201 Varick Street, Room 670

New York, NY 10014

(212) 337-2378

Region III

(DE, DC, MD,* PA, VA,* WV)

The Curtis Center

170 S. Independence Mall West

Suite 740 West

Philadelphia, PA 19106-3309

(215) 861-4900

Region IV 

(AL, FL, GA, KY,* MS, NC,* SC,* TN*)

61 Forsyth Street, SW

Atlanta, GA 30303

(404) 562-2300

Region V

(IL, IN,* MI,* MN,* OH, WI)

230 South Dearborn Street 

Room 3244

Chicago, IL 60604

(312) 353-2220

Region VI

(AR, LA, NM,* OK, TX)

525 Griffin Street, Room 602

Dallas, TX 75202

(214) 767-4731 or 4736 x224

Region VII

(IA,* KS, MO, NE)

City Center Square

1100 Main Street, Suite 800

Kansas City, MO 64105

(816) 426-5861

Region VIII

(CO, MT, ND, SD, UT,* WY*)

1999 Broadway, Suite 1690

PO Box 46550

Denver, CO 80202-5716

(720) 264-6550

Region IX 

(American Samoa, AZ,* CA,* HI,* NV,*

Northern Mariana Islands)

71 Stevenson Street, Room 420

San Francisco, CA 94105

(415) 975-4310

Region X

(AK,* ID, OR,* WA*)

1111 Third Avenue, Suite 715

Seattle, WA 98101-3212

(206) 553-5930
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www.osha.gov