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Fumigationofoperationtheatres 110705072247-phpapp01


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Fumigation slide show

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Fumigationofoperationtheatres 110705072247-phpapp01

  3. 3. WHAT IS FORMALDEHYDE?DR.T.V.RAO MD 3• Formaldehyde has the chemical elements carbon, hydrogen andoxygen in its structure. Hydrocarbons are among the mostcommon of chemical compositions. The human body includeshydrocarbons among its elements and compounds, and itrequires formaldehyde to metabolize biochemical substances.• Formaldehyde is usually sold as an aqueous or watery solutioncalled formalin, which contains 37 to 50 percent formaldehydeby weight. It is soluble in water, but not in most organic solvents,except alcohol and ether. It is principally used to produce resins,other industrial chemicals, and consumer items and as abactericide or fungicide.
  4. 4. HOW CAN FORMALDEHYDE AFFECT OURHEALTH?DR.T.V.RAO MD 4• Based on the best available evidence in OSHA’s record on formaldehyde,OSHA determined that formaldehyde isgenotoxic, showing properties of botha cancer initiator and promoter (early and late stage carcinogen). Wheninhaled, formaldehyde is a carcinogen in rats. In humans, formaldehydeexposure has been associated with cancers of the lung,nasopharynx andoropharynx, and nasal passages• When humans are exposed to excess levels of formaldehyde, adverse healtheffects can result. Symptoms of excess exposure include respiratoryirritation; watery, itchy eyes; itchy, runny, or stuffy nose; dry or sore throat;and headache.• The EPA and OSHA recognize that contact with formaldehyde can causeskin irritation and dermatitis.
  5. 5. FUMIGATION• Formaldehyde a Age old compound.• Low temp heating produce vapor• Vapor phase decontaminates the air/environment.• Kills vegetative bacteria / Spore ?• When Formaldehyde mixed with water and exposed toelevated temperature• Gaseous formaldehyde is generatedTime X TempDR.T.V.RAO MD 5
  6. 6. FUMIGATION• To sterilize the operation theatre formaldehydegas (bactericidal & sporicidal,viricidal) is widelyemployed as it is cheaper for sterilization ofhuge areas like operation theatres.Formaldehyde kills the microbes by alkylating theamino acids and sulfhydryl group of proteins andpurine bases.• In spite of the gas being hazardous continuesto be used in several developing countriesDR.T.V.RAO MD 6
  7. 7. FUMIGATION• Fumigation usually involves the following phases:First the area to be fumigated is usually covered tocreate a sealed environment; next the fumigant isreleased into the space to be fumigated; then, thespace is held for a set period while the fumigantgas percolates through the space and acts on andkills any infestation in the product, next the spaceis ventilated so that the poisonous gases areallowed to escape from the space, and render itsafe for humans to enter.DR.T.V.RAO MD 7
  8. 8. PROCEDURE OF FUMIGATION• Thoroughly clean windows, doors, floor, walls andall washable equipments with soap and water.• Close windows and ventilators tightly. If anyopenings found seal it with cellophane tape orother material.• Switch off all lights, A/C and other electrical &electronic items• Calculate the room size in cubic feet (L×B×H)and calculate the required amount offormaldehyde as given inDR.T.V.RAO MD 8
  9. 9. • Adequate care must betaken by wearing cap,mask, foot cover,spectacles• Formaldehyde is irritant toeye & nose; and it hasbeen recognized as apotential carcinogen.• So the fumigatingemployee must be providedwith the personal protectiveequipments.PERSONAL CARE DURING FUMIGATIONDR.T.V.RAO MD 9
  10. 10. • Electric Boiler FumigationMethod: For Each 1000 cu.ftof the volume of the operationtheatre 500ml offormaldehyde (40% solution)added in 1000ml of water inan electric boiler. Switch onthe boiler, leave the room andseal the door. After 45 minutes(variable depending to volumepresent in the boils apparatus)switch off the boiler withoutentering in to the room .CREATING THE FORMALDEHYDE GASDR.T.V.RAO MD 10
  11. 11. METHODS ON FUMIGATION• In principle we have togenerate Formaldehyde gas.• Can be done by Most easierway to mix the neededquantity of Formalin to waterand heating at lowertemperatures at 800c – 900cCan done also with addition ofFormalin to potassiumpermanganateDR.T.V.RAO MD 11
  12. 12. ADDING POTASSIUM PERMANGANATE TOFORMALDEHYDE..• Potassium Permanganate Method: For every1000 cubic feet add 450gm of Potassiumpermanganate (KMnO4) to 500 ml offormaldehyde (40% solution). Take about 5 to 8bowels (heat resistant; place it in variouslocations) with equally divided parts offormaldehyde and add equally divided KMnO4 toeach bowel. This will cause auto boiling andgenerate fume.• After the initiation of formaldehyde vapour,immediately leave the room and seal it for atleast 48 hours.DR.T.V.RAO MD 12
  13. 13. FUMIGATION TO BE NEUTRALIZED• Neutralize Residualformalin gas withAmmonia by exposing250 ml of Ammonia perliter of Formaldehydeused.• Place the ammoniasolution in the centre ofthe room and leave it for 3hours to neutralize theformalin vapourDR.T.V.RAO MD 13
  14. 14. AN EXAMPLE IS SET AS..• Operation Theatre Volume = L×B×H = 20 × 15 × 10 =3000 cubic feet• Formaldehyde required for fumigation = 500 ml for1000 cubic feet• = So 1500 ml of formaldehyde required• Ammonia required for neutralization = 150ml of 10%ammonia for 500 ml of formaldehyde• = So 450 ml of 10% ammonia requiredDR.T.V.RAO MD 14
  15. 15. • Inhaling formaldehyde canlead to symptoms such asa burning sensation andirritation in eyes, nose andthroat, coughing, wheezing,tightness in throat, wateryeyes and runny nose. It canalso lead to breathlessness.Pulmonary edema andpneumonitis can be causedif it injures the respiratorytract.WHAT ARE THE SYMPTOMS OFFORMALDEHYDE ALLERGY?DR.T.V.RAO MD 15
  16. 16. • Formaldehyde allergysymptoms include redness,burning sensation, skinrash, scaling, cracking,white discoloration andirritation of skin and mightcause hives as well. Eyecontact can cause pain,inflammation, blurred visionand excess tearing.FORMALDEHYDE ALLERGYDR.T.V.RAO MD 16
  17. 17. First thing to do in case of any allergy is toavoid contact with the substance causingallergic reaction. With formaldehydepresent in so many things, it might bedifficult to do so. If your skin or eyes comein direct contact with formaldehyde, youmust soon flush that part with a lot of coldwater. If you observe the formaldehydeallergy symptoms after consuming food,then you must drink a lot of water or milkso as to dilute it and consult a physiciansoon. In case of a skin reaction, topicalointments used for eczema and contactdermatitis might be prescribed by yourdoctor for allergy reliefWHAT IS THE FORMALDEHYDE ALLERGY TREATMENT?DR.T.V.RAO MD 17
  18. 18. • Formaldehyde is listed by theInternational Agency for Research onCancer as probably carcinogenic tohumans, on the basis of animalevidence and at least limited humandata (IARC group 2A); listed by theNational Toxicology Program asreasonably anticipated to becarcinogenic; listed by ACGIH as anA2 Industrial Substance Suspect ofCarcinogenic Potential for Man; andOSHA, in its formaldehyde standard(29 CFR 1910.1048), considersformaldehyde potential carcinogen.Formaldehyde (gas) is a chemicalknown to the state of California tocause cancer.FORMALDEHYDE AS CARCINOGENDR.T.V.RAO MD 18
  19. 19. NEED FOR NEWER CHEMICAL AGENTS INHOSPITAL USE• 1. A need for NonAldehyde basedChemicals is growingconcern• 2 Need for quickersterilization methods withever increasing workloads.• 3. Need for non toxic safeagents.DR.T.V.RAO MD 19
  21. 21. BACILLOCID® RASANT• Formaldehyde-freedisinfectant cleanerwith low useconcentration verygood cost/benefit ratiogood materialcompatibility excellentcleaning propertiesvirtually no residueDR.T.V.RAO MD 21
  22. 22. • Bacillocid special® Is a surfaceand environmental disinfectant®Has a very good cleansingproperty along with bactericidal,virucidal , sporicidal andfungicidal activity• ®Composition• ® Each 100 g contains: • 1.6Dihydroxy 11.2G ® ( Chemicallybound formaldehyde) •Glutaraldehyde 5.0• Benzalkoniumchloride 5.0 • Alkyl ureaderivatives 3.0gCOMMERCIALLY AVAILABLEDISINFECTANTDR.T.V.RAO MD 22
  23. 23. BACILLOCID® RASANT• Active ingredients: Glutaral 100 mg/g, benzyl-C12-18-alkyldimethylammonium chlorides 60 mg/g,didecyl-dimethylammonium chloride 60 mg/g.• Bacillocid® rasant is suitable for the disinfectantcleaning of washable surfaces using the wet-wipe-procedure.• Especially suitable for economic short-termdisinfection in risk areas that are likely sources ofinfectionDR.T.V.RAO MD 23
  24. 24. • Provides complete asepsiswithin 30 to 60 mts.• ® Cleaning with detergentor carbolic acid• not required• ® Formalin fumigation notrequired• ® Shutdown of O.T. for 24hrs not requiredBACILLOCID® ADVANTAGESDR.T.V.RAO MD 24
  25. 25. • A Chemical compoundVIRKON gainingimportance as nonAldehyde compound.• Virkon proved to be safeVirucidalBactericidal,FungicidalMycobactericidalNEWER AND NON TOXIC COMPOUNDS.DR.T.V.RAO MD 25
  26. 26. VIRKON A MULTIPURPOSE DISINFECTANTDR.T.V.RAO MD 26• Virkon is a multi-purpose disinfectant. It contains oxone(potassium peroxymonosulphate), sodiumdodecylbenzenesulfonate, sulphamic acid; and inorganicbuffers. It is typically used for cleaning up hazardous spills,disinfecting surfaces and soaking equipment. The solution isused in many areas, including hospitals, laboratories, nursinghomes, funeral homes, medical, dental and veterinary facilities,and anywhere else where control of pathogens is required.• Virkon has a wide spectrum of activity against viruses, somefungi, and bacteria. However, it is less effective against sporesand fungi than some alternative disinfectants.
  27. 27. • As a Chemical disinfectant.• Disinfects Medical devices.• Disinfects Laboratoryequipment.• Decontaminate spillageswith Blood and body fluids.• Finding usefulness inreplacing autoclaving andsaving time.VIKRON IS FINDING PLACE INDR.T.V.RAO MD 27
  28. 28. • Virkon® S has a uniqueformulation; no other disinfectanthas the same powerfulcomposition. In terms of efficacyVirkon® S has been proven highlyeffective against 65 strains of virusin over 19 viral families, 400 strainsof bacteria and over 100 strains offungi. This list of proven efficacyincludes the major OIE List Adiseases of concern; AvianInfluenza (H5N1), NewcastleDisease, Classical Swine Fever(Hog Cholera) and Foot andMouth Disease.VIRKON® S HAS A UNIQUEFORMULATIONDR.T.V.RAO MD 28
  29. 29. • Do not useUVGI in theoperatingtheatre toprevent Surgicalsite infections.ULTRAVIOLET GERMICIDAL IRRADIATION(UVGI)DR.T.V.RAO MD 29
  30. 30. INFECTION CONTROL IS MULTIDISCIPLINARYAPPROACH• Despite the limited time spent by patients in the operationtheatre (in majority of circumstances), the environment ofoperation theatre plays a great role in the onset and spread ofinfection due to multifactor causation of infection.• Hence, it becomes essential to study the epidemiology ofinfection as a multidisciplinary approach. In resource poorcircumstances as in most developing countries, it is believedthat though routine Microbiological monitoring is most essential,in reality it is not practicable. But it is the responsibility of everyhospital to pay good attention in proper maintenance of airconditioning plants, ventilator systems, and to have greatercontrol on mechanisms and personnel involved in disinfectionand sterilization of materials used in the theatres in operativeprocedures.DR.T.V.RAO MD 30
  31. 31. • Several Chemicalsare available butthe EconomicLimitation are greathurdle in exploringthe Utility inDevelopingcountriesECONOMIC CONSIDERATIONS COMPROMISES SAFECHEMICAL APPROACHESDR.T.V.RAO MD 31
  35. 35. • Created by Dr.T.V.Rao MD for ‘e’ learningresources for Microbiologists and Healthcare Workers in Developing World• Email• doctortvrao@gmail.comDR.T.V.RAO MD 35