CHEMICAL AGENT
IN HOSPITAL
Oleh :
Reny Indrayani, M.KKK.
Bag. Kesling dan K3 FKM UNEJ
TYPE OF CHEMICAL HAZARDS
Health hazards These are properties of a chemical that have
the potential to cause adverse health effects. Adverse health
effects can be acute (short term) or chronic (long term).
Physicochemical hazards Result in injury to people and/or
damage to property. Examples of physicochemical hazards include
flammable, corrosive, explosive, chemically reactive and oxidising
chemicals.
Many chemicals have both health
and physicochemical hazards
ASSESSING HEALTH RISKS
Things to consider in assessing health risks :
The physical form
The routes of entry
Inhalation and skin absorption are the most common routes by which workplace
chemicals enter the body
Dose or Concentration
Toxicity
Risk = Toxicity x Dose
TOXICITY
TOXICITY
Acute Toxicity Chronic Toxicity
Short-term Long-term
Single Exposure Multiple Exposures
LEVEL OF ACUTE TOXICITY
Acute Toxicity
Refers to those adverse effects occurring following oral or dermal
administration of a single dose of a substance, or multiple doses given within
24 hours, or an inhalation exposure of 4 hours.
LD stands for "Lethal Dose". LD50 is the
amount of a material, given all at once,
which causes the death of 50% (one half)
of a group of test animals.
LC stands for "Lethal Concentration. The
concentrations of the chemical in air that
kills 50% of the test animals during the
observation period is the LC50 value
ACUTE TOXICITY HAZARD CATEGORIES
Sumber : http://www.ilo.org/legacy/english/protection/safework/ghs/ghsfinal/ghsc05.pdf
GOVERNMENT REGULATION
Undang-Undang RI No. 1 Tahun 1970
Tentang Keselamatan Kerja
Kepmenakertrans RI No. 187 Tahun 1999
Tentang Pengendalian Bahan Kimia di Tempat Kerja
Permenakertrans RI No. 13 Tahun 2011
Tentang NAB Fakor Fisika dan Kimia di Tempat Kerja
Kepmenkes RI No. 432 Tahun 2007
Tentang Pedoman Manajemen Kesehatan dan
Keselamatan Kerja di Rumah Sakit
HAZARD FAKTOR KIMIA RS
Sumber : Kemenkes RI Nomor 432/MENKES/SK/IV/2007
DISINFECTANT
TYPES OF ANTIMICROBACTERIALS
Sanitizers Disinfectants Sterilizer
Reduce Germs Kill viruses, bacteria Kill ALL microbes
and fungi
*Not spores
LEVEL OF DISINFECTION
1
Low level disinfection:
Low level disinfectants kill most
vegetative bacteria and some fungi as
well as enveloped (lipid) viruses (e.g.,
hepatitis, hantavirus, and HIV).
Low level disinfectants do not kill
mycobacteria or bacterial spores.
Sumber :
BCCDC. 2003. A Guide to Selection and Use of
Disinfectant
LOW LEVEL DISINFECTION
Phenol
Phenol is commonly found in mouthwashes, scrub soaps and surface
disinfectants, and is the active ingredient found in household
disinfectants (e.g. Lysol, Pine Sol).
This class of compounds is used for decontamination of the hospital
environment, including laboratory surfaces, and noncritical medical
items.
Phenolic disinfectants are generally
safe, but prolonged exposure to the
skin may cause irritation.
LEVEL OF DISINFECTION
2
Intermediate level disinfection:
Intermediate level disinfectants kill
vegetative bacteria, most viruses and
most fungi but not resistant bacterial
spores
INTERMEDIATE LEVEL
Alcohols Sodium hypochlorite
Alcohols are flammable. Sodium hypochlorite may
They also evaporate rapidly produce skin and ocular
Alcohol irritates tissues. irritation or oropharygeal,
esophageal, and gastric
burns.
corrosiveness to metals in
high concentrations
release of toxic chlorine gas
when mixed with ammonia
or acid.
LEVEL OF DISINFECTION
3
High level disinfection:
High level disinfection processes destroy
vegetative bacteria, mycobacteria, fungi
and enveloped (lipid) and nonenveloped
(non lipid) viruses, but not necessarily
bacterial spores.
HIGH LEVEL DISINFECTION
Formaldehyde
Formaldehyde is a colorless, flammable gas at room temperature and
has a strong odor
It is used as a disinfectant and sterilant both in the liquid and gaseous
states. The aqueous solution is bactericidal, tuberculocidal, fungicidal,
virucidal and sporicidal
Formaldehyde can cause irritation of
the skin, eyes, nose, and throat. High
levels of exposure may cause some
types of cancers.
Bacteria with Spores (B. subtilis, C. tetani,
C.difficile, C. botulinum)
Least
Susceptible Protozoa with Cysts (Giardia lablia,
Cryptosporidium parvum)
Mycobacteria (M. tuberculosis, M.
aviumintracellulare, M. chelonae)
Non-Enveloped Viruses (Coxsachievirus,
poliovirus, rhinovirus, Norwalk-like Virus, hepatitis A
virus)
Intermediate level Disinfectant
Fungi (Candida species, Cryptococcus species,
Aspergillus species, Dermatophytes)
High level Disinfectant
Low level Disinfectant
Vegetative Bacteria (Staphylococcus aureus,
Salmonella typhi, Pseudomonas aeruginosa,
Chemical Sterilant
coliforms)
Most Enveloped Viruses (Herpes simplex, varicella-
zoster virus, cytomegalovirus, measles virus, mumps
Susceptible
virus, rubella virus, influenza virus, influenza virus,
respiratory syncytial virus, hepatitis B & C viruses,
hantavirus and human immunodeficiency virus)
EPA PESTICIDE TOXICITY CATEGORIES
Level disinfectant level of toxicity to human
Intermediate Level
Disinfectant
EPA pesticide toxicity
Categories #1
Higly Toxic
Oral Irritates digestive system
Dermal Corrosive, severe skin damage
Inhalation Asthma-like symptopms
Eye Permanent, corrosive damage
HOW ARE WORKERS EXPOSED TO DISINFECTANTS ?
DISINFECTANT EXPOSURE
Spilling and Splashing when
handling the product
Mixing disinfectant with
incompatible cleaning product
Putting disinfectant into food
and drink containers
Failing the follow the label
instructions
PREVENT SPIILLS & SPLASHES
Point containers away from
Occur during mixing, application,
body when opening, pouring
and pulling a disinfecting wipe out
or pulling wipes from
of its container
container
Wear Appropriate Personal
Equipment (PPE)
PPE & CLOTHING REQUIREMENT
MIXING DISINFECTANT
Mixing disinfectant with other Example : Together, bleach and
cleaning products can be very ammonia can produce
harmful to your health extremely harmful gases that
can be lethal
MIXING DISINFECTANT
Other cleaning Products You Should NEVER Mix! NEVER !
MIXING DISINFECTANT
Other cleaning Products You Should NEVER Mix! NEVER !
MIXING DISINFECTANT
Other cleaning Products You Should NEVER Mix! NEVER !
AVOID FOOD & DRINK CONTAINERS
Each year, people ingest
pesicides stored in unlbeled
food and drik containers
Always store pesticides in
original container with label
PESTICIDES CONTAINERS
READING THE LABEL
Benefits fo reading labels :
1. How to use the product
safely
2. How to use it effectively
3. How to use it legally
READING THE LABEL
Matur Thank You
