The Less Stress Book (A Consumers’ Institute Guide, NZ, 1997) does provide some understanding of why many health professionals describe ill-health from chemical exposure as stress . From p29:
PHYSICAL SIGNS OF STRESS
“Tiredness, fatigue. Difficulty catching breath, frequent deep sighing, shallow, rapid breaths
Cold hands. Muscular tension. Clenched jaw.. stiff neck, frequent fidgety movement, difficulty keeping still. Grinding teeth, sore muscles, tight stomach. Frequent urge to urinate. Diarrhoea and stomach upsets, heartburn. Increased illness - especially colds that won’t go, small rashes.
Headaches, migraines, tinnitus. Easily startled, jumpy, nervous, anxious. Trembling or shaking
Significant weight change (without dieting).
BEHAVIOURAL AND PERFORMANCE SIGNS OF STRESS
Difficulty sleeping; sleep not restorative. Changes in appearance; slippage in personal standards
Routines break down; apathy and indifference. Reduced activity levels’; a tendency to ‘cruise’ or ‘blob out’. Mental disorganisation, difficulty concentrating, forgetting things. Multi-tasking inefficiently... Missing deadlines, meetings, appointments (not just very occasionally). Work piles up; quality breaks down. Avoidance of certain situations or people. Calls not returned. Absences; increased sick days. Increased use of alcohol, drugs, partying, overeating.
RELATIONSHIP AND EMOTIONAL SIGNS OF STRESS
Cynical, hostile or rigid attitudes to work or other circumstances. Hardening of stances on touchy issues. Reduced tolerance; inability to see both sides of an issue; grumpy with children or partner
Marked mood swings or changes. Unhappiness with life; finding fault, irrational blaming.
Powerful emotions - distress, anger, fear - closer to the surface. Withdrawal from friends, lovers
Avoidance of social situations and commitments. Sexual appetite falls away. Able to talk only about ‘problems’.”
HEALTH AND SAFETY
As chemical illnesses resulting from workplace exposures are preventable illnesses, it is scandalous that with the knowledge of the dangers of these chemicals, people have continued to have been, and are still being made ill. In X-ray, if the chemical can’t be eliminated or substituted for, the process should be enclosed and ventilated. In theatre, glutaraldehyde remains an outstanding cheap sterilant as long as excellent ventilation/handling is present. This means dedicated local exhaust ventilation eg behind/below the developer or decontamination unit (GA is heavier than air) and sufficient general room ventilation ensuring the recommended number of air changes per hour, (between 10-20 air changes are suggested in various sources) with good directional air flow to avoid fumes being drawn into the breathed-air flow. Fume adsorbers don’t replace good ventilation. New research has shown that the absorbstar filters are not as effective because of the increased humidity levels needed in the darkrooms.
Centralise use of chemicals. Pouring GA disturbs the surface tension and releases GA into the air. Note that health problems are being reported from products replacing glutaraldehyde (eg peracetic acid as a sterilant) despite calculated levels in the atmosphere being almost negligible.[1] Note also, if using GA, thorough cleaning of scopes before soaking is critical as glutaraldehyde bonds protein in place inside the scopes. Put dried scopes in to soak so as not to dilute the GA. The FDA requires scopes to be soaked 45 mins @ 25º.
Monitor the level of chemicals. Minimise the number of people exposed. Reduce the period of exposure. Clean regularly. Store and dispose safely so fumes cannot escape.
Check out environmental requirements. It is not acceptable to tip the waste untreated down the drain. Union Carbide, manufacturers of glutaraldehyde, Ucarsan®, state the product “should not be disposed of by draining into a sewer system or natural waterways. They could be toxic to the biomass of biological waste treatment systems or to aquatic life in natural waters. The situation is complicated by the inclusion of quaternary ammonium compounds in glutaraldehyde formulations which can be toxic to fish.”
‘Neutralin’, manufactured by National Diagnostics, neutralises all aldehydes by converting them into nonhazardous, non-toxic, non-corrosive, polymer and water. You buy a 5 gallon pail which is ready to receive 5 gallons of 4% formaldehyde (10% formalin) .
Under 1996 regulations in the UK (and in Europe), likely in force end of 1998, most photographic solutions must be labelled “Special (Hazardous) Waste” because of the ammonium thiosulphate and each consignment will incur a £15 fee.[2]
Use low-allergy latex gloves for short term use (GA penetrates latex) or nitrile gloves for longer periods and suitable masks/respirators eg organic vapour masks, for short term possible high exposure (eg changing chemicals). Filters in activated carbon filter masksmust be changed according to a regular programme - once the filter is saturated there is no barrier to any further contaminant passing through to the wearer’s lungs. High humidity affects their life. In some situations one solvent may displace another releasing the first substance into the lungs. The respirator should be stored in a clean sealed container.[3] Goggles are compulsory; an eyewash station should be near. Rinse the eye for 15 mins. Contact lenses may bond to the eye. Do not smoke, eat, drink in the area. Small spills can be neutralised with ammonia. Larger spills require a special clean-up team. A personal health surveillance system is essential. Glutaraldehyde-free Xray chemicals are available. Equipment has to be regularly inspected and maintained and procedures developed. A good publication detailing all of the above in X-Ray is Photosol’s Safety with Chemicals and Fumes (1997). Note that problems can still arise from air conditioning, building materials, photocopiers etc.
[1]BSG Working Party Report, UK, 1997
[2]RAD Magazine, Nov, 1998, p25.
[3]Gardner G. How long will your filter last? Safeguard. Nov/Dec 1998.
