Chemical exposures & Pregnancy

Editorial Team / Admin · Dec 12, 2014

Definitely talk to your OB, and it would probably be helpful to take a copy of the MSDS with you.

dishes, BSN, RN · Dec 13, 2014

Were the publications you researched from the CDC National Institute of Health and Safety?

naptimeRN · Dec 14, 2014

I was unable to find anything about pregnancy in all of the documents on the CDC website. I e-mailed them asking if there is any further literature. From a document on the department of health California website I found "Reproductive System: Whether glutaraldehyde can affect the reproductive system has not been studied thoroughly. In limited studies, it did not harm the offspring of animals exposed during pregnancy. Glutaraldehyde is believed to be unlikely to affect pregnancy or reproductive function so long as exposure levels are below those that cause noticeable symptoms". Most sources say there has not been sufficient studies on this and I'm not sure how good I feel about negative affects during pregnancy are "Believed to be unlikely".

The CDC website mentions proper ventilation and monitoring to be done to ensure breathing in exposure is limited. We have a tiny, tiny old ventilation fan in a tiny room where the chemicals are and I have never heard of or seen any monitoring of the air levels done. Hmm...

dishes, BSN, RN · Dec 14, 2014

I read the same as you, they cannot do research on pregnant humans. You only have a ventilation fan, no fume hood? Do you wear the proper gloves, mask, goggles and gown when disinfecting the scopes and changing the solution? Suggest you email your manager and occupational health nurse and ask if the clinic's current practice meets the NIOSH guidelines for handling of glutaraldehyde.

Also, the AUA and SUNA published a joint white paper on reprocessing of flexible cystoscopes, it is available on both of their websites, have you read it?

naptimeRN · Dec 14, 2014

Dishes, I had not read it , but just did with your recommendation. I am going to need to talk to my manager. We only have the tiny ceiling ventilation fan, and that's an upgrade from what they used to have. Before I came here, they used to keep the sterilization chemicals in the patient rooms! Crazy!

I know most places do short-cuts due to time constrains and financial reasons and such, I'm just thinking working with chemicals that have been shown to have negative effects on health with exposure is not the place to do it (for patient safety too, of course!) People always leave the tops off the soaking tubs too and I can always tell because the chemical smell is so strong in the hallway (there is no door). My husband does not like that I am continuing to work here while pregnant due to the chemical and radiation exposure, I am just trying to figure out what is best. I don't want to make any irrational decisions, but also do not want to risk things.

dishes, BSN, RN · Dec 14, 2014

I recommend showing the link and a hard copy of the white paper to not only your manager but your colleagues and the urologists as well, the more staff who are informed the better. Everyone should be following the guidelines in the paper. Since the soaking tub lids have been left off frequently, it seems the staff were not properly trained in the first place, this can be remedied with a mandatory staff education session.

Is the radiation exposure from video urodynamics?

naptimeRN · Dec 15, 2014

We use fluoroscopy during lithotripsy, stent insertions, PNE, retrograde pyelograms, etc. I do Urodynamics but it does not involve any radiation where I work.

I agree that staff, myself included, was not properly trained to work with the chemicals. Those documents were definitely eye openers! I have been a bit concerned about working with them and breathing in fumes since starting there, but now even more so.

Thank you, I appreciate your response with this and your suggestions.

dishes, BSN, RN · Dec 15, 2014

Do you wear a dosimeter badge? Now that you are pregnant are you having the dosimeter badge processed every 2 weeks instead of every three months? Are you wearing a lead apron?

naptimeRN · Dec 15, 2014

I wear a lead apron and thyroid cover when in the room with fluoroscopy. I just recently found out I was pregnant, so I will be wearing two dosimeter badges which was discussed, but I am not sure how often they will be processed now. I will have to inquire about that to make sure it's every 2 weeks. I would like to not have to work right up next to the patient and the fluoro like I must do when assisting with stent insertion due to the very close proximity, but I'm not sure if that would be accommodated.

I work in a hospital per diem where I do not use chemicals and I'm not around radiation. My husband would like me to just work at the hospital while pregnant to avoid the chemicals and rad. I didn't think I would become pregnant so soon and had not put much thought yet into what I would do in terms of my jobs, so here I am trying to figure things out...

I guess I am more concerned about the chemicals since there is less research on it and obviously my work place is not following all of the safety protocols such as monitoring air levels, proper ventilation, etc. I have no real health issues but have had several severe migraines while working there and that made me wonder if it could be related to breathing in those fumes in a tiny, not well ventilated room throughout the day.

dishes, BSN, RN · Dec 15, 2014

I think asking not to stand right up next to the patient during fluoroscopy, while pregnant is a reasonable request. There is more information on staff radiation exposure during urologic procedures than glutaraldehyde exposure, but if it is any reassurance, I do know of pregnant nurses who were exposed to glutaraldehyde fumes in conditions similar to yours, no fume hood, improper ventilation, no air monitoring and they had healthy babies.