Keywords: enzyme cleaners, adverse effects, protective measures
Sterilization and supply room staff is a special group of people engaged in special work in a special environment is responsible for a variety of clinical use of examination, treatment of instruments and dressing packages recovery, classification, cleaning, cleaning and disinfection, packaging, sterilization, distribution and other work, in this series of processes, faced with a number of occupational injuries and unsafe factors, threatening the health of staff. factors, threatening the health of the staff [1]. Enzymatic cleaning agents used in the cleaning of medical devices, applied at home and abroad for many years, multi-enzyme cleaning agents for the complex structure, the surface is not smooth, with pores in the cleaning of organic matter of medical devices is very important, but the enzyme cleaning fluid should be noted in the process of using the matter and the harm caused by the not have been paid attention to.
1 enzyme cleaning agent role
1.1 The principle of action is to decompose large molecules of fats, proteins, sugars and other organic substances into water-soluble small molecules, so as to achieve the purpose of cleaning.
1.2 Multi-enzyme cleaning agent mainly contains hydrolytic enzymes of proteins, fats, mucopolysaccharides and carbohydrates, which have strong dissolving and removing ability for pus, blood and other secretions on the articles, especially the dirt dried on the surface.
1.3 Enzymatic cleaners can increase the ability to remove microorganisms on the surface of the items when cleaning, can enter the deep lumen, penetrate all surfaces of the lumen and decompose the organic matter, reduce the bioburden on the surface of the object by 3 to 5 logarithmic levels.
2 Classification of enzyme cleaners
2.1 The main use of microbial fermentation to produce a variety of enzyme preparations. Single enzyme and multi-enzyme [1]: cleaning the use of enzyme cleaners contain at least 1 enzyme (single enzyme cleaner), the use of enzyme cleaners used in medical device cleaning, you must use multiple enzyme cleaners, multiple enzyme cleaners must contain at least 4 kinds of enzymes: protease, lipase, cellulase and amylase. Protease: catalyzes the hydrolysis of proteins. Amylase: an enzyme that generally acts on soluble starch, straight-chain starch, glycogen and other α-1,4-glucans to hydrolyze α-1,4-glycosidic bonds. Cellulase: an enzyme that acts as a biocatalyst in the breakdown of cellulose. Lipase: catalyzes the hydrolysis of natural substrate fats and oils to produce fatty acids, glycerol, and glycerol monoesters or diesters.
2.2 Powder enzyme and liquid enzyme Powder state of the enzyme cleaner industrial technology is low, most of the single enzyme, easy to have residue, activity is relatively low, dilution is easy to cause uneven dissolution, incomplete, solubility is difficult to control, easy to splash the human skin, mucous membranes caused by damage.
3 enzyme cleaner adverse effects
3.1 Multi-enzyme cleaner in the configuration process is easy to form aerosols, the human respiratory tract, skin irritation, and even chemical bronchitis or pneumonia symptoms. Enzyme immersion disinfection after cleaning, long-term exposure to the human skin, nervous system, gastrointestinal tract have adverse effects [3]. 3.2 At present, there are many types of medical enzyme cleaners, and the quality requirements, enterprise production standards and product specifications are inconsistent. Multi-enzyme cleaning agents generally also contain stabilizers, preservatives and bleaching agents. Stabilizers and preservatives prevent mutual destruction of enzymes and maintain the stability of the enzyme solution; rinsing agents can remove and prevent the re-accumulation of dirt. Some domestic . Enzyme cleaners use highly toxic ethylene glycol as stabilizer. Glycol is mainly used as antifreeze and stabilizer, colorless, odorless, sweet, non-volatile, non-corrosive, inhalation of human body will cause chronic poisoning, pregnant women and the fetus in the womb has a serious impact, and may even cause deformities, and men will reduce the number of spermatozoa, indirectly affecting fertility.
4 Protective measures
4.1 Strengthen health education and training, improve the understanding of occupational protection, the establishment of occupational exposure protection system, strengthen the knowledge of occupational safety and protection learning.
4.2 When using enzyme cleaners, the operation should be standardized. First of all, when choosing a multi-enzyme cleaning agent, you should choose a liquid, clear and transparent, no bubble or less bubble, uniform and no impurities, with bleaching and cleaning function, optimal water temperature requirements, no restriction on the water quality of the multi-enzyme detergent. Master the correct configuration method, enzyme detergent can not be sprayed, in contact, should wear a round hat, mask, rubber gloves, protective mask, rubber shoes. At the same time in the use of immersion, ultrasound instruments, because of its volatility, exposure to the air is easy to cause respiratory irritation symptoms so it should be sealed with a lid, if accidentally splashed into the eyes, should be immediately rinsed with flowing water.
4.3 Strengthen hand hygiene, work should be completed as soon as possible to remove the contaminated gloves, immediately standardized hand washing.
4.4 Regularly open the windows to ventilate, regularly open the exhaust fan. To reduce the content of harmful gases in the air.
4.5 Annual health checkups to strengthen the protection of personnel in the disinfection and supply center, and the establishment of health records.
4.6 Reasonable scheduling, monthly shifts are adjusted to avoid prolonged exposure to enzyme cleaners, reduce occupational injuries, and advocate the concept of people-oriented management.
4.7 Usually strengthen physical exercise, adequate rest, enhance physical fitness.
5 experience
The nature of the work of the disinfection supply room determines the staff during the work of the possibility of obtaining hospital-acquired infections is very large, in the whole process of operation, at any time there are biological, physical, chemical and other occupational exposure factors, we not only pay attention to common hazards, but also to a comprehensive understanding of the hazards that are usually ignored such as the cleaning agent and disinfectant factors, the occupational protection is particularly important. For these, occupational protection is particularly important. Occupational protection of supply room personnel should first start from prevention, strengthen occupational safety and technical operation training, especially to strengthen the training of new nurses, caregivers; strict implementation of the operating procedures, strengthen the awareness of safety and protection, create a safe and healthy working environment, improve the necessary protective instruments and equipment.
References
[1]Zhang Chunfei, Wu Junling, Ying Yongfang. Occupational hazards and protection of hospital supply room staff [J]. Chinese Journal of Sterilization, 2008, 25(6):687-688.
[2]Wei Lihe. Problems associated with enzymatic washing of medical devices [J]. Chinese Journal of Misdiagnosis, 2007, 10(7):5726～5727.
[3]Zheng ZL, Guo K. Harmful factors affecting supply room nurses. Harmful factors endangering supply room nurses and preventive measures[J]. The Sixth Sterilization Supply Center Development Forum, 2010, 8:897～898. ;