Hospitals clean out allergy, asthma triggers

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by Jon Brodkin, Daily News, 22 Oct 2006

It's no surprise a severe asthma attack can force someone to go to the hospital. It might surprise some to learn chemicals and substances commonly found inside hospitals can cause asthma or trigger asthma attacks.

Cleaning products, latex gloves, pesticides, dust, mold and even some medications can cause or exacerbate asthma, according to a report issued Wednesday by Health Care Without Harm, an international coalition of 450 groups trying to make the health care industry safer.

"Ironically, many products that are used in hospitals to keep patients, visitors and personnel safe from pathogens represent some of the very same products that have some potential to cause or exacerbate asthma in susceptible individuals," the report states.

Low doses of certain chemicals can trigger attacks in asthma patients, said Polly Hoppin, a report co-author who directs the Environmental Health Initiative at UMass-Lowell.

Janitors, nurses and laboratory technicians are also exposed to harmful chemicals, she said.

Hospital officials have long been aware that cleaning chemicals and other substances may pose harm, even if they have not thought about the potential link to asthma, said Susan Macdonald, infection control practitioner at Newton-Wellesley Hospital.

Newton-Wellesley officials have replaced many chemicals with safer alternatives. The challenge is finding replacements that are cost-effective and perform their tasks well, whether it be cleaning, disinfecting, sterilizing or killing bugs.

"That's always the trick for hospitals," Macdonald said. "You're trying to balance the risk of the product and the chemical in question with its overall efficiency."

Newton-Wellesley stopped using most latex products and latex gloves years ago, except for certain products that are made only with latex and in surgeries where latex gloves are more effective than substitutes, Macdonald said.

Medical products are not the only concern. MetroWest Medical Center in Framingham and Natick does not allow visitors to bring in latex balloons, said Beth Donnelly, hospital spokeswoman. Doctors and nurses at the hospital do use latex gloves, unless a patient is allergic to them, she said.

"Doctors prefer to use the latex gloves. They have a better feel," Donnelly said.

Newton-Wellesley has stopped most usage of the disinfectant glutaraldehyde, and stopped all use of ethylene oxide, a sterilizer, Macdonald said. Getting rid of bleach, a known irritant, has been more difficult, she said.

"It's the most effective environmental cleaner in certain situations," Macdonald said. "We've not been able to completely eliminate it. We've tried to be judicious in its use."

MetroWest Medical Center no longer uses bleach, ammonia or formaldehyde in any cleaning products, said Linda Campbell, director of quality, risk management and safety. The hospital's use of chemicals is limited by its membership in the Massachusetts Water Resources Authority, which does not allow certain substances to be discharged into the waste stream, Campbell said.

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