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
Alcohols are flammable.
They also evaporate rapidly
Alcohol irritates tissues.
Sodium hypochlorite
Sodium hypochlorite may
produce skin and ocular
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