Use of topical biocide HYDREX for skin disinfection

recently introduced into hospital product is licencesed as a biocide contains 2% chlorhexidine in isopropyl alcohol also applied by use pump dispenser generating a mist. Previous product 0.5% chlorhexidine and applied use of swab in solution. Basis for Increase in % chlorhexidine is to improve efficacy of skin disinfection. re MRSA ,HIA etc Irritant symptoms of cough shortly after use in staff using HAVE others in health care establishments had problems with chest symptoms ? removed product ref in BMJ 8 april 1989 Dr Waclawski to occupational asthma in nurses caused by chlorhexidine/alcohol aerosols Waclawski ER, McAlpine LG, Thomson NC, Occupational asthma in nurses due to chlorhexidine and alcohol aerosols, Br Med J, 1989;298:929-930,

Occupational Asthma, Employer, 12/5/2008, 12/10/2008,

Biocides as a group are likely to cause occupational asthma, particularly when inhaled. Some seem to cause more problems than other (particularly glutaraldehyde). There are a number of reports with chlorhexidine, I don't know of anybody who has done any intervention replacing it with something else but in general it would be much safer to mop it rather than spray it. Pham NH, Weiner JM, Reisner GS, Baldo BA, Anaphylaxix to chlorhexidine. Case report. Implication of immumoglobulin E antidodies and identification of an allergenic determinant, Clin Exp Allergy, 2000;30:1001-1007, Waclawski ER, McAlpine LG, Thomson NC, Occupational asthma in nurses due to chlorhexidine and alcohol aerosols, Br Med J, 1989;298:929-930, Layton GT, Stanworth DR, Amos HE, The incidence of IgE and IgG antibodies to chlorhexidine, Clin Exp Allergy, 1989;19:307-314, Ohtoshi T, Yamauchi N, Tadokoro K, Miyachi S, Suzuki S, Miyamoto T, Muranaka M, IgE antibody-mediated reaction caused by topical application of chlorhexidine, Clin Allergy, 1986;16:155-161,

12/10/2008