MEDICAL SURVEILLANCE FOR ETHYLENE-OXIDE EXPOSURE - PRACTICES AND CLINICAL FINDINGS IN MASSACHUSETTS HOSPITALS

The medical surveillance requirements of the Occupational Safety and H ealth Administration's (OSHA) ethylene oxide (EtO) standard became eff ective in 1985. However, little is known about the nature of the respo nse of EtO users to this regulatory requirement. In an effort to begin to understand this, we conducted a survey of EtO health and safety in Massachusetts hospitals (n = 92). We determined the cumulative incide nce of provision of EtO medical surveillance, the characteristics of t he surveillance interventions provided, and the clinical findings of E tO medical surveillance efforts in Massachusetts hospitals. From 1985 to 1993 medical surveillance for EtO exposure was provided one or more times in 62% of EtO-using hospitals. Sixty-five percent of EtO medica l surveillance providers reported performance of all five medical surv eillance procedures required by OSHA's EtO standard. Medical surveilla nce provider certification in occupational medicine or nursing, and a greater extent of coverage of written medical surveillance policies, w ere related to higher likelihoods of fulfillment of OSHA-required proc edures. Twenty-seven percent of medical surveillance providers reporte d detection of EtO-related symptoms or conditions, ranging from mucous membrane irritation to peripheral neuropathy. These findings reveal w idespread implementation of OSHA-mandated EtO medical surveillance, wi th concomitant incomplete fulfillment of OSHA-specified procedures. Fr om the provider-based survey, we estimate that one or more workers at 19% of EtO-using Massachusetts hospitals have experienced EtO-related health effects.