OSHA requirements are set by statute, standards and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult OSHA's website at https://www.osha.gov.

June 12, 1986

Peggy Weaver, S.T.
c/o Bronson Methodist Hospital
252 E. Lovelle Street
Kalamazoo, Michigan 49007

Dear Ms. Weaver:

Thank you for your letter dated May 13, inquiring if scrubbing with an iodophor disinfectant for approximately 35 minutes per day can result in adverse effects in operating room personnel.

Firstly, I want to reassure you regarding the use of iodine based soap solution. Povidine-iodine solution is an effective disinfectant used extensively in the hospital setting for several years with few documented adverse effects. Although, you did not mention the concentration of iodine in the disinfectant solution you use, most currently used povidine-iodine solutions have relatively low iodine content compared to earlier iodine solutions. Most of the iodine absorbed will be protein-bound, and any adverse effects will result from the free iodine. We were unable to find reports of adverse reactions (other than hypersensitivity reactions) to povidine-iodine after application to hands and forearms such as that which occurs in the operating room. Also, we found no reports of iodine levels in hospital personnel after such application of this agent. Provided that operating room staff have healthy skin and wash off the solution after scrubbing, absorption of iodine should be minimal.

Iodine can be absorbed after ingestion, inhalation and application to the skin and mucous membranes. Skin application infrequently causes irritation and hypersensitivity reactions. Serious reactions have been documented in burn patients and after intra-operative cavity applications. Absorption in these instances would certainly be greater than that experienced after surgical scrubbing of healthy skin.

Although , iodine solutions have more irritating effects to the skin and less residual antimicrobial activity than some of the other disinfectant solutions, it also appears to be one of the safer agents. I am including an article comparing the various properties of disinfectant agents that will provide you with further detail and an excellent bibliography.

Please do not hesitate to contact us if we can be of further assistance. We hope this information will be helpful to your committee.

Sincerely,

Ralph Yodaiken, M.D., M.P.H.
Director
Office Of Occupational Medicine