Fumigation
Procedure
Formaldehyde vapor is an
extremely effective biocidal agent. It acts as an alkylating agent,
inactivating micro-organisms by reacting with carboxyl, amino, hydroxyl and
sulphydral groups of proteins as well as amino groups of nucleic acid bases. Fumigation
is effective at above the temperature of 20ÂșC and relative humidity of 65%.
Formalin is commercially
available as 40% solution of formaldehyde in water. When formalin is heated
formaldehyde vapor is generated. Formaldehyde is a Schedule 1 chemical under
the COSHH (Control of Substances Hazardous to Health) Regulations and has a
Maximum Exposure Limit (MEL) of 2 ppm. But, concentrations encountered during
fumigation is many hundred times higher than this, so fumigation procedure must
be carried out only by trained personnel under strictly defined conditions. All
workers using formaldehyde must be aware of safe handling procedures.
Under certain conditions
formaldehyde can react with hydrochloric acid and chlorine containing
disinfectants such as hypochlorites to form chlormethyl ether, a potent lung
carcinogen. So hydrochloric acid and chlorine-containing disinfectants must be
removed from the room before fumigation.
Step 1:
Preparation
- Thoroughly clean windows, doors, floor, walls, surgery table and all washable equipments with soap and water.
- Close windows and ventilators tightly. If any openings found seal it with cellophane tape or other material to avoid the leak of fume.
- Switch off all lights, A/C and other electrical & electronical items.
- Calculate the room size (surgical theater only) in cubic feet (L×B×H) and calculate the required amount of formaldehyde as given in step 3.
Step 2:
Precaution
- Adequate care must be taken by wearing cap, mask, foot cover, spectacle etc.,
- Formaldehyde is irritant to eye & nose; and it has also been recognized as a potential carcinogen.
- So the fumigating person must be provided with the personal protective equipments (PPE).
- Paste a warning notice on the front door indicating fumigation is in progress.
Step 3:
Fumigation
- Electric Boiler Fumigation Method (Recommended): For Each 1000 cubic feet, 500 ml of formaldehyde (40% solution) added in 1000 ml of distilled water (if not available use tap water) in an electric boiler. Switch on the boiler, leave the room and seal the door. After 45 minutes (variable depending to volume present in the boils apparatus/its heating proficiency) switch off the boiler without entering in to the room (Switch off the main from outside).
or
- Potassium Permanganate Method: Here the heat generation is induced by an oxidizer - Potassium permanganate (KMnO4), which results in auto boiling and generates fume from formaldehyde. Take 500 ml of formaldehyde (40% solution) in 1000 ml of distilled water (if not available use tap water) in a heat resistant bowel, preferably in a steel bucket and then add 450gm of KMnO4 for 1000 cubic feet of theater volume. Repeat the same in separate bucket for every another 1000 cubic feet until it reaches the complete theater volume. It is important to add KMnO4 to all buckets simultaneously to reduce the exposure to fume (i.e., need 3 or 4 persons at different location).
- After the initiation of formaldehyde vapor, immediately leave the room and seal it for at least 12 to 24 hours.
Step 4: Neutralization
- Before neutralization, formaldehyde fumigation system should be taken out from the surgical theater. Then the toxicity of formaldehyde vapor should be neutralized with ammonia solution.
- Place a cotton ball and pour 300 ml of 10% ammonia (for each 500 ml of formaldehyde used) on the floor of surgical theater, at least 4 hours before (07 a.m.) the “Sterility Test”.
- Formaldehyde gas reacts with ammonia gas and produce hexamine (synonym hexamethylenetetramine) which is considered a harmless substance.
- Switch on the A/C, at least 2 hours before (09 a.m.) the “Sterility Test”.
Example:
Surgical Theater Volume = L×B×H = 20 × 15 × 10 = 3000 cubic feet
Note: Make it into nearest 1000, if the volume is in
fractions
Formaldehyde required for fumigation = 500 ml for
1000 cubic feet
= So, 1500 ml of formaldehyde required (to be diluted in 3000 ml of
distilled water)
Ammonia required for
neutralization = 300 ml of 10% ammonia for 500 ml of formaldehyde
= So 900 ml of 10%
ammonia required