The effect of scrubbing hands with iodine-containing solutions on urinary iodine concentrations of the operating room staff.

Background: Excessive iodine exposure is associated with thyroid dysfunction and thyroid autoimmunity. Most surgical hand-scrub solutions contain large amounts of iodine, and transcutaneous and mucosal absorption of iodine from these antiseptic solutions has been demonstrated. In this study we determined the effect of hand scrubbing with iodine-containing surgical hand-scrub solutions on urinary iodine concentrations (UICs) in operating room staff.

Methods: The study included 117 surgeons and surgical nurses from two different hospitals who often used surgical hand-scrub solutions as the iodine exposure group and 92 age-matched hospital staff from nonsurgical units of the same hospitals as the controls. In the iodine exposure group, 39 subjects (from hospital 1) used iodine-containing hand scrub solutions intermittently, and the remaining 78 in the surgical staff (from hospital 2) used only iodine-containing hand-scrub solutions. Morning spot urine specimens were collected from all participants for the analysis of UIC.

Results: The operating room staff had significantly higher UICs compared to the control group (142 μg/L [12-822 μg/L] vs. 89 μg/L [10-429 μg/L], p<0.001). UICs from 39% of the subjects from hospital 2 were found to reach levels higher than 300 μg/L.

Conclusion: Scrubbing with iodine-containing solutions might lead to iodine excess among surgical staff. Further studies investigating the effects of hand scrubbing with iodine-containing products on thyroid function and on thyroid antibodies of the operating room staff are needed to determine the consequences of this high iodine exposure.