This publication describes best practices for the safe use of glutaraldehyde in health care facilities. Glutaraldehyde is used widely as a cold sterilant to disinfect a variety of heat-sensitive instruments, such as endoscopes, bronchoscopes, and dialysis equipment. In addition, health care employees may be exposed to glutaraldehyde in its uses as a hardener in x-ray developing and as a tissue fixative in histology and pathology labs. Glutaraldehyde's properties as a chemical sterilant were initially recognized in the early 1960s as the health care industry searched for a safer alternative to formaldehyde, which is regulated by OSHA as a carcinogen (29 CFR 1910.1048). In the years since its introduction as a disinfectant/sterilant, glutaraldehyde has been linked with a variety of health effects - ranging from mild to severe - including asthma, breathing difficulties, respiratory irritation, and skin rashes. The purpose of this publication is to provide information that can be used by health care employers and employees to understand and control exposures to glutaraldehyde. This publication describes engineering controls, work practices, and facility design considerations that will help reduce employee exposure to glutaraldehyde. This publication also includes recommendations for personal protective equipment, employee training, exposure monitoring, disposal practices, and spill and cleanup procedures. The use of alternatives to glutaraldehyde is also addressed.