This document describes the best practices for the safe use of gluteraldehyde in health care facilities. It is widely used as a cold sterilant to disinfect a variety of heat-sensitive instruments such as endoscopes, bronchoscopes and dialysis equipment. In addition, health care employee may be exposed to gluteraldehyde in it uses as a hardener in x-ray developing and as a tissue fixative in histology and pathology labs. This document describes engineering controls, work practices, and facility design considerations that will help reduce employee exposure. It also provides recommendations for personal protective equipment, employee training, exposure monitoring, disposal practices, and spill cleanup procedures. The use of alternative to gluteraldehyde is also addressed. OSHA 3258-08N