Dr. Muscarella points out that this extremely scrupulous task is often performed by workers making as little as $13 an hour. It has been recommended that these technicians be certified to ensure that everyone undergoes the training required to properly perform the steps. However, at this time, certification of reprocessing technicians is only required in New Jersey & New York in the United States. On top of the laborious job and often modest salaries, technicians are faced with enormous pressure to reprocess endoscopes quickly and work towards increasing scope throughput in their facility.
Often because of the countless factors working against technicians, steps in the critical cleaning process are not performed as thoroughly as required, or steps can be missed altogether. Without effective cleaning to remove organic material from the endoscope, the disinfection process will not be as effective in high-level disinfecting the endoscope.