Disinfectant Used in Hospitals Tied to COPD
Studies find that use of disinfectants once every week can increase the risk of developing chronic obstructive pulmonary disease (COPD) by as much as 32%. This according to a joint 30-year study by the French National Institute of Health and Medical Research (INSERM) and Havard University which found that the use of products such as glutaraldehyde, hydrogen peroxide, bleach, alcohol and quaternary ammonium compounds (quats) (commonly found in furniture and floor disinfectants) increased the risk of developing COPD by 22 – 32 % in an occupational setting.
Researchers looking at the incidence of COPD in more than 55,000 nurses in the US, found that the regular use of disinfectants has been linked to a higher risk of developing the disease.
COPD which affects an estimated 30 million people in the United States is a group of lung conditions such as chronic bronchitis and emphysema which make it hard to breathe air into and out of the lungs. This is due to the narrowing of the airways as a result of blockage and inflammation in the lungs.
Symptoms caused by the blockage of the airways include; breathlessness, wheezing, chest pain and a chronic cough. It commonly affects heavy smokers over the age of 35 and can also be developed through exposure to second hand smoke and other lung irritants such as chemical fumes, dust and air pollution. It is strongly recommended that you wear a face mask should you be in contact with any of these at your place of work or your environment in general.
Nearly 120,000 people lose their lives to COPD every year in the United States making it the third leading cause of death in the country. An estimated 12 million people living in the United States are believed to be undiagnosed and unaware that they have the disease.
Dr. Orianne Dumas (PHD) from INSERM, Villejuif, France, told the European Respiratory Society (ERS) International Congress that certain tasks such as frequent exposure to disinfectants, cleaning surfaces and specific chemicals in disinfectants increased the risk of developing COPD by 22%. This is according to data from the Unites States Nurses Health Study II (NHS II) which was surveyed for 8 years.
“The potential adverse effects of exposure to disinfectants on COPD have received much less attention, although two recent studies in European populations showed that working as a cleaner was associated with a higher risk of COPD. To the best of our knowledge, we are the first to report a link between disinfectants and COPD among other healthcare workers and to investigate specific chemicals that may underlie this association,” Dumas said.
“Our findings provide further evidence of the effects of exposure to disinfectants on respiratory problems and highlight the urgency of integrating occupational health considerations into guidelines for cleaning and disinfection in the healthcare settings such as hospitals.”
More than 100,000 nurses in the United States enrolled in the NHS II which began in 1989. Dumas and her colleagues analyzed data from those who were still working as nurses in the year 2009 and had no previous history of COPD. The number of nurses that fell under this category was 55,185 nurses. They were followed by Dumas’ group for a period of approximately eight years up until May, 2017. Within this period, 663 nurses had developed COPD.
Their exposure was evaluated through the Job-Task-Exposure matrix which assigned exposure to disinfectants by task or job and a questionnaire. Results were adjusted based on factors that might affect the results such as ethnicity, age, Body Mass Index (BMI) and smoking. The nurses were surveyed after every two years said Dumas.
Mina Gaga, MD of the Athens Chest Hospital and ERS president-elect, said, “This study shows that you have to be careful when you are around substances known to be a lung irritant, and we also know that lung irritation may lead to development of COPD down the road.”
“We do tell people who work with these chemicals to use them properly and particularly not to mix them, but you can’t completely eliminate their use because there is a need to keep things clean with these agents,” she told MedPage Today.
She made a suggestion that people, “Use caution and use common sense: Open a window when using them. This is true for anyone, not just nurses in hospitals.”
Dumas said at the press conference that 37% of the nurses reported weekly involvement in the use of disinfectants to clean surfaces and 19% in the use of disinfectants to clean medical instruments. She reported a suggested association for weekly use of disinfectants to clean medical instruments.
In a separate study conducted in 2017, Dumas and her colleagues described disinfectants used by nurses, and investigate quantitative and qualitative differences according to workplace characteristics and region. Dumas’ group found that working in a hospital was tied to higher disinfectant use but lower spray use. Also, nurses working in a smaller hospital setting (50 to 200 beds) were more likely to use disinfectants and sprays. Finally, spray use was higher in the Northeast than in the West.
Dumas said, “These are preliminary findings and more research needs to be carried out. In particular, we need to investigate the lifetime impact on COPD of lifetime occupational exposure to chemicals and clarify the role of each specific disinfectant. We hope to receive funding from the United States Centers for Disease Control and Prevention to continue this important work.”
She added that, “Some of these disinfectants such as bleach and quats are used frequently in ordinary households and the potential impact of domestic use of disinfectants on COPD development is unknown. Earlier studies have found a link between asthma and exposure to cleaning products and disinfectants at home, such as bleach and sprays, so it is important to investigate further.”
Dr. Dumas put a lot of emphasis on the fact that since this was an observational study, the findings are not able to show that disinfectants cause COPD but that there is an association between some of the disinfectants which are used and the development of the disease.