When I first started collecting my thoughts for this week’s blog post on Occupational Asthma and the potential contributing role played by cleaning and disinfectant products, the final lyrics from the chorus of Maroon 5’s 2002 hit “Harder to Breathe” rang clearly in my head, “it’s getting harder and harder to breathe!”. For many professionals in the cleaning industry, this statement has the potential to ring true over the span of their careers.
In the USA, several states conduct work related asthma surveillance as part of the Sentinel Event Notification System for Occupational Risks (SENSOR). The surveillance system in California showed that custodians and cleaners had the highest incidence of work related asthma. Furthermore, Rosenman et al reported that a cleaning product was 1 or more of the 3 suspected agents identified in 12% of the confirmed cases that they reviewed. The fact that bleach was the most frequently identified product should not be all that surprising considering that bleach was recently designated an asthma-causing agent by the Association of Occupational and Environmental Clinics (Sastre 2011).
Quaternary ammonium compounds (Quats or QACs) also tend to be frequently identified as potential asthma causing agents due to their prevalence in numerous cleaning and disinfectant products. Michigan’s SENSOR program published a detailed report on the link between asthma and quats in their 2008-2009 newsletter (http://www.oem.msu.edu/userfiles/file/News/v20n1.pdf). The newsletter includes several case reports and a review of several peer reviewed studies completed on the subject.
This past summer, Massachusetts’ Dept. of Health issued an Occupational Lung Disease Bulletin as part of their SENSOR program (http://www.mass.gov/eohhs/docs/dph/occupational-health/sensor-lung-disease-bulletins/summer2013.pdf). This bulletin further detailed the potential link between the use of certain cleaning and disinfectant products and work-related asthma but also included valuable recommendations related to the correct use of cleaning products and the consideration of safer disinfectant chemistries. The bulletin states that “The prevention goal is to balance the two needs—to reduce infectious disease transmission without causing chemical related disease”. Ensuring that disinfectants are not overused, unnecessarily aerosolized or misted into the air, and employed at the correct concentration are important points to consider. The bulletin also includes reference to the consideration of safer disinfectants: “EPA’s Design for the Environment (http://www.epa.gov/dfe/) has begun promoting use of safer disinfectants that pose lower risks of adverse human effects and environmental degradation. To date, the active ingredients approved as safer include citric acid, lactic acid and hydrogen peroxide”.
In summary, where the use of disinfectants are necessary, steps should be taken to reduce the potential exposure to harmful and potentially asthma causing chemicals by considering safer cleaning and disinfectant options or by employing practices and protocols that will reduce a user’s direct contact and risk.
Hasta la vista!
The Germinator - Lee