Whether we’re talking politics, religious beliefs,
vaccination, science or the use of disinfectants as part of an infection
prevention program, there will always be differing opinions and there will
always be that polarizing personality that you either love or hate. As a wise woman (or man) once said “there are
two sides to every story and the truth lies somewhere in the middle”.
vaccination, science or the use of disinfectants as part of an infection
prevention program, there will always be differing opinions and there will
always be that polarizing personality that you either love or hate. As a wise woman (or man) once said “there are
two sides to every story and the truth lies somewhere in the middle”.
A great example of this is the use of disinfectants and
their role in occupational or worked-related asthma. According to sources I have read, more than
300 workplace substances have been identified as possible causes of occupational asthma. These substances can be broken down into the
following categories: animal substances, chemicals, enzymes, metals, plant
substances and respiratory irritants. If
you’re luckier than me, I hope you’ve never experienced an asthma attack. If you’re not familiar with asthma, symptoms
start when your lungs become irritated which leads to inflammation. This inflammation causes a restriction of the
airways which makes breathing difficult. With occupational asthma, lung inflammation
may be triggered by either an allergic response to a substance or irritation of
the lungs caused by an inhalation of a substance, such as chlorine.
their role in occupational or worked-related asthma. According to sources I have read, more than
300 workplace substances have been identified as possible causes of occupational asthma. These substances can be broken down into the
following categories: animal substances, chemicals, enzymes, metals, plant
substances and respiratory irritants. If
you’re luckier than me, I hope you’ve never experienced an asthma attack. If you’re not familiar with asthma, symptoms
start when your lungs become irritated which leads to inflammation. This inflammation causes a restriction of the
airways which makes breathing difficult. With occupational asthma, lung inflammation
may be triggered by either an allergic response to a substance or irritation of
the lungs caused by an inhalation of a substance, such as chlorine.
Enter the differing opinions. A study published in May 2016 in AJIC titled
“Occupational healthrisks associated with the use of germicides in health care” concluded that
the data reviewed in the study demonstrate that occupational asthma as a result
of chemical exposures, including low-level disinfectants, are exceedingly rare. However, unprotected exposures to high-level
disinfectants may cause respiratory symptoms.
“Occupational healthrisks associated with the use of germicides in health care” concluded that
the data reviewed in the study demonstrate that occupational asthma as a result
of chemical exposures, including low-level disinfectants, are exceedingly rare. However, unprotected exposures to high-level
disinfectants may cause respiratory symptoms.
On the other side of the story, a
study by Rosenman et al. reported that a cleaning
product was at least 1 of the 3 suspected agents identified in 12% of confirmed
work related asthma 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). Furthermore, 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. The newsletter includes
several case reports and a review of several peer reviewed studies completed on
the subject.
study by Rosenman et al. reported that a cleaning
product was at least 1 of the 3 suspected agents identified in 12% of confirmed
work related asthma 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). Furthermore, 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. The newsletter includes
several case reports and a review of several peer reviewed studies completed on
the subject.
This leads me to try to figure out
what the “truth” is. I think there is
enough evidence to support the fact that the use of some chemicals (including
some disinfectants) can lead to occupational asthma particularly with our
increased reliance on disinfectants as part of our infection prevention
program. However, I also believe that we
cannot with broad strokes state that all disinfectants will cause occupational
asthma. I think there are products
available on the market that meet the criteria of non-asthma inducing agents
that can be used safety and effectively.
what the “truth” is. I think there is
enough evidence to support the fact that the use of some chemicals (including
some disinfectants) can lead to occupational asthma particularly with our
increased reliance on disinfectants as part of our infection prevention
program. However, I also believe that we
cannot with broad strokes state that all disinfectants will cause occupational
asthma. I think there are products
available on the market that meet the criteria of non-asthma inducing agents
that can be used safety and effectively.
As a person with asthma, I know I
can state categorically that some disinfectant actives irritate my airways more
than others. I can also state without a
doubt that the method of application can also dramatically increase or decrease
the level of irritation. Perhaps the
next investigation should be to look at the method of application – spray and
wipe versus wiping with a cloth or pre-moistened wipe to see which method
reduces the likelihood of inducing respiratory irritation. Not to say I already know the answer, but I
do know which method bugs me the least!
Wiping! I also happen to believe
that wiping is the best method of application for disinfectants to ensure even
distribution of the disinfectant solution and physical friction to help lift
and remove soils and bugs from the surface you are wiping. But, I’ll let you decide for yourself!
can state categorically that some disinfectant actives irritate my airways more
than others. I can also state without a
doubt that the method of application can also dramatically increase or decrease
the level of irritation. Perhaps the
next investigation should be to look at the method of application – spray and
wipe versus wiping with a cloth or pre-moistened wipe to see which method
reduces the likelihood of inducing respiratory irritation. Not to say I already know the answer, but I
do know which method bugs me the least!
Wiping! I also happen to believe
that wiping is the best method of application for disinfectants to ensure even
distribution of the disinfectant solution and physical friction to help lift
and remove soils and bugs from the surface you are wiping. But, I’ll let you decide for yourself!
Bugging Off!
Nicole
