A new study has warned that using bleach and common household disinfectants increases the risk of developing a potentially fatal lung disease. Regularly breathing in the strong cleaning chemicals can increase the risk of developing chronic obstructive pulmonary disease (COPD) – usually associated with smoking by up to 32 per cent. The findings have implications for nurses, cleaners and others who use the products as part of the daily work routine. Previous studies have linked exposure to disinfectants with breathing problems such as asthma, but much less attention has been paid to their contribution to COPD.
COPD is a group of lung conditions that cause breathing difficulties including emphysema, where there is damage to the air sacs in the lungs, or chronic bronchitis which is the long-term inflammation of the airways. It affects an estimated three million Britons.
The study led by Dr Orianne Dumas from the French National Institute of Health and Medical Research, looked at nurses who have to disinfect instruments and wards as part of their duties. It looked at exposure to specific disinfectants such as glutaraldehyde, a strong disinfectant used for medical instruments, bleach, hydrogen peroxide, alcohol and quaternary ammonium compounds known as ‘quats’, mainly used for low-level disinfection of surfaces such as floors and furniture. All of these ‘were associated with an increased risk of COPD of between 24 to 32 per cent.’
Dr Dumas said “We found that nurses who use disinfectants to clean surfaces on a regular basis – at least once a week – had a 22 per cent increased risk of developing COPD. There was a suggestion of a link with the weekly use of disinfectants to clean instruments but this was not statistically significant. In our study population, 37 per cent of nurses used disinfectants to clean surfaces on a weekly basis and 19 per cent used disinfectants to clean medical instruments on a weekly basis.”
The findings were based on more than 55,000 US nurses taking part in the US Nurses’ Health Study II, which started in 1989, and looked at nurses still working in the profession in 2009. They followed them for eight years, during which time 663 of them were diagnosed with COPD. The nurses’ exposure to disinfectants was evaluated via a questionnaire and adjusted the results for factors that might affect the outcome, such as smoking, age, body mass index and ethnicity.
Dr Dumas added, “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 healthcare workers, and to investigate specific chemicals that may underlie this association.
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 healthcare settings such as hospitals. These are preliminary findings and more research needs to be carried out. In particular, we need to investigate the impact on COPD of lifetime occupational exposure to chemicals and clarify the role of each specific disinfectant.”