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Regular use of disinfectants is linked to a higher
risk of developing chronic obstructive pulmonary
disease (COPD), according to new research looking at
incidence of the disease in over 55,000 nurses in
the USA.
Dr Orianne Dumas (PhD) from INSERM, Villejuif,
France, told the European Respiratory Society
International Congress that certain tasks involving
frequent exposure to disinfectants, such as cleaning
surfaces, and specific chemicals in disinfectants,
were associated with a 22% to 32% increased risk of
developing COPD.
Dr Dumas and her colleagues analysed data from
55,185 female registered nurses enrolled in the US
Nurses’ Health Study II, which started in 1989.
They looked at those nurses who were still in a
nursing job and with no history of COPD in 2009, and
then followed them for approximately eight years
until May 2017.
During that time 663 nurses were diagnosed with COPD.
The nurses’ exposure to disinfectants was evaluated
via a questionnaire and a matrix that assigns
exposure to disinfectants by job or task.
The results were adjusted for factors that might
affect the outcome, such as smoking, age, body mass
index and ethnicity.
“We found that nurses who use disinfectants to clean
surfaces on a regular basis – at least once a week –
had a 22% increased risk of developing COPD,” says
Dr Dumas.
“There was a suggestion of a link with the weekly
use of disinfectants to clean instruments but this
was not statistically significant.”
The researchers also looked at exposure to specific
disinfectants: 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%.
“In our study population, 37% of nurses used
disinfectants to clean surfaces on a weekly basis
and 19% used disinfectants to clean medical
instruments on a weekly basis,” Dr Dumas will tell
the congress.
Previous studies have linked exposure to
disinfectants with breathing problems such as asthma
among healthcare workers.
“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,” she
says.
“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.
Some of these disinfectants, such as bleach and
quats, are frequently used 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 this further.”
Dr Dumas emphasises that, as this is an
observational study, the findings cannot show that
disinfectants cause COPD, only that there is an
association between some disinfectants and the
development of the disease.
The Nurses’ Health Study II is coordinated at the
Channing Division of Network Medicine, Brigham and
Women’s Hospital and Harvard Medical School, Boston,
Massachusetts, USA.
For more information
European Respiratory Society
Link...
Channing Division of Network Medicine, Brigham and
Women's Hospital
Link...
Harvard Medical School
Link...
Institut national de la santé et de la recherche
médicale
Link...
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