Assessment of transpulmonary absorption of ethanol from alcohol-based hand rub

Ethanol-based disinfectant sprays drive rapid changes in the chemical composition of indoor air in residential buildings

The COVID-19 pandemic has resulted in increased usage of ethanol-based disinfectants for surface inactivation of SARS-CoV-2 in buildings. Emissions of volatile organic compounds (VOCs) and particles from ethanol-based disinfectant sprays were characterized in real-time (1 Hz) via a proton transfer reaction time-of-flight mass spectrometer (PTR-TOF-MS) and a high-resolution electrical low-pressure impactor (HR-ELPI+), respectively. Ethanol-based disinfectants drove sudden changes in the chemical composition of indoor air. VOC and particle concentrations increased immediately after application of the disinfectants, remained elevated during surface contact time, and gradually decreased after wiping. The disinfectants produced a broad spectrum of VOCs with mixing ratios spanning the sub-ppb to ppm range. Ethanol was the dominant VOC emitted by mass, with concentrations exceeding 103 μg m-3 and emission factors ranging from 101 to 102 mg g-1. Listed and unlisted diols, monoterpenes, and monoterpenoids were also abundant. The pressurized sprays released significant quantities (104-105 cm-3) of nano-sized particles smaller than 100 nm, resulting in large deposited doses in the tracheobronchial and pulmonary regions of the respiratory system. Inhalation exposure to VOCs varied with time during the building disinfection events. Much of the VOC inhalation intake (>60 %) occurred after the disinfectant was sprayed and wiped off the surface. Routine building disinfection with ethanol-based sprays during the COVID-19 pandemic may present a human health risk given the elevated production of volatile chemicals and nano-sized particles.

Assessment of occupational exposure to nebulized isopropyl alcohol as disinfectant during aseptic compounding of parenteral cytotoxic drugs in cleanrooms

Pharmacy technicians are exposed to volatile organic compounds, like the disinfectant isopropyl alcohol (IPA), during the process of aseptic compounding of parenteral cytotoxic drugs. The occupational exposure to nebulized IPA during aseptic compounding has not been investigated. The aim of this study was to investigate the exposure to IPA during aseptic compounding of parenteral cytotoxic drugs and to assess compliance with legal and regulatory limits. As a secondary endpoint, the difference between two disinfection methods was compared regarding the exposure to IPA. The exposure to IPA was measured during five working shifts of 8 hr and one shift of 4 hr. The concentration IPA was measured by using a six-gas monitor. Total daily exposure was calculated as 8-hr Time Weighted Average (TWA) air concentration in mg/m³ and compared with an Occupational Exposure Limit (OEL) value of 500 mg/m³ and incidental peak exposure of 5,000 mg/m³. To assess whether the 8-hr TWA air concentration meets the legal and regulatory limits the Similar Exposure Groups (SEG) compliance test was used. A paired sample t-test was conducted to assess difference in exposure between two disinfection methods. The average 8-hr TWA exposure to IPA during the six measurements varied from 2.6 mg/m³ to 43.9 mg/m³ and the highest momentary concentration measured was 860 mg/m³. The result of the SEG compliance test was 3.392 (U_r value) and was greater than the U_t value of 2.187 which means the exposure to IPA is in compliance with the OEL value. No significant difference in exposure was shown between two disinfection methods (p = 0.49). In conclusion, exposure to IPA during aseptic compounding of parenteral cytotoxic drugs showed compliance to the OEL values with no significant difference in exposure between two disinfection methods.

Neonatal ethanol exposure from ethanol-based hand sanitisers in isolettes

OBJECTIVE

The aims of this study is to measure the ethanol vapours in the isolette after use of hands cleaned with ethanol-based hand sanitiser (EBHS).

METHODS

Two squirts (1.5 mL) of hand sanitiser were rubbed on hands for 10 or 20 s before inserting the hands in the isolette for 5 min. Ethanol vapours were measured in the isolette with photoionisation detector and alcohol breathalyser for 30 min.

RESULTS

Peak ethanol concentration in the isolette was considerably higher with a 10 s hand rub (381±192 ppm) compared with a 20 s hand rub (99±50 ppm), and dissipated to ≤5 ppm within 30 min. Under routine care, EBHS use by care providers exposes neonates in isolettes to 3.7-7.3 or 1.4-2.8 mg/kg ethanol per day with 10 or 20 s hand rubs, respectively. The expected blood level from average single exposure is 0.036 mg/dL with 10 s hand rub and may increase further with multiple exposures in a short period.

CONCLUSION

Preterm neonates in the isolette are at risk of inadvertent exposure to ethanol. The expected blood alcohol level from this exposure is small and below 1 mg/dL level recommended by European Medicines Agency to limit the ethanol exposure in children. The unintended ethanol exposure can be avoided by rubbing hands for at least 20 s after applying EBHS.

Inhalation of Alcohol Vapor: Measurement and Implications

Decades of alcohol research have established the health risks and pharmacodynamic profile of oral alcohol consumption. Despite isolated periods of public health concern, comparatively less research has evaluated exposure to alcohol vapor. Inhaled alcohol initially bypasses first-pass metabolism and rapidly reaches the arterial circulation and the brain, suggesting that this route of administration may be associated with pharmacological effects that increase the risk of addiction. However, detailed reviews assessing the possible effects of inhaled alcohol in humans are lacking. A comprehensive, systematic literature review was conducted using Google Scholar and PubMed to examine manuscripts studying exposure to inhaled alcohol and measurement of biomarkers (biochemical or functional) associated with alcohol consumption in human participants. Twenty-one publications reported on alcohol inhalation. Fourteen studies examined inhalation of alcohol vapor associated with occupational exposure (e.g., hand sanitizer) in a variety of settings (e.g., naturalistic, laboratory). Six publications measured inhalation of alcohol in a controlled laboratory chamber, and 1 evaluated direct inhalation of an e-cigarette with ethanol-containing "e-liquid." Some studies have reported that inhalation of alcohol vapor results in measurable biomarkers of acute alcohol exposure, most notably ethyl glucuronide. Despite the lack of significantly elevated blood alcohol concentrations, the behavioral consequences and subjective effects associated with repeated use of devices capable of delivering alcohol vapor are yet to be determined. No studies have focused on vulnerable populations, such as adolescents or individuals with alcohol use disorder, who may be most at risk of problems associated with alcohol inhalation.

Hazardous substances in frequently used professional cleaning products

Background:

A growing number of studies have identified cleaners as a group at risk for adverse health effects of the skin and the respiratory tract. Chemical substances present in cleaning products could be responsible for these effects. Currently, only limited information is available about irritant and health hazardous chemical substances found in cleaning products. We hypothesized that chemical substances present in cleaning products are known health hazardous substances that might be involved in adverse health effects of the skin and the respiratory tract.

Methods:

We performed a systematic review of cleaning products used in the Swiss cleaning sector. We surveyed Swiss professional cleaning companies (n = 1476) to identify the most used products (n = 105) for inclusion. Safety data sheets (SDSs) were reviewed and hazardous substances present in cleaning products were tabulated with current European and global harmonized system hazard labels.

Results:

Professional cleaning products are mixtures of substances (arithmetic mean 3.5±2.8), and more than 132 different chemical substances were identified in 105 products. The main groups of chemicals were fragrances, glycol ethers, surfactants, solvents; and to a lesser extent, phosphates, salts, detergents, pH-stabilizers, acids, and bases. Up to 75% of products contained irritant (Xi), 64% harmful (Xn) and 28% corrosive (C) labeled substances. Hazards for eyes (59%) and skin (50%), and hazards by ingestion (60%) were the most reported.

Conclusions:

Cleaning products potentially give rise to simultaneous exposures to different chemical substances. As professional cleaners represent a large workforce, and cleaning products are widely used, it is a major public health issue to better understand these exposures. The list of substances provided in this study contains important information for future occupational exposure assessment studies.