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Okeke CAV, Khanna R, Ehrlich A. Quaternary Ammonium Compounds and Contact Dermatitis: A Review and Considerations During the COVID-19 Pandemic. Clin Cosmet Investig Dermatol 2023; 16:1721-1728. [PMID: 37409071 PMCID: PMC10319159 DOI: 10.2147/ccid.s410910] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/16/2023] [Indexed: 07/07/2023]
Abstract
The recent global pandemic has resulted in increased use of quaternary ammonium compounds (QACs). Currently, QACs are active ingredients in 292 disinfectants recommended by the US EPA for use against SARS-CoV-2. Among QACs, benzalkonium chloride (BAK), cetrimonium bromide (CTAB), cetrimonium chloride (CTAC), didecyldimethylammonium chloride (DDAC), cetrimide, quaternium-15, cetylpyridinium chloride (CPC), and benzethonium chloride (BEC) were all identified as potential culprits of skin sensitivity. Given their widespread utilization, additional research is needed to better classify their dermal effects and identify other cross-reactors. In this review, we aimed to expand our knowledge about these QACs to further dissect its potential allergic and irritant dermal effects on healthcare workers during COVID-19.
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Affiliation(s)
- Chidubem A V Okeke
- Department of Dermatology, Howard University College of Medicine, Washington, DC, USA
| | - Ramona Khanna
- Georgetown University School of Medicine, Washington, DC, USA
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Arnold W, Blum A, Branyan J, Bruton TA, Carignan CC, Cortopassi G, Datta S, DeWitt J, Doherty AC, Halden RU, Harari H, Hartmann EM, Hrubec TC, Iyer S, Kwiatkowski CF, LaPier J, Li D, Li L, Muñiz Ortiz JG, Salamova A, Schettler T, Seguin RP, Soehl A, Sutton R, Xu L, Zheng G. Quaternary Ammonium Compounds: A Chemical Class of Emerging Concern. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:7645-7665. [PMID: 37157132 PMCID: PMC10210541 DOI: 10.1021/acs.est.2c08244] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/24/2023] [Accepted: 03/24/2023] [Indexed: 05/10/2023]
Abstract
Quaternary ammonium compounds (QACs), a large class of chemicals that includes high production volume substances, have been used for decades as antimicrobials, preservatives, and antistatic agents and for other functions in cleaning, disinfecting, personal care products, and durable consumer goods. QAC use has accelerated in response to the COVID-19 pandemic and the banning of 19 antimicrobials from several personal care products by the US Food and Drug Administration in 2016. Studies conducted before and after the onset of the pandemic indicate increased human exposure to QACs. Environmental releases of these chemicals have also increased. Emerging information on adverse environmental and human health impacts of QACs is motivating a reconsideration of the risks and benefits across the life cycle of their production, use, and disposal. This work presents a critical review of the literature and scientific perspective developed by a multidisciplinary, multi-institutional team of authors from academia, governmental, and nonprofit organizations. The review evaluates currently available information on the ecological and human health profile of QACs and identifies multiple areas of potential concern. Adverse ecological effects include acute and chronic toxicity to susceptible aquatic organisms, with concentrations of some QACs approaching levels of concern. Suspected or known adverse health outcomes include dermal and respiratory effects, developmental and reproductive toxicity, disruption of metabolic function such as lipid homeostasis, and impairment of mitochondrial function. QACs' role in antimicrobial resistance has also been demonstrated. In the US regulatory system, how a QAC is managed depends on how it is used, for example in pesticides or personal care products. This can result in the same QACs receiving different degrees of scrutiny depending on the use and the agency regulating it. Further, the US Environmental Protection Agency's current method of grouping QACs based on structure, first proposed in 1988, is insufficient to address the wide range of QAC chemistries, potential toxicities, and exposure scenarios. Consequently, exposures to common mixtures of QACs and from multiple sources remain largely unassessed. Some restrictions on the use of QACs have been implemented in the US and elsewhere, primarily focused on personal care products. Assessing the risks posed by QACs is hampered by their vast structural diversity and a lack of quantitative data on exposure and toxicity for the majority of these compounds. This review identifies important data gaps and provides research and policy recommendations for preserving the utility of QAC chemistries while also seeking to limit adverse environmental and human health effects.
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Affiliation(s)
- William
A. Arnold
- University
of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Arlene Blum
- Green
Science Policy Institute, Berkeley, California 94709, United States
- University
of California, Berkeley, California 94720, United States
| | - Jennifer Branyan
- California
Department of Toxic Substances Control, Sacramento, California 95814, United States
| | - Thomas A. Bruton
- California
Department of Toxic Substances Control, Sacramento, California 95814, United States
| | | | - Gino Cortopassi
- University
of California, Davis, California 95616, United States
| | - Sandipan Datta
- University
of California, Davis, California 95616, United States
| | - Jamie DeWitt
- East
Carolina University, Greenville, North Carolina 27834, United States
| | - Anne-Cooper Doherty
- California
Department of Toxic Substances Control, Sacramento, California 95814, United States
| | - Rolf U. Halden
- Arizona
State University, Tempe, Arizona 85287, United States
| | - Homero Harari
- Icahn
School of Medicine at Mount Sinai, New York, New York 10029, United States
| | | | - Terry C. Hrubec
- Edward Via College of Osteopathic Medicine, Blacksburg, Virginia 24060, United States
| | - Shoba Iyer
- California Office of Environmental Health Hazard Assessment, Oakland, California 94612, United States
| | - Carol F. Kwiatkowski
- Green
Science Policy Institute, Berkeley, California 94709, United States
- North Carolina State University, Raleigh, North Carolina 27695 United States
| | - Jonas LaPier
- Green
Science Policy Institute, Berkeley, California 94709, United States
| | - Dingsheng Li
- University
of Nevada, Reno, Nevada 89557, United States
| | - Li Li
- University
of Nevada, Reno, Nevada 89557, United States
| | | | - Amina Salamova
- Indiana University, Atlanta, Georgia 30322, United States
| | - Ted Schettler
- Science and Environmental Health Network, Bolinas, California 94924, United States
| | - Ryan P. Seguin
- University of Washington, Seattle, Washington 98195, United States
| | - Anna Soehl
- Green
Science Policy Institute, Berkeley, California 94709, United States
| | - Rebecca Sutton
- San Francisco Estuary Institute, Richmond, California 94804, United States
| | - Libin Xu
- University of Washington, Seattle, Washington 98195, United States
| | - Guomao Zheng
- Southern University of Science and Technology, Shenzhen, Guangdong 518055, China
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Mohapatra S, Yutao L, Goh SG, Ng C, Luhua Y, Tran NH, Gin KYH. Quaternary ammonium compounds of emerging concern: Classification, occurrence, fate, toxicity and antimicrobial resistance. JOURNAL OF HAZARDOUS MATERIALS 2023; 445:130393. [PMID: 36455328 PMCID: PMC9663149 DOI: 10.1016/j.jhazmat.2022.130393] [Citation(s) in RCA: 49] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/01/2022] [Accepted: 11/11/2022] [Indexed: 05/25/2023]
Abstract
Amplified hygiene and precautionary measures are of utmost importance to control the spread of COVID-19 and future infection; however, these changes in practice are projected to trigger a rise in the purchase, utilisation and hence, discharge of many disinfectants into the environment. While alcohol-based, hydrogen peroxide-based, and chlorine-based compounds have been used widely, quaternary ammonium compounds (QACs) based disinfectants are of significant concern due to their overuse during this pandemic. This review presents the classification of disinfectants and their mechanism of action, focusing on QACs. Most importantly, the occurrence, fate, toxicity and antimicrobial resistance due to QACs are covered in this paper. Here we collated evidence from multiple studies and found rising trends of concern, including an increase in the mass load of QACs at a wastewater treatment plant (WWTP) by 331% compared to before the COVID-19 pandemic, as well as an increases in the concentration of 62% in residential dust, resulting in high concentrations of QACs in human blood and breast milk and suggesting that these could be potential sources of persistent QACs in infants. In addition to increased toxicity to human and aquatic life, increased use of QACs and accelerated use of antibiotics and antimicrobials during the COVID-19 pandemic could multiply the threat to antimicrobial resistance.
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Affiliation(s)
- Sanjeeb Mohapatra
- NUS Environmental Research Institute, National University of Singapore, Singapore 117411, Singapore; Energy and Environmental Sustainability for Megacities (E2S2) Phase II, Campus for Research Excellence and Technological Enterprise (CREATE), 1 Create Way, Singapore 138602, Singapore
| | - Lin Yutao
- NUS Environmental Research Institute, National University of Singapore, Singapore 117411, Singapore
| | - Shin Giek Goh
- NUS Environmental Research Institute, National University of Singapore, Singapore 117411, Singapore; Energy and Environmental Sustainability for Megacities (E2S2) Phase II, Campus for Research Excellence and Technological Enterprise (CREATE), 1 Create Way, Singapore 138602, Singapore
| | - Charmaine Ng
- NUS Environmental Research Institute, National University of Singapore, Singapore 117411, Singapore; Energy and Environmental Sustainability for Megacities (E2S2) Phase II, Campus for Research Excellence and Technological Enterprise (CREATE), 1 Create Way, Singapore 138602, Singapore
| | - You Luhua
- NUS Environmental Research Institute, National University of Singapore, Singapore 117411, Singapore; Energy and Environmental Sustainability for Megacities (E2S2) Phase II, Campus for Research Excellence and Technological Enterprise (CREATE), 1 Create Way, Singapore 138602, Singapore
| | - Ngoc Han Tran
- NUS Environmental Research Institute, National University of Singapore, Singapore 117411, Singapore; Energy and Environmental Sustainability for Megacities (E2S2) Phase II, Campus for Research Excellence and Technological Enterprise (CREATE), 1 Create Way, Singapore 138602, Singapore
| | - Karina Yew-Hoong Gin
- NUS Environmental Research Institute, National University of Singapore, Singapore 117411, Singapore; Energy and Environmental Sustainability for Megacities (E2S2) Phase II, Campus for Research Excellence and Technological Enterprise (CREATE), 1 Create Way, Singapore 138602, Singapore; Department of Civil & Environmental Engineering, National University of Singapore, Engineering Drive 2, Singapore 117576, Singapore.
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Won H, Lee JH, Seok JH, Jung K, Yang JY, Jeong J, Lee JK. Single- and repeated-dose 28-day oral toxicity study of MDM hydantoin in Sprague-Dawley rats. Toxicol Res 2021; 37:59-69. [PMID: 33489858 PMCID: PMC7806686 DOI: 10.1007/s43188-020-00055-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/28/2020] [Accepted: 06/11/2020] [Indexed: 11/26/2022] Open
Abstract
1-(hydroxymethyl)-5,5-dimethylimidazolidine-2,4-dione (MDM hydantoin) is a commonly used antiseptic preservative in cosmetics. However, limited toxicity information data are available for this chemical. The aim of this study was to obtain toxicity data for MDM hydantoin through single- and repeated-dose toxicity studies in Sprague-Dawley (SD) rats. In the single-dose toxicity study, MDM hydantoin was administered once orally to SD rats at four doses (5, 50, 300, and 2000 mg/kg/day). There was no significant difference in mortality, clinical signs, and body weight change for 14 days among the animals treated with the different doses in this study. Hence, the approximate lethal dose of MDM hydantoin was considered higher than 2000 mg/kg/day. Based on the results of the dose-range finding study, a 28-day repeated-dose oral toxicity study was conducted. MDM hydantoin was administered orally to SD rats at doses of 125, 250, 500, and 1000 mg/kg/day throughout an experimental period of 28 days. In the repeated-dose oral toxicity study, the adverse effects caused by MDM hydantoin were not detected in terms of body weight, clinical signs, food and water intake, hematology, organ weights, gross pathology, and histopathology. Therefore, the no-observed-adverse-effect level of MDM hydantoin was considered to be greater than 1000 mg/kg/day.
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Affiliation(s)
- Hansol Won
- Toxicological Research Division, National Institute of Food and Drug Safety Evaluation, 187, Osongsaengmyeong 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28159 Republic of Korea
| | - Jin Hee Lee
- Toxicological Research Division, National Institute of Food and Drug Safety Evaluation, 187, Osongsaengmyeong 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28159 Republic of Korea
| | - Ji-Hyun Seok
- Toxicological Research Division, National Institute of Food and Drug Safety Evaluation, 187, Osongsaengmyeong 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28159 Republic of Korea
| | - Kikyung Jung
- Toxicological Research Division, National Institute of Food and Drug Safety Evaluation, 187, Osongsaengmyeong 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28159 Republic of Korea
| | - Jun-Young Yang
- Toxicological Research Division, National Institute of Food and Drug Safety Evaluation, 187, Osongsaengmyeong 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28159 Republic of Korea
| | - Jayoung Jeong
- Toxicological Research Division, National Institute of Food and Drug Safety Evaluation, 187, Osongsaengmyeong 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28159 Republic of Korea
| | - Jong Kwon Lee
- Toxicological Research Division, National Institute of Food and Drug Safety Evaluation, 187, Osongsaengmyeong 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28159 Republic of Korea
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Princy Maria J, Bhuvaneswari R, Nagarajan V, Chandiramouli R. Diethanolamine and quaternium-15 interaction studies on antimonene nanosheet based on first-principles studies. COMPUT THEOR CHEM 2019. [DOI: 10.1016/j.comptc.2019.04.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Osdoit S, Guillet MH, Guillet G. Contact sensitization to quaternium-15 acting as a warning sign for curare allergy. Contact Dermatitis 2011; 65:120-2. [DOI: 10.1111/j.1600-0536.2011.01923.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
The successful treatment of hand dermatitis (HD) depends less on the selection of the proper topical steroid or a particular systemic agent than on addressing any underlying cause or perpetuating factor. Thus, innovative treatment is based on comprehensively addressing the patient's problem. Aggressive approaches may be required for the most severe forms of HD.
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Affiliation(s)
- William Abramovits
- Department of Medicine, Baylor University Medical Center, Dallas, TX, USA.
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Final Report of the Amended Safety Assessment of Quaternium-15 as Used in Cosmetics. Int J Toxicol 2010; 29:98S-114S. [DOI: 10.1177/1091581810363915] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Quaternium-15 is an antimicrobial agent used in cosmetics as a cosmetic preservative and antistatic agent. Little systemic toxicity was reported in most single-dose or repeated-dose animal studies. Quaternium-15 was an oral teratogen, but not a dermal teratogen, in rats at doses that exceeded the expected cumulative exposure from cosmetics. The frequency of sensitization increased in North America but not in Europe, where Quaternium-15 is used less often. In almost all animal and human studies, Quaternium-15 at 0.2% was not a sensitizer. The weight of evidence suggested that a 0.2% concentration is not a sensitizer and that cosmetic products containing Quaternium-15 up to that level are safe.
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Nicol AM, Hurrell AC, Wahyuni D, McDowall W, Chu W. Accuracy, comprehensibility, and use of material safety data sheets: a review. Am J Ind Med 2008; 51:861-76. [PMID: 18651574 DOI: 10.1002/ajim.20613] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Material safety data sheets (MSDSs) are used in workplaces to communicate to workers the hazards of chemical products. This article describes a review of the peer-reviewed scientific literature regarding the accuracy, comprehensibility and use of MSDSs in the workplace. METHODS Articles were retrieved via a systematic search of indexes and databases, followed by hand searching and citation index searching. Two reviewers independently read and coded the articles using an iterative matrix. RESULTS Of the 280 unique articles retrieved, 24 fit the review criteria. Eligible articles included a range of methodologies: laboratory analyses, site audits, surveys and qualitative inquiry. Articles were grouped into three main topic categories: accuracy and completeness, awareness and use, and comprehensibility. Accuracy and completeness were found to be relatively poor, with the majority of studies presenting evidence that the MSDSs under review did not contain information on all the chemicals present, including those known to be serious sensitizers or carcinogens. Poor presentation and complex language were consistently associated with low comprehensibility among workers. Awareness and use of MSDSs was suboptimal in workplaces where these factors were studied. CONCLUSIONS Despite the fact that these studies varied in methodology and spanned a period of more than 15 years, a number of common themes emerged regarding inaccuracies, incompleteness, incomprehensibility and overall low use of MSDSs. The results of the literature review suggest that there are serious problems with the use of MSDSs as hazard communication tools. The article concludes with recommendations for governments, regulatory bodies, and occupational health and safety personnel to seriously reassess the ways in which MSDSs are written, monitored, regulated, and used.
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Affiliation(s)
- Anne-Marie Nicol
- Centre for Health and Environment Research, University of British Columbia, Vancouver, British Columbia, Canada.
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10
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Patel AR, Jacob SE. Learning through Crosswords. Dermatitis 2008. [DOI: 10.2310/6620.2008.07027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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