Hazardous substances in frequently used professional cleaning products

Inconsistent health hazard information across safety data sheets for substances in cleaning products used in healthcare centres

Safety Data Sheets (SDSs) are used to inform downstream users of any hazardous substances in chemical products and advise on how to manage the risks from using these products. It is therefore important that information on the SDS is accurate and consistent. This study investigates the accuracy and consistency of hazard information included in the SDSs of cleaning products used in the healthcare sector in England and Wales. Data on cleaning products used in the National Health Service (NHS) in England and Wales and their chemical composition and any hazard information (as H-statements) were collected from the products' SDSs obtained from the NHS supply online catalogue. By each hazard, mainly respiratory hazards, the number of hazardous substances specified as hazardous in all SDSs was identified. Moreover, we investigated hazard characteristics of substances identified by only SDS (at least one SDS) or only through Harmonised Classifications and Labeling (CLH) or by SDS and through CLH simultaneously. In total, 229 unique chemical substances were found in 473 cleaning products' SDSs. All 4 respiratory sensitisiers were identified in all SDSs and through CLH. However, only 14 of the 25 respiratory irritants (56.0 %) were consistently labelled across all SDSs. Although respiratory irritation characteristics of 3 substances were classified through CLH, it was not identified by any of the relevant SDSs. Substantially incorrect and inconsistent health hazard information for the same substances was identified across SDSs. Therefore, healthcare workers and their managers may not receive accurate information on the presence of and potential for exposure to hazardous substances in the cleaning products they are using.

Airway Diseases Related to the Use of Cleaning Agents in Occupational Settings

Exposure to disinfectants and cleaning products (DCPs) is now a well-established risk factor for work-related asthma (WRA). However, questions remain on the specific causal agents and pathophysiological mechanisms. Few studies have also reported an association between DCPs and rhinitis or chronic obstructive pulmonary disease. This review discusses the recent evidence pertaining to airway diseases attributable to occupational exposure to DCPs. In contrast to other agents, the incidence of WRA due to DCPs has increased over time. The use of DCPs in spray form has clearly been identified as an added risk factor. The mechanisms for WRA associated with DCPs remain poorly studied; however, both allergic and nonallergic responses have been described, with irritant mechanisms thought to play a major role. An early diagnostic workup based on clinical assessment accompanied by evaluation of lung function and immunological and airway inflammatory markers is important to guide optimal care and exposure avoidance to the implicated agent. Future research should focus on the effects of "green" products, pathophysiological mechanisms, and quantitative exposure assessment including the use of barcode-based methods to identify specific agents. There is an urgent need to strengthen preventive measures and interventions to reduce the burden of airway diseases associated with DCPs.

Fragrances as a trigger of immune responses in different environments

Fragrances can cause allergic skin reactions, expressed as allergic contact dermatitis and reactions in the respiratory tract that range from acute temporary upper airway irritation to obstructive lung disease. These adverse health effects may result from the stimulation of a specific (adaptive) immune response. Th1 cells, which essentially produce interleukin-2 (IL-2) and interferon-γ (IFN-γ), play a key role in allergic contact dermatitis and also on allergic sensitization to common allergens (e.g., nickel and fragrance). It has been shown that fragrance allergy leads to Th2/Th22 production of IL-4, IL-5 and IL-13, controlling the development of IgE and mediating hypersensitivity reactions in the lung, such as asthma. Cytokines released during immune response modulate the expression of cytochrome P450 (CYPs) proteins, which can result in alterations of the pharmacological effects of substances in inflammatory diseases. The mechanisms linking environment and immunity are still not completely understood but it is known that aryl hydrocarbon receptor (AhR) is a sensor with conserved ligand-activated transcription factor, highly expressed in cells that controls complex transcriptional programs which are ligand and cell type specific, with CYPs as targeted genes. This review focuses on these important aspects of immune responses of the skin and respiratory tract cells, describing some in vitro models applied to evaluate the mechanisms involved in fragrance-induced allergy.

The application of the mobile application for the assessment of cleaning workers' exposure to cleaning products: a pilot study

BACKGROUND

Cleaning product use has been associated with adverse respiratory health effects such as asthma in cleaning staff and healthcare workers. Research in health effects from cleaning products has largely depended upon collecting exposure information by questionnaires which has limitations such as recall bias and underestimation of exposure. The aim of this study was to develop a Cleaning and Hazardous Products Exposure Logging (CHaPEL) app with a barcode scanner and to test the feasibility of this app with university cleaners.

METHODS

The CHaPEL app was developed to collect information on demographics, individual product information, and exposure information. It also included an ease-of-use survey. A pilot study with university cleaning workers was undertaken in which cleaning workers scanned each product after use and answered the survey. Respiratory hazards of cleaning substances in the scanned cleaning products were screened by safety data sheets, a Quantitative Structure-Activity Relationship model and an asthmagen list established by an expert group in the US.

RESULTS

Eighteen university cleaners participated in this study over a period of 5 weeks. In total, 77 survey responses and 6 cleaning products were collected and all reported that using the app was easy. The most frequently used product was a multi-surface cleaner followed by a disinfectant. Out of 14 substances in cleaning products, ethanolamine and Alkyl (C12-16) dimethyl benzyl ammonium chloride were found as respiratory hazardous substances.

CONCLUSION

The CHaPEL app is a user-friendly immediate way to successfully collect exposure information using the barcodes of cleaning products. This tool could be useful for future epidemiological studies focused on exposure assessment with less interruption to the workers.

Perspectives and Attitudes of Newer New Jersey High School Teachers towards Cleaning, Sanitizing, and Disinfecting Consumer Products Used in School Classrooms

During the COVID-19 pandemic, there was an increased reported use of chemical cleaning, sanitizing, and disinfecting products (CSDPs), which created public concerns about negative health consequences for both children and adults in public schools. A subset of newer teachers shared experiences regarding safety and health (S&H) while working in school-based settings through a series of online surveys. Surveys were provided to teachers who completed work-based learning supervisory trainings provided by the New Jersey Safe Schools Program between October 2021 and June 2023. The participants answered questions focusing on CSDPs purchased for school use, their attitudes towards CSDPs, their use of personal protective equipment, and symptoms employees may have had due to CSDPs. A total of 205 teacher participants successfully completed the surveys. Over 25% of the teachers did not know where their CSDPs originated from, as they were provided by the school. Most participants "sometimes", "not often", or "never" read labels for CSDP ingredients or looked them up on healthy product apps. The participants (60%) tended to wear gloves while cleaning/disinfecting but did not wear masks. A third of the participants experienced respiratory health problems after working at school. Overall, the data suggest that more education on S&H regarding CSDPs needs to be provided to New Jersey teachers.

Changes in total volatile organic compound concentration in Seoul subway stations before (2019) and after (2021) the COVID-19 outbreak

Volatile organic compounds (VOCs) are major air pollutants often designated as specific hazardous or toxic. This study analyzed the trends in concentration changes and influencing factors of VOCs in underground subway stations in the Seoul Metro before (2019) and after (2021) the COVID-19 pandemic. A total of 506 samples were collected from 253 stations on lines 1-8 between May 2019 and September 2021. Total VOC concentrations in Seoul Metro increased after the COVID-19 pandemic 3.8 times over. The deeper the underground station platform, the greater the difference in the VOC concentrations between 2019 and 2021, which was positively related. Average VOC concentration was the highest (52.8 µg/m3) at a depth of 25-30 m and the lowest (23.9 µg/m3) at a depth of < 10 m in 2019. In conclusion, excessive disinfection during the COVID-19 pandemic resulted in increased VOC concentrations in the Seoul Metro, especially in the deeper underground stations. Less frequent quarantine disinfection is recommended to improve air quality.

Safety data sheets as an information pathway on hazards of occupationally used cleaning agents

To investigate consistency and accessibility of asthma and skin allergy hazard information in safety data sheets (SDSs) for cleaning agents on the Swedish market, we compiled a database of 504 SDSs and 351 therein declared ingredients. Labelling of products was compared to that of ingredients according to harmonised classification. For each ingredient, also notified classification and three additional sources on sensitising properties were compared. Product labelling most frequently indicated corrosion and irritation hazards. Only 3% of products were labelled as skin sensitisers and none as asthmagens. According to harmonised classification, 9% of products contained skin sensitisers, using other information sources increased the number to 46%. While 2% of products contained respiratory sensitisers according to harmonised classification, the number increased to 17% when using other information sources. Furthermore, sensitisers were declared across several sections of the SDSs, hampering easy access of such information. In conclusion, there are inconsistencies in hazard identification of cleaning agents and their ingredients. Hence, SDSs may not altogether fulfil its hazard information role. Improved criteria for identifying sensitisers and respiratory irritants are warranted. Additionally, we argue that all ingredients should be listed in section 3 regardless of concentration, to facilitate access of information about sensitising properties.

Comparison of ConsExpo estimated exposure levels to glycol ethers during professional cleaning work to existing regulatory occupational exposure limit values

Objectives. Researchers have shown that cleaning workers have an increased risk of asthma and rhinitis, mainly due to exposure to chemical substances present in the cleaning products they use. Among the important substances are glycol ethers, increasingly used as components in cleaning products. This study aimed to assess exposure levels of glycol ether in professional cleaning products and compare them to existing regulatory exposure limit values. Methods. Information from safety data sheets of the products is used to identify the glycol ethers present in the cleaning products and their respective concentrations. Other sources were used to obtain the relevant data required for use in the tool to generate exposure assessments. Exposure levels for various cleaning work exposure scenarios were estimated using the ConsExpo Web tool. Results. The estimated exposure values are significantly lower than the existing regulatory occupational exposure limit (OEL) values for the different glycol ethers. Conclusions. The study showed that the risk of exposure to glycol ethers by inhalation from professional cleaning products is minimal as exposure estimates were much below the regulatory OEL values.

Environmental cleaning battling against Covid-19 infection in health-care facilities

Purpose

This study aims to identify and validate the environmental cleaning elements and performance criteria to prevent Covid-19 infection in health-care facilities.

Design/methodology/approach

Eight elements and 38 performance criteria were identified from the literature, and a questionnaire survey that involved environmental cleaning experts was carried out. Content validity index was used to validate the content of the environmental cleaning elements and performance criteria in this study.

Findings

The result indicates that the performance criteria of “Finishes, furnishings” and “Equipment Maintenance Log” were not relevant to be applied in current fighting against Covid-19 infection in health care. However, the remaining 36 performance criteria were proved as relevant and acceptable.

Practical implications

The findings of this study can provide a significant contribution to the built environment industry. By knowing the environmental cleaning elements and performance criteria, efforts can be carried out to explore measures that can be taken to improve the environmental cleaning practice in health care to battle against Covid-19 infection.

Originality/value

This paper fulfils an identified need to study how environmental cleaning can be implemented in health-care facilities.

Assessing measurement model of green cleaning components for green buildings

Purpose

This paper aims to assess a measurement model of green cleaning for green buildings in Malaysia. Being one of the contributors to the indoor environmental quality performance, green cleaning has become one of the significant aspects that need to be considered for the well-being and performance of a building, particularly in a green building's operations and maintenance performance. Green buildings without green cleaning practices would hinder the benefits that should be rendered economically, socially and environmentally. However, the absence of clear green cleaning components and requirements in Malaysia has become a motivation to undertake this research.

Design/methodology/approach

A questionnaire survey involving cleaning service providers and green building index (GBI) facilitators was carried out, and the data was then analyzed using partial least squares structural equation modeling. However, this paper will only be focusing on the measurement model assessment.

Findings

Most of the green cleaning components and requirements are acceptable in the model except integrated pest management (in the cleaning procedure component) and hand soaps (in the product and materials component) due to lower factor loadings. Therefore, these two requirements were removed from the measurement model.

Research limitations/implications

Due to a paucity of professionals in the field of green cleaning, the researchers have selected GBI facilitators and cleaning service providers as respondents for this research. The researchers assumed that GBI facilitators are aware of acceptable products and materials for green buildings; meanwhile, cleaning service providers know what is the best cleaning technique and process that helps in achieving cost and resource efficiency. This research also assumed that the green cleaning components identified can be applied to any type of green building, regardless of the differences in needs in each type of building.

Practical implications

This discovery will give the industry, particularly cleaning service providers and green building management teams, a first look at the green cleaning components and requirements.

Originality/value

This paper fulfills the need to study how green cleaning helps in achieving the benefits rendered by green buildings.

Maternal occupational exposure to chemicals and child cognitive function

BACKGROUND

Limited data exist regarding child neurodevelopment in relation to maternal occupational exposure to endocrine-disrupting chemicals (EDCs).

METHODS

We included 1058 mother-child pairs from the INfancia y Medio Ambiente (INMA) project (2003-2008). Using a job-exposure matrix, exposure probability scores for ten EDC groups were assigned to each mother based on her longest held job during pregnancy. At the child's 5-year visit, the McCarthy Scales of Children's Abilities was administered, yielding the general cognitive index and scales for specific cognitive domains. We analyzed region-specific associations between EDC exposures and each outcome separately using adjusted linear regression and combined region-specific effect estimates using random-effects meta-analyses.

RESULTS

Approximately 24% of women were exposed to at least one EDC group, but exposure to most individual EDC groups was low (<5%). Maternal organic solvent exposure was associated with lower quantitative scores among children (-5.8 points, 95% confidence interval: -11.0, -0.5). Though statistically non-significant, exposures to polycyclic aromatic hydrocarbons, phthalates, alkylphenolic compounds, and miscellaneous chemicals were associated with poorer offspring performance for most or all cognitive domains.

CONCLUSIONS

This study found limited evidence for a role of maternal occupational EDC exposures on child cognition. Further research is needed to better characterize exposures among pregnant workers.

IMPACT

Using data from a prospective birth cohort, we help fill an important research gap regarding the potential consequences of work-related exposure to endocrine-disrupting chemicals (EDCs) among pregnant women on child neurodevelopment. We expand on existing literature-largely limited to pesticide and organic solvent exposures-by using a job-exposure matrix to estimate exposure to several EDC groups. We found limited evidence of an association between maternal occupational EDC exposure and children's overall cognition. We did observe specific associations between exposure to organic solvents and lower quantitative reasoning scores.

Environmental Health Needs Among Latinas in Cleaning Occupations: A Mixed Methods Approach

In the U.S., approximately half of maids and housekeeping cleaners are Latino or Hispanic, while the vast majority are women (88.3%). This largely immigrant, underserved workforce faces complex factors, which may contribute to adverse health outcomes. To understand relevant barriers and challenges, this mixed-methods study explored the environmental health needs of a heterogeneous group of Latinas in New Jersey (NJ) who clean occupationally, and consisted of 3 focus groups (N = 15) with a cross-sectional survey (N = 9), both conducted in Spanish. Participants were recruited from community-based English as a Second Language classes in Hackensack, NJ. Analysis of focus group audio recordings included descriptive and in vivo coding followed by inductive coding to explore thematic analysis. The survey responses were evaluated using descriptive statistics. As per the survey results, the environmental health needs of this population include sore muscles, back problems, asthma, other respiratory issues, migraine or headache, and skin issues (rash, etc.). In the group discussions, the roles of genetics, food, and chemical exposures in cancer etiology were of great interest and a variety of opinions on the topic were explored. Both the focus group discussions and survey responses suggested that this population also faces barriers including lack of training, chemical exposures and inadequate personal protective equipment (PPE). These barriers are compounded by daily environmental exposures from personal home cleaning practices. The development of culturally- and linguistically-appropriate interventions are warranted to better protect the health of essential occupational cleaners who keep homes, businesses and schools clean.

Cleaning Products Commonly Used in Oklahoma Family Child Care Homes: Implications for Respiratory Risk and Children's Health

Little is known about the cleaning products used by early care and education programs that contribute to childhood asthma, particularly in Oklahoma where rates of uncontrolled asthma are higher than national rates (60.0% vs. 50.3%, respectively). We conducted a cross-sectional study of cleaning products used by Oklahoma-licensed family child care homes (FCCHs) (n = 50) to characterize and identify potential respiratory-health risks associated with chemical contents. Overall, 386 chemicals were abstracted from the 132 reported products. Of these, 100 unique chemicals were identified. Four percent (4.2%) of providers used a product with a sensitizer that may cause allergy or asthma symptoms if inhaled and 35.4% used a product with an irritant that may cause irritation to the respiratory tract. Most (62.5%) reported using a product with a chemical that had a C=C double bond in its molecular structure that may make it highly reactive with other substances in the air and produce secondary air pollutants and 83.3% reported using a sodium hypochlorite containing product. Twenty-three percent reported products that contain carcinogens. Policy, educational, and technical assistance interventions are needed to promote the use of safer products and reduce respiratory and other health risks posed by chemicals in Oklahoma FCCHs.

Modelling Treated Laundry Greywater Reuse for Irrigation Using an Affordable Treatment Method and Seed Germination Test

A potential solution in areas facing water shortages is greywater (GW) reuse. GW is produced in bathrooms, laundry rooms, and kitchens of households. With proper treatment, it can be an alternative source for the agriculture sector, which consumes approximately 70% of the world’s water. This paper represents the characterization of synthetic laundry GW fraction (LGW), its treatment and modelling of treated LGW reuse for irrigation using a seed germination test. LGW’s constant quality (pH = 8.0 ± 0.3, turbidity = 174 ± 73 NTU, BOD5 = 300 ± 60 mgL−1, TOC = 162 ± 40 mgL−1) is suitable for testing the treatment method’s efficiency. Coagulation–flocculation, applying iron(III) chloride and sand filtration as a simple treatment combination, generates good-quality irrigation water (pH = 7.27 ± 0.23, turbidity = 0.6 ± 0.4 NTU, BOD5 = 17 ± 8 mgL−1, TOC = 16 ± 6 mgL−1). Seed germination tests with different waters, and elemental analysis of water, roots, and stems of the plants were done to verify the plants’ quality. The sodium adsorption ratio (SAR) for the raw LGW (SAR = 4.06) was above the threshold (<3) for safe irrigation, thus it is not recommended for this purpose. Based on the elemental analysis results and SAR value of treated LGW (SAR = 2.84), it can potentially be used for irrigation purposes.

OUP accepted manuscript

Using data from the Swedish Products Register, hosted by the Swedish Chemicals Agency (KemI), national occupational injury and disease statistics, and call records from the Swedish Poisons Information Centre (PIC) we characterize health hazards of marketed cleaning products and recorded injuries, disease, and incidents linked to cleaning or disinfection agents. The results show that cleaning agents pose many kinds of health hazards, although corrosion and irritation hazards dominate, in particular for the eyes (54% of all included products). Few products were recognized as inhalation hazards. The nature of the health hazards is reflected in the occupational disease and injury statistics and PIC records for eyes and skin but not for the respiratory tract. Among occupational disease cases attributed to cleaning or disinfection agents, 61% concern skin and 26% the respiratory tract. Among occupational injury cases 64% concern chemical burns. However, only a small part (<0.5%) of all reported diseases and injuries were explicitly attributed to cleaning or disinfection agents. On average, there were 11 cases of disease attributed to cleaning or disinfection agents per million workers and year. For occupational injuries the corresponding number was 8. The data concern a broad range of sectors and occupations, but notable sectors were healthcare, accommodation and food service, and manufacturing. Women were more likely to suffer from disease, men and women equally likely to suffer from injury. PIC cases were evenly distributed between men and women, but the clear risk cases more frequently involved men. Occupational diseases increased many-fold in 2020 while injuries decreased, which could be due to COVID-19 changing use patterns of cleaning and disinfection agents at work. We conclude that cleaning agents pose a variety of risks to a large part of the workforce, although particular attention for preventive efforts may need to be directed to the healthcare, accommodation and food service, and manufacturing sectors.

Knowledge, attitudes and behaviors of Latinas in cleaning occupations in northern New Jersey: a cross-sectional mixed methods study

BACKGROUND

In the United States, 88.3% of all 1,163,000 maids and housekeeping cleaners are female, and approximately half of them Latinas. Latinas are understudied and underrepresented in health research, particularly involving chemical exposure in cleaning practices, lack of job training, and inadequate access to personal protective equipment. The purpose of this study is twofold: 1) to examine the knowledge (via training experiences), attitudes and behaviors of a heterogeneous group of Latinas who clean occupationally and 2) to assess their cleaning practices at work and at home.

METHODS

This mixed-method study consisted of two phases: 1) three focus groups to explore knowledge (via training experiences), attitudes, and behaviors regarding cleaning practices (N = 15) and 2) a 43-question cross-sectional survey. Focus group audio recordings were analyzed using descriptive and in vivo coding and then coded inductively to explore thematic analysis. Statistical analysis of the survey evaluated means, frequency and percentage for each of the responses.

RESULTS

Participants (n = 9) were women (mean age = 48.78 and SD = 6.72) from South America (n = 5), Mexico (n = 1), El Salvador (n = 1) and Dominican Republic (n = 2). The mean length of time living in the US was 18.78 years and over half (55.6%) worked in the cleaning industry for 10 or more years. Findings from the three focus groups (n = 15) included that training in cleaning often occurred informally at a very young age at home. Participants reported cleaning in groups where tasks are rotated and/or shared. Most were the primary person cleaning at home, suggesting increased exposure. Gloves and masks were the most frequently used PPE, but use was not consistent. For participants who purchase their own products, driving factors included price, smell and efficacy. Some participants used products supplied or preferred by the employer.

CONCLUSIONS

Latinas in cleaning occupations face a range of social and health barriers including lack of safety and health training, inadequate PPE and low literacy. To address these issues, the development of an intervention is warranted to provide training and resources for this critical population of essential workers.

The use of cleaning products and its relationship with the increasing health risks during the COVID-19 pandemic

OBJECTIVE

The present study aimed to determine the factors affecting the use of cleaning products at the home environment and the frequency of problems during the coronavirus disease-19 (COVID-19) pandemic.

MATERIALS AND METHODS

This cross-sectional research was performed online between 30 August 2020 and 15 September 2020. The population of the study consisted of adults aged between 18 and 80 years, affected by the COVID-19 pandemic. Data collection forms (introductory information and risk perception form and cleaning products usage characteristics form) were shared through Web2 tools. The questionnaire study was completed with 674 participants between the ages of 18 and 80 years in Turkey. Descriptive statistics and classification tree were used in the analysis of the data. Statistical significance was accepted as P ≤ .01 in all analyses.

RESULTS

During the pandemic period compared with the pre-pandemic period, it was observed that the frequency of cleaning (69.3%) and the amount of cleaning product usage (74.2%) increased significantly and the frequency of problems related to the use of cleaning products was found as 46.9%. The most commonly reported problems were skin disturbances (68%) and shortness of breath (23%). It was determined that the history of contact with the COVID-19 patient, the perceived risk of COVID-19 infection and risky cleaning behaviour were predictive in determining the risk of experiencing problems related to cleaning products. The amount of bleach consumed per month among who did experience problems was higher than those who did not experience problems and was associated with the perceived risk of COVID-19 infection.

CONCLUSION

In the COVID-19 pandemic, human beings have been found to increase the frequency of cleaning and using cleaning products. In order to reduce the negative effects of chemicals used for cleaning on human and environmental health, the trainings to be given by the teams providing primary healthcare services can be effective as well as general education activities for community groups.

Insufficient respiratory hazard identification in the safety data sheets for cleaning and disinfection products used in healthcare organisations across England and Wales

BACKGROUND

Exposure to cleaning and disinfection products has been associated with respiratory disorders such as asthma in cleaning and healthcare workers. Safety data sheets (SDSs) provide information on hazardous chemicals that are present in products to help users with risk assessment and implement appropriate control measures. However, they have potential limitations in identifying respiratory hazards due to a lack of regulatory test methods for respiratory sensitisation and irritation of chemicals.

METHODS

SDSs were first used to identify chemicals on the database as respiratory sensitisers and irritants. A quantitative structure-activity relationship (QSAR) model and an asthmagen list established by the Association of Occupational and Environmental Clinics (AOEC) were used to identify potential respiratory sensitisers and irritants (by the AOEC list only) in the cleaning and disinfection products.

RESULTS

From a total of 459 cleaning and disinfection products used in healthcare organisations across England and Wales, 35 respiratory sensitisers not labelled as such on the SDS were identified by QSAR or AOEC. Only 2% of cleaning and disinfection products contained at least one respiratory sensitiser as identified by their SDSs; this was increased to 37.7% of products when the QSAR or the AOEC list was used.

CONCLUSIONS

A significantly higher proportion of cleaning products contain respiratory hazardous chemicals, particularly respiratory sensitisers than would be expected from the information provided by SDSs alone. Cleaners and healthcare workers may, therefore, be insufficiently protected.

Human skin permeation rates ex vivo following exposures to mixtures of glycol ethers

Skin exposure to cleaning products in the general and occupational population are a public health concern. Among the most frequently identified amphiphilic organic solvents in cleaning products are propylene glycol monomethyl ether (PGME) and propylene glycol n-butyl ether (PGBE). Internal dose from skin exposure may be efficiently evaluated using in vitro flow-through diffusion cells with excised human skin. Our aim in this study was two-fold; 1) characterize the permeation rates (J), time lag (T_lag), and permeation coefficients (Kp) of PGME and PGBE in human ex-vivo skin permeation assays, and 2) determine a possible mixture effect on skin permeation characteristics when applied together. Our results showed a short T_lag for PGME and was reduced further depending on the amount of PGBE in the mixture (T_lag was reduced from 2 h to 1-1.7 h) for fresh skin. PGBE T_lag slightly increased when mixed with 50 % or more PGME. Permeation rate decreased to half for both PGME and PGBE in mixture at any concentration. This substantial permeation was greater with previously frozen skin. This mixture effect could favor permeation of other compounds through human skin.

Chemicals inhaled from spray cleaning and disinfection products and their respiratory effects. A comprehensive review

Spray cleaning and disinfection products have been associated with adverse respiratory effects in professional cleaners and among residents doing domestic cleaning. This review combines information about use of spray products from epidemiological and clinical studies, in vivo and in vitro toxicological studies of cleaning chemicals, as well as human and field exposure studies. The most frequent chemicals in spray cleaning and disinfection products were compiled, based on registrations in the Danish Product Registry. The chemicals were divided into acids, bases, disinfectants, fragrances, organic solvents, propellants, and tensides. In addition, an assessment of selected cleaning and disinfectant chemicals in spray products was carried out. Chemicals of concern regarding respiratory effects (e.g. asthma) are corrosive chemicals such as strong acids and bases (including ammonia and hypochlorite) and quaternary ammonium compounds (QACs). However, the evidence for respiratory effects after inhalation of QACs is ambiguous. Common fragrances are generally not considered to be of concern following inhalation. Solvents including glycols and glycol ethers as well as propellants are generally weak airway irritants and not expected to induce sensitization in the airways. Mixing of certain cleaning products can produce corrosive airborne chemicals. We discuss different hypotheses for the mechanisms behind the development of respiratory effects of inhalation of chemicals in cleaning agents. An integrative assessment is needed to understand how these chemicals can cause the various respiratory effects.

Emissions of VOCs, SVOCs, and mold during the construction process: Contribution to indoor air quality and future occupants' exposure

Building materials and human activities are important sources of contamination indoors, but little information is available regarding contamination during construction process which could persist during the whole life of buildings. In this study, six construction stages on two construction sites were investigated regarding the emissions of 43 volatile organic compounds (VOCs), 46 semi-volatile organic compounds (SVOCs), and the presence of 4 genera of mold. Results show that the future indoor air quality does not only depend on the emissions of each building product but that it is also closely related to the whole implementation process. Mold spore measurements can reach 1400 CFU/m³ , which is particularly high compared with the concentrations usually measured in indoor environments. Relatively low concentrations of VOCs were observed, in relation to the use of low emissive materials. Among SVOCs analyzed, some phthalates, permethrin, and hydrocarbons were found in significant concentrations upon the delivery of building as well as triclosan, suspected to be endocrine disruptor, and yet prohibited in the treatment of materials and construction since 2014. As some regulations exist for VOC emissions, it is necessary to implement them for SVOCs due to their toxicity.

Peaks, Means, and Determinants of Real-Time TVOC Exposures Associated with Cleaning and Disinfecting Tasks in Healthcare Settings

Cleaning and disinfecting tasks and product use are associated with elevated prevalence of asthma and respiratory symptoms among healthcare workers; however, the levels of exposure that pose a health risk remain unclear. The objective of this study was to estimate the peak, average, and determinants of real-time total volatile organic compound (TVOC) exposure associated with cleaning tasks and product-use. TVOC exposures were measured using monitors equipped with a photoionization detector (PID). A simple correction factor was applied to the real-time measurements, calculated as a ratio of the full-shift average TVOC concentrations from a time-integrated canister and the PID sample, for each sample pair. During sampling, auxiliary information, e.g. tasks, products used, engineering controls, was recorded on standardized data collection forms at 5-min intervals. Five-minute averaged air measurements (n = 10 276) from 129 time-series comprising 92 workers and four hospitals were used to model the determinants of exposures. The statistical model simultaneously accounted for censored data and non-stationary autocorrelation and was fit using Markov-Chain Monte Carlo within a Bayesian context. Log-transformed corrected concentrations (cTVOC) were modeled, with the fixed-effects of tasks and covariates, that were systematically gathered during sampling, and random effect of person-day. The model-predicted geometric mean (GM) cTVOC concentrations ranged from 387 parts per billion (ppb) for the task of using a product containing formaldehyde in laboratories to 2091 ppb for the task of using skin wipes containing quaternary ammonium compounds, with a GM of 925 ppb when no products were used. Peak exposures quantified as the 95th percentile of 15-min averages for these tasks ranged from 3172 to 17 360 ppb. Peak and GM task exposures varied by occupation and hospital unit. In the multiple regression model, use of sprays was associated with increasing exposures, while presence of local exhaust ventilation, large room volume, and automatic sterilizer use were associated with decreasing exposures. A detailed understanding of factors affecting TVOC exposure can inform targeted interventions to reduce exposures and can be used in epidemiologic studies as metrics of short-duration peak exposures.

Methodological evaluation of human research on asthmagenicity and occupational cleaning: a case study of quaternary ammonium compounds ("quats")

In this paper, we review methodological approaches used in studies that evaluated the association between occupational exposure to quaternary ammonium compounds (quats) and occupational asthma. This association is of interest because quats are a common active ingredient of disinfectants and have been linked to work-related asthma in some circumstances. However, any evidence-based assessment of an exposure-outcome association needs to consider both strengths and limitations of the literature. We focus on publications cited by various US and international organizations. Eighteen investigations included in the review fall into two broad categories: case reports and challenge studies of individual patients and population studies that examined the association between quats and asthma occurrence in groups of subjects. We evaluated these studies guided by questions that address whether: exposure data on specific quat(s) and other agents that may cause asthma were included, new asthma cases were differentiated from asthma exacerbation, and information on respiratory sensitivity versus irritation was given. We also assessed consistency across studies. Studies of individual patients, particularly those that provided detailed information on challenge test results, document cases of asthma induced by exposure to quats. By contrast, studies of occupational groups with the highest potential for quats exposure (e.g., cleaners and farmers) do not consistently report increased incidence of asthma due specifically to quats. The unresolved methodological issues include: poor understanding of exposure pathways considering that quats are non-volatile, lack of quantitative data allowing for identification of an asthmagenicity threshold, insufficient information on whether quats are sensitizers or act via dose-dependent irritation or some other mechanism, and inability to quantify risk of new-onset asthma attributable to quats. Another important area of uncertainty is the lack of information on the specific quats being used. There is also a lack of data capable of distinguishing the effects of quats from those of other chemical and biological workplace exposures. The current state-of-the-science does not allow a proper assessment of the potential link between quats and occupational asthma.

From one species to another: A review on the interaction between chemistry and microbiology in relation to cleaning in the built environment

Since the advent of soap, personal hygiene practices have revolved around removal, sterilization, and disinfection-both of visible soil and microscopic organisms-for a myriad of cultural, aesthetic, or health-related reasons. Cleaning methods and products vary widely in their recommended use, effectiveness, risk to users or building occupants, environmental sustainability, and ecological impact. Advancements in science and technology have facilitated in-depth analyses of the indoor microbiome, and studies in this field suggest that the traditional "scorched-earth cleaning" mentality-that surfaces must be completely sterilized and prevent microbial establishment-may contribute to long-term human health consequences. Moreover, the materials, products, activities, and microbial communities indoors all contribute to, or remove, chemical species to the indoor environment. This review examines the effects of cleaning with respect to the interaction of chemistry, indoor microbiology, and human health.

Cleaning workers' exposure to volatile organic compounds and particulate matter during floor polish removal and reapplication

The floor polish removal (FPR) and reapplication (FPA) are important cleaning tasks in public buildings that have hard floor surfaces. Usually, the FPR and FPA are conducted once or twice a year, during the periodic cleaning of these buildings. The FPR can be performed either chemically (CFPR) or by using dry scrubber (DFPR), when the polish is ground from the floor. In this study, cleaning workers' exposure to volatile organic compounds (VOCs) and particulate matter (PM) during the FPR and FPA, and the differences in the exposures between the two FPR methods were investigated. In total, three buildings located in Central Finland were included, and total of six cleaning workers (two per building) participated in the study. In Buildings 1 and 2, the CFPR and FPA were performed and in Building 3, the DFPR was conducted. TVOC (total volatile organic compounds) concentrations in the breathing zone of the workers during the CFPR were 8,740 and 390 µg/m³ (SD 3,290 and 180 µg/m³) for Buildings 1 and 2, respectively. During the DFPR in Building 3, the average TVOC concentration was 400 µg/m³ (SD 180 µg/m³, stationary sampling). The TVOC concentrations during the FPA were high, 1,640 and 2,170 µg/m³ on average (SD 1,570 and 930 µg/m³) for Buildings 1 and 2, respectively. Glycol ethers were the most prominent VOCs during the CFPR and FPA, whereas carboxylic acids were the most common during the DFPR. The inhalable dust concentrations in the workers' breathing zone were noticeably higher during the DFPR (1.55 mg/m³ on average, SD 0.01 mg/m³) than the CFPR (0.24 mg/m³ on average, SD 0.05 mg/m³). Finnish occupational exposure limit value for organic inhalable dust is 5 mg/m³. As the products used during the CFPR and FPA contain glycol ethers and ethanolamines that are absorbed via the skin as well, the use of skin protection is recommended. Whereas the use of FFP3 respirators and skin protection are recommended during the DFPR to prevent the PM exposure.

Ethanolamines permeate slowly across human skin ex vivo, but cause severe skin irritation at low concentrations

Skin exposures are common during cleaning activities, and may contribute to the overall body burden. Cleaning products may contain irritants such as monoethanolamine (MEA) and diethanol amine (DEA). The significance of the skin exposure route is unknown, as no estimates for MEA skin permeation are available. We used in vitro flow-through diffusion cells with excised fresh human skin to measure skin permeation, and assessed skin damage with histological methods. MEA(aq) by itself (2%) or as a constituent in cleaning products (0.25% working solution) did not permeate after 1 h or 24 h of exposure. MEA(aq) (10%) did not permeate skin after 1 h but after 24 h with a delay (T_lag; 7 h) and a moderate permeation rate (J; 26.6 μg/cm²/h). MEA permeation rate was 20-fold greater (544 μg/cm²/h) and ¼ of the time lag (1.5 h) when applied as undiluted cleaning product (13% MEA) compared to 10% MEA(aq). DEA in cleaning products did not permeate skin after 24 h. MEA and DEA produced skin irritations at low concentrations (1% MEA) and severe skin irritations when tested as a constituent in cleaning products. Absorption increased from 0 to 3% after 24 h to 14-29% after 88 h of MEA exposure, and is likely explained by the increased damage of the skin barrier. Limitations of this study are the low number of skin donors (N = 5) available. Our results demonstrate that topically applied MEA permeates across human skin relatively slowly and not below 5% while relatively extensively as a constituent of a commercial cleaning product.

Development of a bar code-based exposure assessment method to evaluate occupational exposure to disinfectants and cleaning products: a pilot study

OBJECTIVE

Healthcare workers are highly exposed to various types of disinfectants and cleaning products. Assessment of exposure to these products remains a challenge. We aimed to investigate the feasibility of a method, based on a smartphone application and bar codes, to improve occupational exposure assessment among hospital/cleaning workers in epidemiological studies.

METHODS

A database of disinfectants and cleaning products used in French hospitals, including their names, bar codes and composition, was developed using several sources: ProdHyBase (a database of disinfectants managed by hospital hygiene experts), and specific regulatory agencies and industrial websites. A smartphone application has been created to scan bar codes of products and fill a short questionnaire. The application was tested in a French hospital. The ease of use and the ability to record information through this new approach were estimated.

RESULTS

The method was tested in a French hospital (7 units, 14 participants). Through the application, 126 records (one record referred to one product entered by one participant/unit) were registered, majority of which were liquids (55.5%) or sprays (23.8%); 20.6% were used to clean surfaces and 15.9% to clean toilets. Workers used mostly products with alcohol and quaternary ammonium compounds (>90% with weekly use), followed by hypochlorite bleach and hydrogen peroxide (28.6%). For most records, information was available on the name (93.7%) and bar code (77.0%). Information on product compounds was available for all products and recorded in the database.

CONCLUSION

This innovative and easy-to-use method could help to improve the assessment of occupational exposure to disinfectants/cleaning products in epidemiological studies.

Influence of indoor environmental factors on mass transfer parameters and concentrations of semi-volatile organic compounds

Semi-volatile organic compounds (SVOCs) in indoor environments can partition among the gas phase, airborne particles, settled dust, and available surfaces. The mass transfer parameters of SVOCs, such as the mass transfer coefficient and the partition coefficient, are influenced by indoor environmental factors. Subsequently, indoor SVOC concentrations and thus occupant exposure can vary depending on environmental factors. In this review, the influence of six environmental factors, i.e., indoor temperature, humidity, ventilation, airborne particle concentration, source loading factor, and reactive chemistry, on the mass transfer parameters and indoor concentrations of SVOCs was analyzed and tentatively quantified. The results show that all mass transfer parameters vary depending on environmental factors. These variations are mostly characterized by empirical equations, particularly for humidity. Theoretical calculations of these parameters based on mass transfer mechanisms are available only for the emission of SVOCs from source surfaces when airborne particles are not present. All mass transfer parameters depend on the temperature. Humidity influences the partition of SVOCs among different phases and is associated with phthalate hydrolysis. Ventilation has a combined effect with the airborne particle concentration on SVOC emission and their mass transfer among different phases. Indoor chemical reactions can produce or eliminate SVOCs slowly. To better model the dynamic SVOC concentration indoors, the present review suggests studying the combined effect of environmental factors in real indoor environments. Moreover, interactions between indoor environmental factors and human activities and their influence on SVOC mass transfer processes should be considered.

A chamber study of alkyl nitrate production formed by terpene ozonolysis in the presence of NO and alkanes

Organic nitrates are relatively long-lived species and have been shown to have a potential impact on atmospheric chemistry on local, regional, and even global scales. However, the significance of these compounds in the indoor environment remains to be seen. This work describes an impinger-based sampling and analysis technique for organic nitrate species, focusing on formation via terpene ozonolysis in the presence of nitric oxide (NO). Experiments were conducted in a Teflon film environmental chamber to measure the formation of alkyl nitrates produced from α-pinene ozonolysis in the presence of NO and alkanes using gas chromatography with an electron capture detector. For the different concentrations of NO and O3 analyzed, the concentration ratio of [O3]/[NO] around 1 was found to produce the highest organic nitrate concentration, with [O3] = 100 ppb & [NO] = 105 ppb resulting in the most organic nitrate formation, roughly 5 ppb. The experiments on α-pinene ozonolysis in the presence of NO suggest that organic nitrates have the potential to form in indoor air between infiltrated ozone/NO and terpenes from household and consumer products.

A cautionary note on the effects of laboratory air contaminants on ambient ionization mass spectrometry measurements

RATIONALE

Ambient ionization mass spectrometry methods are convenient, sensitive and require little sample preparation. However, they are susceptible to species present in air surrounding the mass spectrometer. This study identifies some challenges associated with the potential impacts of indoor air contaminants on ionization and analysis involving open-air methods.

METHODS

Unexpected effects of volatile organic compounds (VOCs) from floor maintenance activities on ambient ionization mass spectrometry were studied using three different ambient ionization techniques. Extractive electrospray ionization (EESI), direct analysis in real time (DART) and ionization by piezoelectric direct discharge (PDD) plasma were demonstrated in this study to be affected by indoor air contaminants. Identification of contaminant vapors was verified by comparison with standards using EESI-MS/MS product ion scans.

RESULTS

Emissions of diethylene glycol monoethyl ether and ethylene glycol monobutyl ether are identified from floor stripping and waxing solutions using three ambient ionization mass spectrometry techniques. These unexpected indoor air contaminants are capable of more than 75% ion suppression of target analytes due to their high volatility, proton affinity and solubility compared with the target analytes. The contaminant vapors are also shown to form adducts with one of the target analytes.

CONCLUSIONS

The common practice in MS analysis of subtracting a background air spectrum may not be appropriate if the presence of ionizable air contaminants alters the spectrum in unexpected ways. For example, VOCs released into air from floor stripping and waxing are capable of causing ion suppression of target analytes.

Do chronic workplace irritant exposures cause asthma?

PURPOSE OF REVIEW

The present review summarizes the recent literature on the relation between chronic workplace irritant exposures and asthma, focusing on exposures of low to moderate levels. We discuss results from epidemiological surveys, potential biological mechanisms, and needs for further research. These aspects are largely illustrated by studies on exposure to cleaning products.

RECENT FINDINGS

Recent results from nine population-based and workplace-based epidemiological studies, mostly cross-sectional, found an increased risk of both new-onset and work-exacerbated asthma among participants exposed to moderate level of irritants and/or cleaning products.

SUMMARY

Evidence of a causal effect of chronic workplace irritant exposure in new-onset asthma remains limited, mainly because of a lack of longitudinal studies and the difficulty to evaluate irritant exposures. However, recent epidemiological studies strengthen the evidence of an effect of chronic exposure to irritants in work-related asthma. The underlying mechanism remains unknown but may be related to oxidative stress, neurogenic inflammation and dual irritant and adjuvant effects. However, disentangling chronic irritant effects from either acute irritant-induced asthma or immunological low molecular weight agent-induced asthma is difficult for some agents. Further research is needed to improve assessment of irritant exposures and identify biomarkers.

Cleaning practices and cleaning products in nurseries and schools: to what extent can they impact indoor air quality?

In the framework of a nationwide survey on indoor air quality conducted from September 2009 to June 2011 in 310 nurseries, kindergartens, and elementary schools in all regions of France, cleaning practices and products were described through an extensive questionnaire completed on-site by expert building inspectors. The questionnaire included the cleaning frequencies and periods, cleaning techniques, whether windows were open during cleaning, and the commercial names of the products used. Analysis of the questionnaire responses showed that cleaning was generally performed daily for furniture and floors. It was performed mostly in the evening with wet mopping and with one or more windows open. Five hundred eighty-four different cleaning products were listed, among which 218 safety data sheets (SDSs) were available and analyzed. One hundred fifty-two chemical substances were identified in the SDSs. The typical substances in cleaning products included alcohols, chlorides, terpenes, aldehydes, and ethers; more than half of them are irritants. Two endocrine disruptors, 2-phenylphenol and Galaxolide, were identified in two cleaning products used every day to clean the floors, in seven kindergartens and in a nursery respectively. Eleven reactive substances containing C=C double bonds, mostly terpenes, were identified in a wide variety of cleaning products.

Airborne exposures to monoethanolamine, glycol ethers, and benzyl alcohol during professional cleaning: a pilot study

A growing body of epidemiologic evidence suggests an association between exposure to cleaning products and respiratory dysfunction. Due to the lack of quantitative assessments of respiratory exposures to airborne irritants and sensitizers among professional cleaners, the culpable substances have yet to be identified.

PURPOSE

Focusing on previously identified irritants, our aims were to determine (i) airborne concentrations of monoethanolamine (MEA), glycol ethers, and benzyl alcohol (BA) during different cleaning tasks performed by professional cleaning workers and assess their determinants; and (ii) air concentrations of formaldehyde, a known indoor air contaminant.

METHODS

Personal air samples were collected in 12 cleaning companies, and analyzed by conventional methods.

RESULTS

Nearly all air concentrations [MEA (n = 68), glycol ethers (n = 79), BA (n = 15), and formaldehyde (n = 45)] were far below (<1/10) of the corresponding Swiss occupational exposure limits (OEL), except for ethylene glycol mono-n-butyl ether (EGBE). For butoxypropanol and BA, no OELs exist. Although only detected once, EGBE air concentrations (n = 4) were high (49.48-58.72mg m(-3)), and close to the Swiss OEL (49mg m(-3)). When substances were not noted as present in safety data sheets of cleaning products used but were measured, air concentrations showed no presence of MEA, while the glycol ethers were often present, and formaldehyde was universally detected. Exposure to MEA was affected by its amount used (P = 0.036), and spraying (P = 0.000) and exposure to butoxypropanol was affected by spraying (P = 0.007) and cross-ventilation (P = 0.000).

CONCLUSIONS

Professional cleaners were found to be exposed to multiple airborne irritants at low concentrations, thus these substances should be considered in investigations of respiratory dysfunctions in the cleaning industry; especially in specialized cleaning tasks such as intensive floor cleaning.