Can Detergents Increase Risk Of Chronic Obstructive Pulmonary Disease?

Health care workers who are regularly exposed to detergents used to clean equipment and surfaces are at risk of lung diseases.

Highlights

The risk of developing chronic obstructive pulmonary disease (COPD) is higher in those exposed to 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) were associated with COPD risk.
Nurses who use disinfectants to clean surfaces on a regular basis - at least once a week - had a 22% increased risk of developing COPD.

Regular use of disinfectants which are chemicals used to clean surfaces, equipments is linked to a higher risk of developing chronic obstructive pulmonary disease (COPD).

The study which was done among 55,000 nurses in the USA found that frequent exposure to disinfectants was associated with a 22% to 32% increased risk of developing COPD.

Chronic Obstructive Pulmonary Disease
COPD includes respiratory tract disorders that cause obstruction to airflow. These are chronic bronchitis, emphysema and small airway disease.

‘Frequent exposure to disinfectants, used to clean surfaces, and specific chemicals in disinfectants, were associated with a 22% to 32% increased risk of developing chronic obstructive pulmonary disease.’

Danger of Using Disinfectant Use

Dr Orianne Dumas (PhD) from INSERM, Villejuif, France and her colleagues analysed data from 55,185 female registered nurses enrolled in the US Nurses’ Health Study II, which started in 1989. The nurses had no history of COPD in 2009 and they were followed for 8 years till 2017.During that time 663 nurses were diagnosed with COPD.

The 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.

Predicting Risk for Chronic Obstructive Pulmonary Disease
Gene variations associated with chronic obstructive pulmonary disease were identified to determine people at high risk.

"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."

Healthcare Workers At Highest Risk

Non-Smoking Women More Susceptible to Chronic Obstructive Pulmonary Disease!
African-American women have highest prevalence of COPD compared to non-smoking older white men.

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) 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.

Treatment of Chronic Obstructive Pulmonary Disease or COPD: New Revelations
In patients with moderate-to-very-severe COPD, the drug tiotropium is more effective than salmeterol in preventing exacerbations.

"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.

The 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.

More research needs to be carried out to investigate the impact on COPD of lifetime occupational exposure to chemicals and clarify the role of each specific disinfectant.

Dr. Dumas said, "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."

Reference

Orianne Dumas et al., Nurses’ regular use of disinfectants is associated with developing COPD, , European Respiratory Society International Congress 2017.

Source-Medindia