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Disinfectant Use By Nurses Linked to COPD

There are a number of professions where there is an elevated risk for getting chronic obstructive pulmonary disease (COPD) from all the vapors, gases, dust, fumes, and chemicals (all irritants) that one inhales - such as welders, coal miners, cotton textile workers, construction, farmers, even hairdressers. Now a study suggests that nurses who use disinfectants at least once a week are also at higher risk for COPD. The specific disinfectants associated with COPD are glutaraldehyde, bleach, hydrogen peroxide, alcohol, and quats (quaternary ammonium compounds).

From Medscape: Exposure to Disinfectants Linked to COPD

The risk for chronic obstructive pulmonary disease (COPD) is higher in those who use disinfectants at least once a week than in those who do not, a preliminary observational study of a large cohort of female nurses in the United States reveals. 

For their study, Dr Dumas and her colleagues analyzed data from the Nurses' Health Study II. From 2009 to 2017, participants completed a survey every 2 years. ..... And they used the job-task exposure matrix to evaluate seven major disinfectants: formaldehyde, glutaraldehyde, hypochlorite bleach, hydrogen peroxide, alcohol, quaternary ammonium compounds (or quats), and enzymatic cleaners.

In the cohort of 55,185 women who were nursing in 2009, 663 reported incident physician-diagnosed COPD during the follow-up period. The team found an association between incident COPD and high-level exposure to glutaraldehyde, bleach, hydrogen peroxide, alcohol, and quats. Of the nurses diagnosed with COPD, 37% reported the weekly use of disinfectants to clean surfaces, and 19% reported weekly use to clean instruments. Regression models demonstrated that the risk for COPD was 22% higher for nurses who cleaned instruments, and 32% higher for nurses who cleaned surfaces.

We've been aware of the association between disinfectants and asthma for some time, she told Medscape Medical News.... There's no easy solution, Dr Dumas acknowledged. "Protection from infection is important, but so is the health of workers." Green products might be one solution, "but we're not sure of their effect on health either. Just because they're natural, doesn't mean they're safe; they can have allergens." Another solution could be ultraviolet light, as previously reported by Medscape Medical News.

This was a "well-performed study," said Lidwien Smit, PhD, from the University of Utrecht in the Netherlands. "I just wonder about the pathology, and how it influences the microbiome. Disinfectants are meant to kill off bacteria, but if you're exposed to large concentrations, you're also inhaling them, which could affect your airway microbes," she explained. In fact, disinfectants could play a role in killing off bacterial communities in the airways that are responsible for "immune homeostasis" and keep users healthy, she added. If that immune balance gets disturbed, it might have an influence on a person's reaction to pathogens or inflammation. 
Chest X-ray of person with COPD. Credit: Wikipedia

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