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

Lee, Sewon; Povey, Andrew C.; Seed, Martin; Tongeren, Martie van

doi:10.1136/oemed-2020-106881

Cited by 10 publications

(5 citation statements)

References 7 publications

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“…Among 3189 inspected mixture labels, 468 had an error in hazard statements, which in most cases was related to errors in self-classification ( European Chemicals Agency, 2019 ). A recent study on safety data sheets for cleaning and disinfection products used in healthcare, showed that the safety data sheet did not provide complete information for identifying products that contained respiratory sensitizers, but still it was a good available tool for identifying respiratory irritants ( Lee et al , 2021 ). We thus expect Fig.…”

Section: Discussionmentioning

confidence: 99%

An Overview of Cleaning Agents’ Health Hazards and Occupational Injuries and Diseases Attributed to Them in Sweden

Kathare

Julander

Erfani

et al. 2022

Annals of Work Exposures and Health

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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.

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Section: Discussionmentioning

confidence: 99%

An Overview of Cleaning Agents’ Health Hazards and Occupational Injuries and Diseases Attributed to Them in Sweden

Kathare

Julander

Erfani

et al. 2022

Annals of Work Exposures and Health

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show abstract

“…Therefore, the absence of association observed in our results between sensitizers ingredients and asthma symptoms may be due to an underestimation of the number of sensitizers in HDCP. Other methods have been suggested to categorize chemicals according to their irritant or sensitizing properties such as Quantitative Structure Activity Relationship (Lee et al 2021).…”

Section: Discussionmentioning

confidence: 99%

Association between household cleaning product profiles evaluated by the Ménag’Score® index and asthma symptoms among women from the SEPAGES cohort

Lemire

Chevallier²,

Lyon-Caen

et al. 2022

Int Arch Occup Environ Health

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Objective Considering household disinfectants and cleaning products (HDCP) as mixture of ingredients, rather than each ingredient individually, might help in characterizing their role in asthma. We investigated the association between HDCP and asthma, using the recently developed Ménag'Score®, a health risk assessment score based on exhaustive ingredient lists of HDCP. MethodsThe study is based on 103 female volunteers of the SEPAGES cohort (2014-2019), with repeated data (up to 3 collection times, 200 observations). HDCP use was assessed from a barcode-based smartphone application linked with an ingredient database. The Ménag'score® risks for health and environment were computed for each weekly used HDCP from their exhaustive ingredient data (from A: no known risk to E: highest risk). The association between the use of HDCP with a poor Ménag'score® (D or E; overall, health, environment scores) and asthma symptoms, was estimated by generalized estimating equations models adjusted for age, BMI and smoking status. ResultsParticipants were on average 33 years old, 11% smoked and 20% had at least one asthma symptom. The Ménag'score® was computed for 540 HDCP scanned by participants. Weekly use of HDCP with a poor Ménag'score®-health (around 60% of the participants) was associated with a higher risk of asthma symptoms (OR=3.13,). No association was observed for the Ménag'score®-environment. ConclusionThe use of HDCP with a poor Ménag'score®-health was associated with asthma symptoms. The results support the use of the Ménag'score®-health to further evaluate the health risks of HDCP in observational studies and as a potential public health tool.

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“…H334 - respiratory sensitization, H335 - respiratory irritation). Furthermore, two additional methods were used to identify potential respiratory hazards ( Lee et al 2021 ).…”

Section: The Database Of Cleaning and Disinfection Productsmentioning

confidence: 99%

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

Lee,

Povey,

van Tongeren

2023

Annals of Work Exposures and Health

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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.

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

Cited by 10 publications

References 7 publications

An Overview of Cleaning Agents’ Health Hazards and Occupational Injuries and Diseases Attributed to Them in Sweden

An Overview of Cleaning Agents’ Health Hazards and Occupational Injuries and Diseases Attributed to Them in Sweden

Association between household cleaning product profiles evaluated by the Ménag’Score® index and asthma symptoms among women from the SEPAGES cohort

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

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