Document text
Principal Investigator: Soo-Jeong Lee
Organization: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
Fiscal Year: 2022
Award: $201,875
Funding agency: National Institute of Environmental Health Sciences
PROJECT SUMMARY/ABSTRACT
Disinfectants are widely used in various products and in various settings to prevent infection and transmission
of harmful pathogens. Disinfectants, however, contain hazardous chemicals and are known to cause irritation
or allergic symptoms in eyes, skin, respiratory and nervous systems, asthma, and damage to organs with
prolonged or repeated exposure. Quaternary ammonium compounds (QACs) are the most common active
ingredients used in disinfectants approved for SARS-CoV-2 control. The coronavirus disease 2019 (COVID-19)
pandemic led to dramatically increased use of disinfectants in the community and workplaces to prevent
SARS-CoV-2 infection and transmission. Such increased use of disinfectants raises substantial concerns
regarding the health effects of disinfectants. As for health risk by disinfectants, cleaning workers, particularly in
healthcare settings, have been identified as occupational groups most affected by disinfectants. During the
COVID-19 pandemic, with the heightened need for infection control in healthcare settings as well as increased
use of disinfectants at home/community, these workers may have further increased health risks from
disinfectant exposure. The purpose of this study is to assess the impact of the COVID-19 pandemic on
disinfectant use and the incidence of disinfectant-related illness and examine the association between
disinfectant exposure and health symptoms. We propose a study using three approaches: (1) Analysis of
California Pesticide Illness Surveillance Program data (2011-2020) to investigate disinfectant-related illness
cases in California. (2) A survey of 300 cleaning staff (predominantly Chinese and Hispanic) in a university
health system in Northern California on disinfectant use and chemical-related health symptoms. (3)
Measurement of two common QACs (benzalkonium chloride [BAC] and didecyl dimethyl ammonium chloride
[DDAC]) in feces and urine in a subset of survey participants (n=100). The study has the following specific
aims: (1) Characterize disinfectant-related illness cases in California during 2011-2020 and examine the trend
of the annual incidence over time. (2) Characterize disinfectant use during COVID-19 among hospital cleaning
staff and examine the relationship of disinfectant use with self-reported health symptoms. (3) Measure QACs
(BAC/DDAC) in feces and urine among hospital cleaning staff and examine their associations with self-
reported disinfectant use and health symptoms. This study will produce helpful information to assess the public
health burden by the widely used disinfectants and the impact of COVID-19 on disinfectant exposure and
health problems among the general population as well as the high-risk group of hospital cleaning staff. This
study will be one of the first studies that measures and quantifies QACs in human samples to examine health
effects. The biological data on QAC exposure among hospital cleaning staff will capture the body burden of
disinfectant chemicals from both occupational and non-occupational exposures that increased during the
COVID-19 pandemic, and will serve as a valuable foundation for analyses of longer-term health effects.
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