Cleaning Products May Increase Risk for COPD in Nurses

According to new study findings, nurses are between 25% and 36% more likely to develop COPD from using cleaning products and chemicals in the prevention of infection. Read on to learn more about the study’s findings.

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Cleaning Products May Increase Risk for COPD in Nurses

The sprays, wipes and liquids nurses frequently use to prevent infection could be harmful to lung health. A new study, published in JAMA Network Open found workplace exposure to cleaning chemicals significantly increases the risk in COPD among nurses.

In the study, researchers used data from an on-going study of more than 116,000 registered female nurses, in 14 states, dating back to 1989. The study focused on women who were still nurses and without lung disease in 2009. The nurses completed questionnaires every other year to track work history and lung health from 2009 to 2015.

Occupational Exposures and COPD

COPD is not only the third leading cause of death worldwide, but a chronic condition that often can lead to long term disability. Cigarette smoking remains the major risk factor for COPD in the U.S. However, data suggests that 15% to 20% of cases are caused by occupational exposures. Workplace exposures can also contribute to the disease burden of someone with COPD. In the past, studies on occupational exposure and COPD have investigated broad categories of causal agents, such as vapors, dust, gases or fumes and only on a limited number of occupational settings.

Significant Increase in Risk

According to the study findings, nurses were between 25% and 36% more likely to develop COPD based on exposure to certain cleaning products. The percentages reported in the study were determined after accounting for whether the nurses were smokers or suffered from asthma. Researchers found weekly use of disinfectants to clean hospital surfaces increased COPD risk by 38%, while weekly use of chemical to clean medical instruments increased the risk by 31%.

Women at Risk

Although gender roles have changed over the past few decades, exposure to cleaning products at home and at work are more common in women. The majority of nurses are female, with males being only 13% of the nursing workforce. A 2014 survey by the US Bureau of Labor and Statistics found that women perform 55-70% of household cleaning, which is about 30% more than men. In the healthcare industry, exposure levels to cleaning products and disinfectants are particularly high.

Irritation Causing Chemicals

Orianne Dumas, lead study author and researcher with Inserm, states, "We found that exposure to several chemicals were associated with increased risk of developing COPD among nurses.” Glutaraldehyde and hydrogen peroxide, used to disinfect medical instruments were among the chemicals identified by Dumas. Glutaraldehyde exposure can cause throat, nasal and lung irritation, asthma and difficulty breathing, skin irritation, wheezing, burning eyes and conjunctivitis. Nurses were also regularly exposed to fumes from bleach, alcohol and quaternary ammonium compounds, which are used to clean surfaces and floors. All these chemicals are known to cause lung irritation and could lead to the development of COPD. However, Dumas states researchers only found an association in the study, not a cause-and-effect relationship.

More Research Needed

The study authors found further study is needed to determine how these cleaning products might cause COPD, and if they increase the risk of lung disease for workers in other professions. Findings also suggest the need for further research to determine exposure-reduction strategies that provide adequate infection control for healthcare settings.

What Are the Alternatives?

Hospitals could continue to protect nurses' and patients' health by using safer alternatives, such as ultraviolet light or steam for disinfecting equipment and surfaces. Another option is for hospitals to switch to "green" cleaning products that don't emit harmful fumes. The key is finding a balance between safeguarding the health of nurses while maintaining the needed level of infection control.

Additional Resources

CDC Fact Sheet- Glutaraldehyde

Cleaning Chemicals: Know the Risks

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J.Adderton

About J.Adderton, BSN, MSN

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J. Adderton MSN has over 20 years experience in clinical leadership, staff development, project management and nursing education.

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Specializes in ER.

This is an extremely important topic in this era of covid tunnel vision! Thanks!

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Specializes in Mental health, substance abuse, geriatrics, PCU.

A very disturbing find. Think of all the healthcare settings where we use disinfectants on a daily basis, all these settings have various amounts of financial resources that may make it difficult to find safe alternatives. How that ventilators can be made so cheaply they may just hand those out to nurses so they can keep using their current products. ?

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Specializes in ER, Occupational Health.

My mom worked 20+ years for GM, the last several on sanitation, and she was forced to go out on disability from chemical burns on her lungs. 

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Does this study surprise us?

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