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Regular use of disinfectants by nurses 'increases COPD risk'

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Regular use of disinfectants is linked to a higher risk of developing chronic obstructive pulmonary disease (COPD) among nurses, according to a large study looking at thousands of clinicians.

The study, carried out by French researchers, looked at COPD incidence in over 55,000 nurses working in the US.

“We are the first to report a link between disinfectants and COPD among healthcare workers”

Orianne Dumas

It found certain tasks involving frequent exposure to disinfectants, such as cleaning surfaces, and specific chemicals in disinfectants, were linked to a 22-32% increased risk of developing COPD.

Dr Orianne Dumas, from the French National Institute of Health and Medical Research (INSERM), presented the findings on Monday at the European Respiratory Society International Congress conference in Milan, Italy.

She and her colleagues analysed data from 55,185 female registered nurses enrolled in the US Nurses’ Health Study II, which started in 1989.

They focused on those still in a nursing job and with no history of COPD in 2009, and then followed them for around eight years until May 2017. During that time, 663 were diagnosed with COPD.

The nurses’ exposure to disinfectants was evaluated via a questionnaire and a matrix that assigned exposure to disinfectants by job or task.

“We need to investigate the impact on COPD of lifetime occupational exposure to chemicals”

Orianne Dumas

The results were adjusted for factors that might affect the outcome, such as smoking, age, body mass index and ethnicity.

Dr Dumas said: “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.

She added: “There was a suggestion of a link with the weekly use of disinfectants to clean instruments but this was not statistically significant.”

The researchers also looked at exposure to specific disinfectants: glutaraldehyde, bleach, hydrogen peroxide, alcohol and quaternary ammonium compounds – known as “quats”.

INSERM

Regular use of disinfectants by nurses ‘increases COPD risk’

Orianne Dumas

All of these were associated with an increased risk of COPD of between 24% to 32%, said the researchers.

“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,” noted Dr Dumas.

Previous studies have linked exposure to disinfectants with breathing problems such as asthma among healthcare workers.

In addition, as reported by Nursing Times, a recent study suggested healthcare assistants were at a slightly higher risk of rheumatoid arthritis than other occupations, potentially as a result of environmental factors.

Dr Dumas said: “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 told the conference.

Generic cleaning products chemicals

“Our 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,” she said.

She added: “These are preliminary findings and more research needs to be carried out. In particular, we need to investigate the impact on COPD of lifetime occupational exposure to chemicals and clarify the role of each specific disinfectant.”

However, Dr Dumas emphasised that, as it was an observational study, the findings showed only that there is an association between some disinfectants and the development of the disease.

  • The study, titled Occupational exposure to disinfectants and COPD incidence in US nurses: a prospective cohort study, is published in the event programme under abstract OA 1774.
  • 2 Comments

Readers' comments (2)

  • What surprises me about this article is the only passing reference to the circumstances of Cleaners.

    I realise that some specific 'clinical' situations require cleaning to be carried out by Nurses, or more usually HCA's.

    Are the cleaning substances and surficants etc., regularly used by cleaners from the companies' contracted to keep our hospitals hygienic, significantly different to those used in nursing related situations, to sort out blood, urine and feaces, wipe specific surfaces and clean particular instruments?

    Another thought: Does this research into risk for nurses, translate from the US and France, in terms of whom they regard as a Nurse; or am I nit picking?

    I wonder if we have a duty to see if these findings should provide a spur on to conduct further and similar comparative studied regarding regular cleaning staff; whose exposure to cleaning solutions is continuous. Again, I guess the type of compounds in solution, used in general cleaning, is different enough from more specialist solutions.

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  • I agree with the above comments. This study raises some questions but not very well. I think cleaners and health care assistants should have been included more. They after all they do the most with these chemicals. Nurses use chemicals for cleaning but nothing on the scale that the domestic staff have to do every day.

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