What are the health effects of excessive disinfection?

Specific effects of disinfection chemicals on human health
The COVID-19 pandemic and the potential health consequences of using alcohol-based hand sanitizers
References
More information


The use of cleaning agents in disinfection products is thought to lead to a variety of outcomes related to several organ systems, including respiratory and cardiovascular symptoms and effects on the skin. Respiratory effects can range from acute temporary irritation of open airways to two obstructive lung diseases.

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Specific effects of disinfection chemicals on human health

There are several organs and systems that are affected by chemicals present in disinfection products.

Impaired respiratory function

Respiratory diseases are the most common health problem resulting from chemicals present in disinfection products. It has been shown that early exposure to large doses of cleaning chemicals can lead to detrimental and long-term respiratory function, increasing the risk of childhood asthma as a consequence of lung epithelial cell damage mediated through innate immune pathways. Bleach, glutaraldehyde and ethanol are known to cause respiratory irritation, worsen existing asthma or induce what is known as ‘occupational asthma’. Fragrances, which also accompany ingredients in disinfectant products, are also triggers for respiratory disorders.

Liver and kidney damage

QACs, which are disinfectants used in workplaces and healthcare facilities, are believed to be directly toxic to the immune system by compromising the phagocytotic function of macrophages. This is also a similar concern associated with the use of glutaraldehyde. However, the immunotoxicity of this agent has not been adequately evaluated.

Metabolic health and obesity

Research shows that anthropogenic chemicals can lead to long-term effects such as problems with hormone function and body weight regulation in animals and humans. Cleaning chemicals can be considered fattening; the predominant mechanism by which cleaning chemicals compromise hormonal balance and promote obesity is by altering the gut microbiome.

A study that evaluated the gut microbiota of infants between three and four months of age compared to the composition between one and three years of age showed that changes in the gut microbiota were strongly associated with increased use of disinfectants in households. At the same time, children exposed to heavier disinfectants also had higher body mass indices at age three than infants who were less exposed.

Thyroid function

Phthalates are common chemicals found in disinfectant products and are thought to damage thyroid function. Prenatal phthalate exposure has been shown to reduce total thyroxine (T4) levels in pregnant women, which can subsequently lead to adverse effects on fetal development and the subsequent health of the baby.

In particular, a study showed that even small doses of triclosan phthalate can destroy thyroid function in mice due to suppressed hypothalamic gene expression. Despite these observations, the biological mechanisms by which phthalates exert their effects remain to be fully understood – although it is thought that phthalates may affect the binding of T3 to transthyretin, a binding protein that transports both T3 and T4 in the blood next to the target handkerchiefs.

Reproductive health

Cleaning products are thought to reduce fertility due to studies showing such effects. A study of female nurses found reduced fertility among those who reported high levels of disinfectant use. In animal models, exposure to QACs has been found to result in reduced fertility through reduced sperm count and motility in males and inhibition of ovulation and implantation of a fertilized egg in females.

Similarly, fragrances in cleaning products have been shown to exhibit toxic effects on sperm, reducing their viability. Phthalates have a similar effect on male reproduction. QACs have also been linked to neural tube defects or birth defects of the brain and spinal cord in animal models, indicating that some cleaning product ingredients may pose a risk to the developing fetus. Poor infant health outcomes have also been predicted as a consequence of phthalate-mediated disruption of fetal reproductive system development intrauterinewhich can cause premature birth.

Brain health

Acute problems associated with disinfection include headache; however, it is largely considered a harmless effect. However, a growing body of research shows that some chemicals can damage the brain through several mechanisms. For example, perinatal exposure to triclosan has been found to alter brain development and behavior in baby mice.

Phthalates have also been shown to trigger cognitive dysfunction due to increased oxidative stress in the brain. In addition, VOCs, gases emitted by various products, are known to easily cross the blood-brain barrier, where they can enter the central nervous system, causing toxic effects on brain cells.

The microbiome

The microbiome present on the skin, nasopharyngeal and gastrointestinal membranes is vulnerable to overuse of disinfectant products. In principle, these products disrupt the balance of different types of microbes and disrupt the harmonious process of environmental exchange that occurs with the environment that forms the microbial population. Excessive sanitization of indoor environments can reduce the diversity and resilience of microbial communities. Because these populations are critical for regulating health through their multifaceted effects on the immune, metabolic, and endocrine systems, depletion of these populations can have significant and systemic negative effects on the body.

In particular, phthalates are known to inhibit the intestinal synthesis of butyrate, which is an integral component, open, indicating the resistance of intestinal epithelial cells, which interacts with other gastrointestinal microbes to create a functional and healthy microbial landscape. In addition, SLS, a detergent and surfactant found in several disinfectant products, is known to reduce the integrity of the skin barrier by disrupting the skin’s microbiome.

The COVID-19 pandemic and the potential health consequences of using alcohol-based hand sanitizers

Hand hygiene is usually a crucial measure to prevent the spread of viruses and bacteria. This was most notably illustrated during the COVID-19 pandemic. The World Health Organization (WHO) has suggested, among several preventive measures, adaptation to effective hand hygiene; accordingly, WHO recommends frequent hand washing or disinfection with soap or a 60% alcohol-based hand sanitizer.

Image credit: Diego Cervo/Shutterstock.com

Image credit: Diego Cervo/Shutterstock.com

These recommendations are based on their ability to produce rapid, effective and broad-spectrum antibacterial action. The alcohol-based disinfectant recommended by the WHO includes ethanol, isopropanol and several types of hydrogen peroxide. However, these agents are toxic to both human health and the environment.

Alcohol-based disinfectants contain isopropanol. Alcohol is thought to cause RNA decay, denature viral proteins, and disrupt membrane integrity. Skin contact with ethanol-based hand sanitizers is associated with low toxicity. However, different people show different reactions in terms of tolerance levels to ethanol.

In contact with the skin, it can cause eye and skin irritation, as well as allergies. Prolonged contact may cause skin dryness or cracking and itching or redness. It can also cause contact dermatitis if used regularly. Ethanol can accumulate in the respiratory system, causing respiratory depression and arrest, hypothermia, arrhythmia, ketoacidosis, hypoglycemia, and hypotension, with the possibility of cardiac arrest. Ethanol exposure can cause acute liver damage, myoglobinuria, and elevated potassium, calcium, and magnesium levels.

Therefore, if ethanol-based products are used continuously, this prolonged use may cause harm to health as a result of skin absorption and poisoning. In a review of medical outcomes of disinfectant cases between January 2020 and September 2020, major, moderate, and minor effects caused by those using alcohol-based sanitizers were 0, 6, and 25%, respectively.

References

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  • Dodson RE, Nishioka M, Standley LJ, et al. (2012) Endocrine disruptors and asthma-related chemicals in consumer products. An environmental health perspective. doi:10.1289/ehp.1104052.
  • Cao XY, Hua X, Xiong JW, et al. (2018) Effects of Triclosan on Female Reproduction by Reducing Thyroid Hormones to Suppress Hypothalamic Kisspeptin Neurons in Mice. Front Mol Neurosci. doi: 10.3389/fnmol.2018.00006.
  • Melin VE, Potineni H, Hunt P, et al. (2014) Exposure to common quaternary ammonium disinfectants reduces fertility in mice. Reprod Toxicol. doi:10.1016/j.reprotox.2014.07.071.
  • Hrubec TC, Melin VE, Shea CS, et al. (2017) Ambient and dosed exposure to quaternary ammonium disinfectants causes neural tube defects in rodents. Birth Defects Res. doi: 10.1002/bdr2.1064.
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  • Mahmood A, Eqan M, Pervez S, et al. (2020) COVID-19 and frequent use of hand sanitizers; hazards to human health and the environment through routes of exposure. Sci Total Environ. doi:10.1016/j.scitotenv.2020.140561.

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