Quinn Margaret M, Lindberg John E, Gore Rebecca J, Sama Susan R, Galligan Catherine J, Kriebel David, Markkanen Pia K, LeBouf Ryan F, Virji Mohammed Abbas
Department of Public Health and Lowell Center for Sustainable Production, University of Massachusetts Lowell, 820 Broadway St., Room 203, Lowell, MA, United States.
Department of Biomedical Engineering, University of Massachusetts Lowell, 201 Riverside St., Room 302, Lowell, MA, United States.
Ann Work Expo Health. 2025 Feb 25;69(2):173-190. doi: 10.1093/annweh/wxae092.
US home care (HC) aide visits to clients' homes typically involve cleaning and disinfecting (C&D) environmental surfaces, particularly in bathrooms. Some ingredients in C&D products are associated with respiratory illness: sodium hypochlorite (bleach), quaternary ammonium compounds (QACs), and volatile organic compounds (VOCs). This study assessed and compared aides' respiratory exposures to specific VOCs and QACs while using 2 conventional and 1 "green" household C&D spray products during bathroom cleaning. Measured exposures were compared to ingredients listed on publicly available sources.
Three C&D products were selected with principal active disinfecting ingredients: 1% to 5% sodium hypochlorite by weight ("bleach-based"); 0.1% to 1% QACs ("QACs-based"); and 0.05% thymol ("green"). Twenty-two aides were recruited to perform C&D tasks in a simulated residential bathroom constructed in an environmental monitoring laboratory. A balanced experimental study design involved each aide visiting the lab 4 times to perform typical cleaning tasks with the 3 products and distilled water (as a control), randomly assigned across the 4 visits. Aides wore air sampling equipment for breathing zone samples: canisters to collect whole air for VOC analyses and filter cassettes for QACs analyses.
Aides performed 84 cleaning visits contributing approximately 20 air samples each for VOCs and QACs, for each of the 3 products and distilled water. In total, 38 unique VOCs were identified in the canister whole air samples: 20 in the QACs-based product samples, 15 in the bleach-based, and 10 in the green. Most VOCs were not listed in publicly available sources of cleaning product ingredients. Toxicity information was limited. Few VOCs had occupational exposure limits. The QACs-based product generated QACs aerosol: benzalkonium chloride (BAC)12 (geometric mean (GM) = 6.98 µg/m3), BAC14 (GM=2.97 µg/m3), BAC16 (GM=0.78 µg/m3); and the 3 QACs summed (GM=10.86 µg/m3).
The use of C&D spray products for residential cleaning can generate respiratory exposures to complex mixtures of volatile and nonvolatile compounds. Notably, we measured aerosols containing QACs during the use of the QACs-based product. Dermal is usually considered the main route of exposure because QACs are nonvolatile salts. This study provides evidence that QACs inhalation exposure should be recognized and minimized in addition to the well-accepted dermal exposure routes. The green product generated the fewest VOCs. However, more toxicity information is needed on the health impacts of green C&D products. Spraying of C&D products, conventional and green, should be avoided.
Aides' respiratory health should be protected from chemical exposures while performing C&D in home care.
美国家庭护理（HC）助手到客户家中探访通常包括清洁和消毒（C&D）环境表面，尤其是在浴室。C&D产品中的一些成分与呼吸道疾病有关：次氯酸钠（漂白剂）、季铵化合物（QACs）和挥发性有机化合物（VOCs）。本研究评估并比较了助手在浴室清洁过程中使用2种传统家用C&D喷雾产品和1种“绿色”家用C&D喷雾产品时，其呼吸道对特定VOCs和QACs的暴露情况。将测量的暴露量与公开来源列出的成分进行了比较。
选择了3种主要活性消毒成分的C&D产品：按重量计1%至5%的次氯酸钠（“基于漂白剂的”）；0.1%至1%的QACs（“基于QACs的”）；以及0.05%的百里酚（“绿色”）。招募了22名助手在环境监测实验室建造的模拟住宅浴室中执行C&D任务。一项平衡的实验研究设计包括让每位助手到实验室4次，用这3种产品和蒸馏水（作为对照）执行典型的清洁任务，在4次探访中随机分配。助手佩戴空气采样设备采集呼吸带样本：用于收集全空气以进行VOC分析的罐和用于QACs分析的过滤盒。
助手进行了84次清洁探访，每种产品和蒸馏水各为VOCs和QACs贡献了约20个空气样本。总共在罐全空气样本中鉴定出38种独特的VOCs：基于QACs的产品样本中有20种，基于漂白剂的产品样本中有15种，绿色产品样本中有10种。大多数VOCs未列在清洁产品成分公开来源中。毒性信息有限。很少有VOCs有职业接触限值。基于QACs的产品产生了QACs气溶胶：苯扎氯铵（BAC）12（几何均值（GM）=6.98μg/m³），BAC14（GM=2.97μg/m³），BAC16（GM=0.78μg/m³）；3种QACs总和（GM=10.86μg/m³）。
用于住宅清洁的C&D喷雾产品的使用会使呼吸道暴露于挥发性和非挥发性化合物的复杂混合物中。值得注意的是，我们在使用基于QACs的产品过程中测量到了含有QACs的气溶胶。由于QACs是不挥发盐，皮肤接触通常被认为是主要暴露途径。本研究提供了证据，除了已被广泛认可的皮肤暴露途径外，QACs吸入暴露也应得到认识并尽量减少。绿色产品产生的VOCs最少。然而，关于绿色C&D产品对健康影响的更多毒性信息是必要的。应避免喷洒传统和绿色的C&D产品。
在家庭护理中执行C&D任务时，应保护助手的呼吸道健康免受化学暴露。
