Exposures to Volatile Organic Compounds Among Healthcare Workers: Modeling the Effects of Cleaning Tasks and Product Use

Details

• Personal Author:
  Friesen MC ; Henneberger, Paul K. ; Humann M ; LeBouf, Ryan F. ; Liang X ; Stanton, Marcia L. ; Stefaniak, Aleksandr B. ; Su F-C ; Virji, M. Abbas
• Description:
  Objectives: Use of cleaning and disinfecting products is associated with work-related asthma among healthcare workers, but the specific levels and factors that affect exposures remain unclear. The objective of this study was to evaluate the determinants of selected volatile organic compound (VOC) exposures in healthcare settings. Methods: Personal and mobile-area air measurements (n = 143) from 100 healthcare workers at four hospitals were used to model the determinants of ethanol, acetone, 2-propanol, d-limonene, alpha-pinene, and chloroform exposures. Hierarchical cluster analysis was conducted to partition workers into groups with similar cleaning task/product-use profiles. Linear mixed-effect regression models using log-transformed VOC measurements were applied to evaluate the association of individual VOCs with clusters of task/product use, industrial hygienists' grouping (IH) of tasks, grouping of product application, chemical ingredients of the cleaning products used, amount of product use, and ventilation. Results: Cluster analysis identified eight task/product-use clusters that were distributed across multiple occupations and hospital units, with the exception of clusters consisting of housekeepers and floor strippers/waxers. Results of the mixed-effect models showed significant associations between selected VOC exposures and several clusters, combinations of IH-generated task groups and chemical ingredients, and product application groups. The patient/personal cleaning task using products containing chlorine was associated with elevated levels of personal chloroform and alpha-pinene exposures. Tasks associated with instrument sterilizing and disinfecting were significantly associated with personal d-limonene and 2-propanol exposures. Surface and floor cleaning and stripping tasks were predominated by housekeepers and floor strippers/waxers, and use of chlorine-, alcohol-, ethanolamine-, and quaternary ammonium compounds-based products was associated with exposures to chloroform, alpha-pinene, acetone, 2-propanol, or d-limonene. Conclusions: Healthcare workers are exposed to a variety of chemicals that vary with tasks and ingredients of products used during cleaning and disinfecting. The combination of product ingredients with cleaning and disinfecting tasks were associated with specific VOCs. Exposure modules for questionnaires used in epidemiologic studies might benefit from seeking information on products used within a task context. [Description provided by NIOSH]
• Subjects:
  Acetone Air Pollutants, Occupational Air Pollution Asthma Asthma, Occupational Chemistry Chlorine Disinfectants Environmental Exposure Health Care Facilities Workforce And Services Health Personnel Household Work Occupational Health Respiratory System Respiratory Tract Diseases Safety Ventilation Volatile Organic Compounds

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• Keywords:
  Air Contaminants Air Quality Measurement Author Keywords: Cleaning And Disinfecting Bronchial Asthma Chemical Composition Chemicals Chlorine Compounds Chloroform Cleaning Compounds Ethanol Exposure Assessment Exposure Levels Floors Healthcare Health Care Facilities Health Care Workers Hierarchical Clustering Housekeeping Personnel Housekeeping Products Industrial Hygiene Limonene Mathematical Models Modeling Occupational Asthma Pinene Propanols Regression Analysis Sterilizing Agents Task Performance VOCs Volatile Organic Compounds Volatiles

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• ISSN:
  2398-7308
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Maryland ; OSHA Region 3 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  62
• Issue:
  7
• NIOSHTIC Number:
  nn:20051786
• Citation:
  Ann Work Expo Health 2018 Aug; 62(7):852-870
• Contact Point Address:
  M. Abbas Virji, Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC),1095 Willowdale Road, Morgantown, WV 26505, USA
• Email:
  MVirji@cdc.gov
• CAS Registry Number:
  (+)-Limonene (CAS RN 5989-27-5) ; (±)-α-Pinene (CAS RN 80-56-8) ; Acetone (CAS RN 67-64-1) ; Chloroform (CAS RN 67-66-3) ; Ethanol (CAS RN 64-17-5) ; Isopropanol (CAS RN 67-63-0)
• Federal Fiscal Year:
  2018
• NORA Priority Area:
  Healthcare and Social Assistance
• Peer Reviewed:
  True
• Source Full Name:
  Annals of Work Exposures and Health
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:bcd67e9bce6e20e21d6062631ff963abdb3447f77b3c0906825b594f229b5eec3be50c53ef7646255a88d7295a02f46ab334c40777f2352946cef1aff7bd29e4
• Download URL:
  https://stacks.cdc.gov/view/cdc/211541/cdc_211541_DS1.pdf
• File Type:
  [PDF - 2.09 MB ]