Eye and Airway Symptoms in Hospital Staff Exposed to a Product Containing Hydrogen Peroxide, Peracetic Acid, and Acetic Acid

Details

• Personal Author:
  Blackley, Brie H. ; Cox-Ganser, Jean M. ; Harvey, R. Reid ; Nett, Randall J. ; Virji, M. Abbas
• Description:
  Background: Sporicidal products containing hydrogen peroxide (HP), peracetic acid (PAA), and acetic acid (AA) are used widely in multiple industries, including healthcare. Despite widespread use in healthcare, few studies have assessed associations between exposures to HP, PAA, and AA, and work-related symptoms in these settings. Methods: In 2018, we performed a health and exposure assessment at a hospital where a sporicidal product consisting of HP, PAA, and AA, was used as the primary cleaner on hospital surfaces. We collected 56 personal and mobile air samples for HP, PAA, and AA on participants while they performed their regular cleaning duties; collected area samples for HP (n = 28), PAA (n = 28), and AA (n = 70) in multiple hospital locations where cleaning was performed; and administered a postshift survey to assess eye, skin, and upper and lower airway symptoms that occurred cross-shift or in the previous 4 weeks. Results: Full-shift exposure levels for HP (range: <3-559 ppb), PAA (range: <0.2-8 ppb), and AA (range: <5-915 ppb) were all below US occupational exposure limits. We observed positive associations (p < 0.05) between shift, departmental average, and departmental 95th percentile exposures to HP, PAA, and AA vapors, and work-related acute (cross-shift) and chronic (previous 4 weeks) eye, upper airway, and lower airway symptoms after adjusting for age, gender, smoking status, use of other cleaning products containing sensitizers and irritants, allergic status, and stress. Conclusions: Our observations of work-related upper and lower airway symptoms among hospital workers exposed to vapors from a sporicidal product containing HP, PAA, and AA indicate a need for a combination of engineering, administrative, and PPE controls to reduce exposure. Additionally, alternative nonchemical disinfection technologies should be further investigated as a means to simultaneously reduce healthcare workers' exposure to disinfectants while also minimizing costly healthcare-acquired infections. [Description provided by NIOSH]
• Subjects:
  Disinfectants Environmental Monitoring Eye Health Care Facilities Workforce And Services Health Personnel Hydrogen Peroxide Occupational Health Personal Protective Equipment Respiratory System Safety Sense Organs Solvents

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• Keywords:
  Acetic Acid Air Samples Author Keywords: Healthcare Cleaning Compounds Eyes Health Care Workers Hydrogen Peroxide Medical Facilities Peracetic Acid Peroxygen Personal Protective Equipment PPE Respiratory Vapors

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• ISSN:
  0271-3586
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Colorado ; OSHA Region 3 ; OSHA Region 8 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  66
• Issue:
  8
• NIOSHTIC Number:
  nn:20067638
• Citation:
  Am J Ind Med 2023 Aug; 66(8):655-669
• Contact Point Address:
  Brie Hawley Blackley, MS, PhD, Respiratory Health Division, National Institute for Occupational Safety and Health, 1000 Frederick Ln, Morgantown, WV 26508
• Email:
  YGD2@cdc.gov
• CAS Registry Number:
  Acetic acid (CAS RN 64-19-7) ; Hydrogen peroxide (CAS RN 7722-84-1) ; Peracetic acid (CAS RN 79-21-0)
• Federal Fiscal Year:
  2023
• Peer Reviewed:
  True
• Source Full Name:
  American Journal of Industrial Medicine
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:70e3f0f8ba062bca19bdb39a66331bac0c2e034be8ce50dcdfaf4eb4e30b92a7cc7839730e7cbdb34320be4810aba7c3264c6119aa1349b24e1fcb7d72451a66
• Download URL:
  https://stacks.cdc.gov/view/cdc/229910/cdc_229910_DS1.pdf
• File Type:
  [PDF - 1.03 MB ]