Inducible Laryngeal Obstruction in a Healthcare Worker Exposed to Hydrogen Peroxide, Peracetic Acid, and Acetic Acid

Details

• Journal Article:
  Respiratory Medicine Case Reports
• Personal Author:
  Foreman, Anne M. ; Blackley, Brie H. ; Harvey, R. Reid ; Hines, Stella E.
• Description:
  This report describes a case of severe inducible laryngeal obstruction (ILO) in an emergency department nurse. Onset of the condition occurred after an episode of exposure to a disinfectant product containing hydrogen peroxide, peracetic acid, and acetic acid. Previously exposures had been tolerated by the nurse over a period of nine months. Influenza infection may have been a predisposing factor. Despite various interventions, including botulinum toxin A injections, suture lateralization of the right true vocal cord, and right CO2 laser transverse cordotomy with partial medial arytenoidectomy, the patient continued to experience severe symptoms. Ultimately, a tracheostomy was performed to alleviate the obstruction. This case highlights the need for heightened clinician awareness, early and accurate diagnosis, and the development of effective management strategies for ILO patients.
• Subjects:
  Acetic Acid Health Personnel Hydrogen Peroxide Nurses Occupational Health Peracetic Acid Respiratory System Safety
• Keywords:
  Disinfectants; Hydrogen peroxide; Peracetic acid; Acetic acid; Airway obstruction; Health care workers; Cleaning compounds; Nurses
• Source:
  Respir Med Case Rep 2025 Oct; 58:102306
• ISSN:
  2213-0071
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  West Virginia ; Maryland ; Philadelphia Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  5 pdf pages
• Volume:
  58
• NIOSHTIC Number:
  nn:20071242
• Contact Point Address:
  Stella E. Hines, University of Maryland School of Medicine, Division of Occupational and Environmental Medicine, Baltimore, MD, USA
• Email:
  Shines@som.umaryland.edu
• CAS Registry Number:
  Hydrogen peroxide (CAS RN 7722-84-1) ; Peracetic acid (CAS RN 79-21-0) ; Acetic acid (CAS RN 64-19-7)
• Federal Fiscal Year:
  2026
• Peer Reviewed:
  True
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:fe146fb905fb3e4ca60d7eb075dc55b66cb62dcb34999fd9b846ac32aa475d801a4bd544ed466ed17cb162ab28acfde44f05f757dc2f17bec3c6df5615df9229
• Download URL:
  https://stacks.cdc.gov/view/cdc/258720/cdc_258720_DS1.pdf
• File Type:
  [PDF - 765.39 KB ]