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What are the health effects of excessive disinfection?

Specific effects of disinfectants on human health
The COVID-19 pandemic and the potential health consequences of using alcohol-based hand sanitizers
References
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The use of detergents in disinfectant products is believed to produce different results related to different organ systems, including respiratory and cardiovascular symptoms and effects on the skin. The effects on the airways can range from acute transient irritation of the open airways to two obstructive pulmonary diseases.

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Specific effects of disinfectants on human health

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

Decreased respiratory function

Respiratory disease is the most common health problem due to chemicals present in disinfectant products. It has been shown that early exposure to large doses of cleaning chemicals can lead to harmful and prolonged respiratory function, increasing the risk of childhood asthma due to damage to the epithelial lung cells via the innate immune pathways. Bleach, glutaraldehyde and ethanol are known to cause respiratory irritation, exacerbate existing asthma or cause what is known as ‘occupational asthma’. Fragrances that also accompany the ingredients in sanitizer products are also triggers for respiratory illnesses.

Liver and kidney damage

QACs, disinfectants used in workplaces and healthcare, are thought to be directly toxic to the immune system because they compromise the phagocytic function of macrophages. This is also a similar problem associated with the use of glutaraldehyde. However, the immunotoxicity of this agent has not been adequately assessed.

Metabolic Health and Obesity

Research has shown that anthropogenic chemicals can have long-lasting effects, such as problems with hormonal function and body weight regulation in animals and humans. Cleaning chemicals can be considered obesogenic; the main mechanism by which cleansing chemicals compromise hormonal balance and promote obesity is through the alteration of the gut microbiome.

A study evaluating the gut microbiota of infants aged three to four months versus composition at one and three years of age showed that changes in the gut microbiota had a strong association with increased household use of disinfectants. At the same time, children exposed to heavier disinfectants also had a higher body mass index at age three than infants exposed less.

Thyroid function

Phthalates are common chemicals found in disinfectant products and are thought to impair thyroid function. Prenatal phthalate exposure has been shown to decrease total thyroxine (T4) levels in pregnant women, which may subsequently have adverse effects on fetal development and subsequent child health.

In particular, a study has shown that even small doses of phthalate triclosan can destroy thyroid function in mice due to suppressed hypothalamic gene expression. Despite these observations, the biological mechanisms by which phthalates exert their effects have yet to be fully elucidated – although it is believed that phthalates may interfere with the binding of T3 to transthyretin, a binding protein that transports both T3 and T4 in the blood to the target. tissues.

reproductive health

Cleaning products are believed to reduce fertility due to studies indicating such effects. A study of female nurses found reduced fertility in those who reported using a lot of disinfectants. In animal models, exposure to QACs has been found to result in reduced fertility via reduced sperm count and motility in male organisms and the inhibition of ovulation and fertilized egg implantation in female organisms.

Likewise, fragrances in cleaning products have been shown to exhibit toxic effects on sperm, decreasing their viability. Phthalates have a similar effect on male reproduction. QACs have also been associated with neural tube defects or congenital disabilities of the brain and spinal cord in animal models, showing that some components of cleaning products may pose a risk to a developing fetus. Poor health outcomes for the baby are also predicted due to phthalate-mediated disruption of fetal reproductive system development in the wombwhich can cause premature delivery.

brain health

Acute problems associated with disinfection include headaches; however, it is largely considered a harmless effect. Despite this, a growing body of research indicates that some chemicals may harm the brain through various mechanisms. For example, perinatal exposure to triclosan has been found to alter brain development and behavior in young mice.

Phthalates have also been shown that cognitive dysfunction is caused by increased oxidative stress in the brain. In addition, VOCs, gases emitted by various products, are known to readily pass through the blood-brain barrier, where they can enter the central nervous system and cause toxic effects on brain cells.

the microbiome

The microbiome present on the skin, nasopharyngeal and gastrointestinal membranes is vulnerable to overuse of antiseptics. These products mainly upset the balance of different types of microbes and disrupt the harmonious process of environmental exchange that takes place with the environment that makes up the microbial population. Excessive remediation of indoor environments can reduce the diversity and resilience of microbial communities. Because these populations are critical to regulating health through their multifaceted effects on the immune, metabolic and endocrine systems, depleting these populations can have downstream, sizable and systemic negative effects on the body.

In particular, phthalates are known to inhibit the intestinal synthesis of butyrate, an integral component that is open and exhibits the robustness of intestinal epithelial cells, which interacts with other gastrointestinal microbes to produce a functional and healthy microbial landscape. In addition, SLS, a detergent and surfactant found in various sanitizers, is known to reduce the integrity of the skin barrier due to disruption of the skin microbiome.

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

Hand hygiene is typically a critical measure to prevent the spread of viruses and bacteria. This has been particularly illustrated during the COVID-19 pandemic. In addition to several preventive measures, the World Health Organization (WHO) has proposed to adapt to effective hand hygiene; in line with this, the WHO recommends washing or disinfecting hands regularly with soap or hand sanitizer based on 60% alcohol.

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 activity. The alcohol-based sanitizer recommended by the WHO includes ethanol, isopropanol, and various types of hydrogen peroxide. However, these agents are toxic to both human health and the environment.

Alcohol-based disinfectants contain isopropanol. It is believed that alcohol causes disintegration of RNA, denatures viral proteins and disrupts membrane integrity. Skin contact with ethanol-based hand sanitizers is associated with low toxicity. However, different people show different reactions regarding ethanol tolerance levels.

When in contact with the skin, it can cause eye and skin irritation and allergies. Prolonged contact can lead to dry or cracked skin, and itching or redness. It can also cause contact dermatitis if used regularly. Ethanol can build up in the respiratory system and cause respiratory depression and arrest, hypothermia, arrhythmia, ketoacidosis, hypoglycemia and hypotension, with the possibility of cardiac arrest. Exposure to ethanol can cause acute liver damage, myoglobinuria and elevated potassium, calcium and magnesium.

If ethanol-based products are used consistently, long-term use may be harmful to health due to skin absorption and poisoning. In a review of medical outcomes of disinfectant cases between January 2020 and September 2020, the major, moderate, and minor effects caused by those using alcohol-based disinfectant were 0.6 and 25%, respectively.

References

  • Steinemann A. (2016) Perfumed consumer products: exposures and effects of emissions. Air Quality Atmos Health† doi:10.1007/s11869-016-0442-z.
  • Malaguarnera G, Cataudella E, Giordano M, et al. (2012) Toxic hepatitis in occupational solvent exposure. World J Gastroenterol† doi: 10.3748/wjg.v18.i22.2756.
  • Anderson SE, Meade BJ, et al. (2014) Potential health effects associated with dermal exposure to occupational chemicals. Environmental Health Insights† doi: 10.4137/EHI.S15258.
  • Several MK, Mueller NT. (2018) Are household disinfectants microbially-mediated obesogens? CMAJ† doi: 10.1503/cmaj.181134.
  • Dodson RE, Nishioka M, Standley LJ, et al. (2012) Endocrine disruptors and asthma-related chemicals in consumer products. Health perspective for the environment† doi:10.1289/ehp.1104052.
  • Cao XY, Hua X, Xiong JW, et al. (2018) Impact of Triclosan on Female Reproduction by Reducing Thyroid Hormones to Suppress Hypothalamic Kisspeptin Neurons in Mice. Front Mol Neuroscia† 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) Environmental and dosed exposure to quaternary ammonium disinfectants causes neural tube defects in rodents. Birth defects Res† doi: 10.1002/bdr2.1064.
  • Mitro SD, Johnson T, Zota AR. (2015) Cumulative chemical exposures during pregnancy and early development. Curr Environment Health Rep† doi:10.1007/s40572-015-0064-x.
  • Velazquez S, Griffiths W, Dietz L, et al. (2019) From one species to another: an overview of the interaction between chemistry and microbiology in relation to cleaning in the built environment. indoor air. doi:10.1111/ina.12596.
  • Mahmood A, Eqan M, Pervez S, et al. (2020)COVID-19 and frequent use of hand sanitizers; hazards to human health and the environment from routes of exposure. Sci Total Environment† doi:10.1016/j.scitotenv.2020.140561.

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