O-61 Assessment of volatile organic compound exposures from cleaning and disinfection products use in healthcare settings

Introduction

Healthcare workers are exposed to a complex mixture of chemicals from using cleaning and disinfection products. Cleaning tasks and products are associated with elevated prevalence of asthma and respiratory symptoms, however quantitative exposure estimates are lacking which hinders prevention. The objectives of this study were to create a quantitative task exposure matrix (TEM) for cleaning and disinfection product-use for a set of 14 volatile organic compounds (VOCs) and compare exposure estimates by job, unit, and products used.

Material and Methods

Quantitative VOC exposure estimates were obtained using data collected at four U.S. hospitals. Personal time-integrated VOC samples were collected and analyzed for 14 specific VOCs. All measurements included detailed information on tasks, products used, job, unit, and other workplace characteristics. Bayesian multiple linear regression models accounting for measurements below the limit of detection (LOD) were used to assess exposures by job, unit, product, and the interaction of product with job and unit. Geometric mean (GM) exposure estimates in parts per billion generated from the multiple regression models were used to create a TEM and compared to identify differences between jobs, units, and products. Notable differences were identified using non-overlapping 95% credible intervals.

Results

Total 14-VOC exposures (TVOC14) were highest among dental occupations (GM=1680) and lowest among laboratory technicians (GM=399). Nurses (GM=1541) had higher exposures than laboratory technicians. Similarly, laboratory settings (GM= 389) had lower TVOC14 exposures than operating rooms (GM=1440). Of products studied, exposures were highest for high-level disinfectants (GM= 2000) and lowest for enzyme products (GM=322).

Conclusion

A TEM was successfully created using the GM for product-job, product-unit and product, and assigned to participants in an epidemiologic study. The quantitative estimates for the 14 VOCs will be used in multi-pollutant models to explore respiratory health outcomes associated with mixed VOC exposures.