Disinfectant Use May Increase Nurses’ Risk of COPD, Study Finds

Use of chemical disinfectants might increase the risk of chronic obstructive pulmonary disease (COPD) in nurses, a study suggests.

The study, “Association of Occupational Exposure to Disinfectants With Incidence of Chronic Obstructive Pulmonary Disease Among US Female Nurses,” was published in the journal JAMA Network Open.

Although smoking remains the number one cause of COPD, evidence suggests that exposure to health-hazardous substances found in dust, vapor, gases, and fumes may be responsible for as many as a fifth of all COPD cases.

Previous studies have suggested that exposure to cleaning products, particularly disinfectants, could also increase the risk of COPD. However, these studies have been performed mainly in people whose jobs are explicitly cleaning, and not in people working in other fields in which disinfectants are commonly used, including healthcare.

Researchers in France, in collaboration with colleagues in the U.S. and Spain, analyzed the incidence of COPD among nurses in the U.S. who were regularly exposed to disinfectants using data collected as part of the Nurses’ Health Study. All data were self-reported.

The study looked at data from 73,262 female nurses, with an average age of 54.7, who did not have COPD in 2009 and who had data available through at least 2015. Nearly a third (28.2%) were former smokers, and only 5.7% were current smokers.

Of the nurses included, 22.9% reported using disinfectants only to clean surfaces, and 19.0% said they used them to clean medical instruments.

A total of 582 nurses were diagnosed with COPD by the end of the study period. Using statistical models, investigators assessed the relative risk of developing COPD based on exposure to disinfectants.

Nurses who used any type of disinfectant at least weekly had a 35% increased risk of developing COPD. Among those who reported using disinfectants more often (four days per week or more), the risk was increased by 43%. These increased risks remained statistically significant after adjusting for other important factors, including smoking status.

Further analysis of the specific disinfectants used suggested that COPD risk was particularly higher following exposure to hypochlorite bleach or hydrogen peroxide, which are both known to cause cell damage.

“Our findings provide further evidence of an adverse association between disinfectants and cleaning products and respiratory health,” the researchers wrote.

This association “urges the need for the development of exposure-reduction strategies that remain compatible with infection control in health care settings,” the researchers wrote, and “clinicians should be aware of this new risk factor and systematically look for sources of exposure to cleaning products and disinfectants, in addition to other occupational exposures in patients with COPD.”