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A worker cleans an escalator in Hong Kong with a bleach-based solution. Photo: SCMP Picture

Use of bleach cleansers just once a week linked to higher risk of deadly lung disease

Nurses who used bleach suffered up to 33 per cent higher risk of potentially fatal COPD

Regular use of bleach and other common disinfectants has been linked to a higher risk of developing fatal lung disease, researchers have found.

The use of disinfectants is linked to a higher risk of developing chronic obstructive pulmonary disease (COPD), according to research looking at incidence of the disease in more than 55,000 nurses in the US.

The 30-year study by Harvard University and the French National Institute of Health and Medical Research (Inserm) found that those who used the products just once a week had as high as a 32 per cent increased chance of developing the condition.

COPD describes a group of lung conditions such as emphysema and chronic bronchitis that make it difficult to move air in and out of the lungs because the airways have been narrowed.

2003: Hong Kong officials promote bleach usage in wake of Sars outbreak

Former Hong Kong Chief Secretary Donald Tsang Yam-kuen hands out bottles of bleach in 2003 during the city-wide cleanup campaign amid the deadly Sar outbreak. Photo: SCMP Picture

Disinfectant use has previously been associated with an increased risk of respiratory problems such as asthma. However, the new study is thought to be the first to identify a link between COPD and specific cleaning chemicals known as quaternary ammonium compounds, or “quats”.

“The potential adverse effects of exposure to disinfectants on COPD have received much less attention, although two recent studies in European populations showed that working as a cleaner was associated with a higher risk of COPD,” Inserm researcher Orianne Dumas said.

“To the best of our knowledge, we are the first to report a link between disinfectants and COPD among health care workers, and to investigate specific chemicals that may underlie this association.”

The everyday use of bleach currently has no specific health guidelines, but the researchers hope this will be investigated.

The use of bleach in Hong Kong became widespread in 2003 when it was promoted as a way of combatting the deadly Sars outbreak. Top officials including then chief secretary Donald Tsang Yam-kuen toured the city handing out bottles of bleach, while public campaigns promoted its use in a 1:99 water solution.
Bleach is a common cleanser in Hong Kong households, where its use was widely pushed during the deadly Sars outbreak. Photo: SCMP Picture

“Some of these disinfectants, such as bleach and quats, are frequently used in ordinary households, and the potential impact of domestic use of disinfectants on COPD development is unknown,” Dumas said. “Earlier studies have found a link between asthma and exposure to cleaning products and disinfectants at home, such as bleach and sprays, so it is important to investigate this further.”

The researchers analysed data from a mass study on female US nurses commenced by Harvard in 1989. In 2009, they looked at those who were still working as nurses who had no history of COPD and tracked them until May this year. During that period, 663 were diagnosed with the condition.

The nurses’ exposure to disinfectants were evaluated via a questionnaire and other factors that could have distorted the results, such as the age, weight and ethnicity of the subjects, were taken into account.

On Monday, Dumas will tell a meeting of the European Respiratory Society International Congress in Milan that certain tasks involving frequent exposure to disinfectants, such as cleaning surfaces, as well as specific chemicals in disinfectants, were associated with a 22-32 per cent increased risk of developing the disease.

Dumas will say: “We found that nurses who use disinfectants to clean surfaces on a regular basis – at least once a week – had a 22 per cent increased risk of developing COPD ... There was a suggestion of a link with the weekly use of disinfectants to clean instruments but this was not statistically significant.

“In our study population, 37 per cent of nurses used disinfectants to clean surfaces on a weekly basis and 19 per cent used disinfectants to clean medical instruments on a weekly basis.”

She says the findings highlight the need for guidelines for cleaning and disinfection in health care settings such as hospitals to be updated to take the occupational health risks into account.

This article appeared in the South China Morning Post print edition as: Bleach linked to fatal lung disease risk
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