This study investigated exposures generated from common cleaning tasks in hospitals by considering both the product formulations and exposure potential to ingredients of concern during product applications. This work shows that:

  1. Cleaning product are complex mixtures of many chemicals
    The chemical ingredients identified in the products included disinfectants, surfactants, solvents, and fragrances. These ingredients are representative of different chemical classes such as ethers, alcohols, amines, acids and have a very wide range of volatilities and other chemical properties. The same chemical ingredients we have identified here have been previously reported by several studies [1, 26, 27].

When investigating ingredients using product MSDSs, health and safety professionals should review not only MSDSs of concentrated product forms, but also the ready to use forms. We found that many ingredients reported in the concentrated form were missing in the RTU form, because MSDSs are required to list only ingredients at concentrations greater than 1% in the product. This is important for identifying ingredients that are sensitizers in the workplace; given the fact that sensitization may occur even at trace concentrations.

One important finding is related to the high frequency of use of disinfectants among different product groups. Disinfectants are added to the cleaning product with the main goal to destroy microbial life. On the other hand, cleaning is done with the goal of mechanically removing the surface contaminants. An important question that can be raised is: Can disinfectants achieve their goal if they are applied in combination cleaner-disinfectant product? In order for disinfection to be effective, it should follow surface cleaning and the disinfectant should reside on the surface for about 10–15 minutes after application[28]. In the case of combination product (cleaner-disinfectant) application, these procedures can not be followed. The effectiveness of disinfectants used for common cleaning activities has been questioned in the literature [29–31]. Although the evidence to date is minimal, repeated application of disinfectants may increase the risk of microbial resistance, which will require the use of stronger disinfectants in order to be destroyed [32, 33]. Given: 1) the uncertainty of disinfectant effectiveness in cleaning public areas, 2) the risk of inducing bacteria resistance, and 3) the health concerns related to the use of disinfectants, it is critical to further evaluate disinfectants’ effectiveness for common cleaning activities and to develop workplace strategies for preventing workers from exposures to disinfectants. Such strategies may include purchasing of green cleaning product, identification of the areas where disinfection is needed, and following the necessary disinfection procedures in the cases when disinfection is necessary.

  1. There is evidence of exposures to respiratory and dermal irritants and sensitizers from cleaning product
    2-Butoxyethanol (2-BE), a glycol ether with boiling point (BP) of 168°C, was commonly used in cleaning products including glass/window cleaners, carpet cleaners and other surface cleaners[36]. Indoor exposures to its vapors at a concentration threshold of 2 ppm (10 mg/m3) and above may result in sensory irritation [34]. The OSHA permissible exposure limit (PEL) is 50 ppm for 8 h time weighed average (TWA), the ACGIH threshold limit value (TLV) is 20 ppm (8 h TWA) and the NIOSH recommended exposures limit (REL) is 5 ppm (10 hour exposure). There is a skin designation for 2-BE from both OSHA and NIOSH, indicating that 2-BE can be absorbed through the skin. The presence of 2-BE in cleaning products has been reported by several studies [35, 36]. Concentrations of 2-BE in the air generated during window cleaning reported by Vincent 1993 ranges from 0.1–7.33 ppm, lower than existing occupational standards. The study suggested that dermal exposure may be the most important exposure route in the workplace[37]. Because 2-BE was one of the most frequent solvents in our products and had the highest concentrations in the bulk products, it is important to further assess its workplace exposures. Quantitative workplace investigations are necessary to measure the degree of exposure intensity and relationship with irritation symptoms reported among cleaning workers.