A field study on clinical signs and symptoms in cleaners at floor polish removal and application in a Swedish hospital

Abstract

Aim: To study health effects in hospital cleaners (N = 21) at floor polish removal and application.

Methods: The cleaners were investigated before exposure (Monday = day 1), after polish removal work (day 2), and after application of floor polish (day 3). Ratings of symptoms, tear-film break-up-time (BUT), nasal patency and biomarkers in nasal lavage were studied.

Results: There was a significant increase both day 2 and day 3, as compared to pre-exposure, in ocular, nasal, throat symptoms, solvent smell, dyspnoea, and general symptoms such as headache and fatigue. Posterior nasal patency was decreased day 2 (p < 0.01) and day 3 (p < 0.01). No change of nasal biomarkers (ECP, MPO, lysozyme, albumin) was seen. BUT was decreased after polish removal (p < 0.01), but not after polish application. Separate test of the weekday effect in non-exposed showed slight improvements, or no change of symptoms or clinical signs from Monday to Wednesday. Air concentrations of ethylene glycol monoethyl ether, ethylene glycol monobutyl ether, diethylene glycol monoethyl ether, dipropylene glycol monomethyl ether, diethylene glycol monoethyl ether and ethylene glycol phenyl ether 103, 666, 13,650, 7,000, 67, and 27 microg/m(3), respectively, at polish application. Glycol ether levels were reduced to 3% after 2 days and 0.3% after 17 days.

Conclusions: Emissions from a common water-based polish remover and floor polish system may cause ocular and airway irritation and general symptoms, and reduce tear-film stability and nasal patency. The levels of glycol ethers had a rapid decay.