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. 2023 Apr 11;3(1):e71.
doi: 10.1017/ash.2023.138. eCollection 2023.

Environmental chamber studies of eye and respiratory irritation from use of a peracetic acid-based hospital surface disinfectant

Pamela H Dalton  1 , Christopher Maute  1 , Jeffrey B Hicks  2 , Heather N Watson  2 , Anne E Loccisano  3 , Brent D Kerger  4
Affiliations

Environmental chamber studies of eye and respiratory irritation from use of a peracetic acid-based hospital surface disinfectant

Pamela H Dalton et al. Antimicrob Steward Healthc Epidemiol. .

Abstract

Objective: To characterize personal exposures and measures of eye and respiratory tract irritation in controlled environmental chamber studies of 44 healthy adult volunteers simulating upper-bound use of peracetic acid (PAA)-based surface disinfectant for terminal cleaning of hospital patient rooms.

Design: Experimental, within-subject, double-blinded cross-over design.

Methods: Objective and subjective exposure effects were assessed for PAA and its components: acetic acid (AA) and hydrogen peroxide (HP). Deionized water was included as a control. Breathing-zone concentrations of PAA, AA, and HP were assessed for 8 female multiday volunteers (5 consecutive days) and 36 single-day volunteers (32 females and 4 males). Wetted cloths were used to wipe high-touch surfaces for 20 minutes per trial. Also, 15 objective measures of tissue injury or inflammation and 4 subjective odor or irritation scores were assessed.

Results: Disinfectant trials showed 95th percentile breathing zone concentrations of 101 ppb PAA, 500 ppb AA, and 667 ppb HP. None of the volunteers observed over 75 test days exhibited significant increases in IgE or objective measures of eye and respiratory tract inflammation. Subjective ratings for disinfectant and AA-only trials showed similar increases for odor intensity and nose irritation, with lower ratings for eye and throat irritation. Females were 2.5-fold more likely than males to assign moderate + irritation ratings.

Conclusions: Simulated upper-bound hospital use of PAA-based disinfectant led to no significant increases in objective markers of tissue injury, inflammation, or allergic sensitization, and no frank signs of eye or respiratory tract irritation.

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Conflict of interest statement

P.D. and C.M. are salaried employees of Monell Chemical Senses Center, an independent nonprofit science institute that conducts basic research on the chemical senses. B.K., A.L., J.H., and H.W. are salaried employees of Exponent, a scientific and engineering consulting firm. All authors were contracted by Ecolab to provide their scientific expertise in designing and implementing the current study.

Figures

Fig. 1.
Fig. 1.
Chamber configuration and equipment at the Monell Chemical Senses Center. Top 2 photos: Environmental chamber configuration with furniture and high-touch surfaces, sample tubing hook-up, and chamber entrance door, which was modified with a drawer for cloth exchange. Third from top: Sample collection manifold constructed with 4 key instrument rotameters and a Gast DOA P707-AA vacuum pump. Bottom: Customized sampling vest, with Tygon tubing from the 4-channel sample collection manifold to the breathing zone of the volunteer and connected to the sample cartridges.
Fig. 2.
Fig. 2.
Summary of the timing of exposures and endpoints evaluated on each test day and the 4 counterbalance sequences that were varied for each Monell volunteer.
Fig. 3.
Fig. 3.
Labeled magnitude scale and corresponding anchors used for analysis of subjective symptoms.
See this image and copyright information in PMC

References

    1. Monegro A, Muppidi V, Regunath H. Hospital-acquired infections. In: StatPearls. Treasure Island, FL: StatsPearls Publishing; 2022. - PubMed
    1. Wenzel RP, Osterman CA, Hunting KJ, Gwaltney JM Jr. Hospital-acquired infections. I. Surveillance in a university hospital. Am J Epidemiol 1976;103:251–260. - PubMed
    1. Glenister HM, Taylor LJ, Bartlett CL, Cooke EM, Sedgwick JA, Mackintosh CA. An evaluation of surveillance methods for detecting infections in hospital inpatients. J Hosp Infect 199;23:229–242. - PubMed
    1. Melgar M, Ramirez M, Chang A, Antillon F. Impact of dry hydrogen peroxide on hospital-acquired infection at a pediatric oncology hospital. Am J Infect Control 2022;50:909–915. - PubMed
    1. Carling P, O’Hara L, Harris A, Olmsted R. Mitigating hospital-onset Clostridioides difficile: the impact of an optimized environmental hygiene program in eight hospitals. Infect Control Hosp Epidemiol 2023;44:440–446. - PMC - PubMed

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