Impact of COVID-19 on disinfectant exposure and associated health effects.

项目摘要/摘要 消毒剂广泛用于各种产品和各种环境中，以防止感染和传播 有害的病原体。然而，消毒剂含有危险的化学物质，而且众所周知会引起刺激性。 或眼睛、皮肤、呼吸系统和神经系统的过敏症状，哮喘，以及器官损害 长时间或反复暴露。季铵化合物(Qac)是最常见的活性物质。 经批准可控制SARS-CoV-2的消毒剂中使用的成分。冠状病毒病2019(新冠肺炎) 大流行导致社区和工作场所大幅增加消毒剂的使用，以防止 SARS-CoV-2的感染和传播。消毒剂使用量的增加引起了人们的极大关注 关于消毒剂对健康的影响。至于消毒剂对健康的危害，清洁工人，特别是在 卫生保健机构，已被确定为受消毒剂影响最大的职业群体。在.期间 新冠肺炎大流行，随着医疗保健环境中感染控制的需求增加， 在家庭/社区使用消毒剂，这些工人可能会进一步增加健康风险 接触消毒剂。这项研究的目的是评估新冠肺炎大流行对 检查消毒剂使用与消毒剂相关疾病发病率之间的关系 接触消毒剂和健康症状。我们建议使用三种方法进行研究：(1)分析 加州农药疾病监测计划数据(2011-2020)，以调查消毒剂相关疾病 加利福尼亚州的病例。(2)对一所大学300名清洁工作人员(主要是华裔和西班牙裔)的调查 北加州卫生系统对消毒剂使用和与化学物质相关的健康症状的关注。(3) 苯扎氯铵[BAC]和二甲基二甲基氯化铵两种常见QAC的测定 [ddAC])在一组调查参与者(n=100)的粪便和尿液中。这项研究有以下具体内容 目标：(1)描述2011-2020年加州与消毒剂相关的疾病病例的特征，并研究其趋势 随着时间的推移，每年的发病率。(2)新冠肺炎期间医院保洁消毒剂使用特征 并检查消毒剂的使用与自我报告的健康症状的关系。(3)测量QAC 医院保洁人员粪便和尿液中BAC/DDAC的含量及其与自身健康的关系 报告消毒剂的使用和健康症状。这项研究将提供有用的信息来评估公众 广泛使用的消毒剂的健康负担以及新冠肺炎对消毒剂暴露和卫生的影响 在普通人群以及医院保洁人员的高危群体中存在健康问题。这 这项研究将是首批测量和量化人体样本中的QAC以检查健康的研究之一 效果。有关医院清洁人员接触QAC的生物数据将捕捉到 职业性和非职业性接触的消毒化学品在 新冠肺炎大流行，并将成为分析较长期健康影响的宝贵基础。

PROJECT SUMMARY/ABSTRACT Disinfectants are widely used in various products and in various settings to prevent infection and transmission of harmful pathogens. Disinfectants, however, contain hazardous chemicals and are known to cause irritation or allergic symptoms in eyes, skin, respiratory and nervous systems, asthma, and damage to organs with prolonged or repeated exposure. Quaternary ammonium compounds (QACs) are the most common active ingredients used in disinfectants approved for SARS-CoV-2 control. The coronavirus disease 2019 (COVID-19) pandemic led to dramatically increased use of disinfectants in the community and workplaces to prevent SARS-CoV-2 infection and transmission. Such increased use of disinfectants raises substantial concerns regarding the health effects of disinfectants. As for health risk by disinfectants, cleaning workers, particularly in healthcare settings, have been identified as occupational groups most affected by disinfectants. During the COVID-19 pandemic, with the heightened need for infection control in healthcare settings as well as increased use of disinfectants at home/community, these workers may have further increased health risks from disinfectant exposure. The purpose of this study is to assess the impact of the COVID-19 pandemic on disinfectant use and the incidence of disinfectant-related illness and examine the association between disinfectant exposure and health symptoms. We propose a study using three approaches: (1) Analysis of California Pesticide Illness Surveillance Program data (2011-2020) to investigate disinfectant-related illness cases in California. (2) A survey of 300 cleaning staff (predominantly Chinese and Hispanic) in a university health system in Northern California on disinfectant use and chemical-related health symptoms. (3) Measurement of two common QACs (benzalkonium chloride [BAC] and didecyl dimethyl ammonium chloride [DDAC]) in feces and urine in a subset of survey participants (n=100). The study has the following specific aims: (1) Characterize disinfectant-related illness cases in California during 2011-2020 and examine the trend of the annual incidence over time. (2) Characterize disinfectant use during COVID-19 among hospital cleaning staff and examine the relationship of disinfectant use with self-reported health symptoms. (3) Measure QACs (BAC/DDAC) in feces and urine among hospital cleaning staff and examine their associations with self- reported disinfectant use and health symptoms. This study will produce helpful information to assess the public health burden by the widely used disinfectants and the impact of COVID-19 on disinfectant exposure and health problems among the general population as well as the high-risk group of hospital cleaning staff. This study will be one of the first studies that measures and quantifies QACs in human samples to examine health effects. The biological data on QAC exposure among hospital cleaning staff will capture the body burden of disinfectant chemicals from both occupational and non-occupational exposures that increased during the COVID-19 pandemic, and will serve as a valuable foundation for analyses of longer-term health effects.