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% increased chance of developing the condition.

COPD, which affects an estimated 1.2 million people in the UK, 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.

Nearly 25,000 people per year die from the disease in England, which is the third highest death rate in Europe.

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 (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,” said Inserm researcher Orianne Dumas.

“To the best of our knowledge, we are the first to report a link between disinfectants and COPD among healthcare 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.

“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% 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% 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% of nurses used disinfectants to clean surfaces on a weekly basis and 19% used disinfectants to clean medical instruments on a weekly basis.”



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