What are the Reported Risks with Disinfectants Containing Quaternary Ammonium Compounds (QACs or quats)?

You may recall our recent post “Are We Going to Clean Ourselves Sick” where we discussed the increased use of cleaning and disinfecting products along with the rise in exposures reported to the National Poison Data System. We also discussed a Consumer Reports article warning of some risks reportedly associated with Quaternary ammonium compounds (QACs or quats).

Sanitizing and disinfecting agents seem to be in greater demand these days than ever before—at least more than this author can ever recall. This is evidenced by the fact that many grocery stores, pharmacies, and online retailers either do not have many disinfecting agents in stock or are rationing how many consumers can purchase at a time. Regardless of treatments or vaccines for COVID-19, it is likely the use of these products will continue with greater frequency in the coming years, including in schools and at daycare centers.

The 2019 article published in the American Journal of Infection Control (“Do we know how best to disinfect child care sites in the United States? A review of available disinfectant efficacy data and health risks of the major disinfectant classes”) addressed some of the risks reported with disinfectants. Notably, the review article also formed part of the basis for the Consumer Reports article discussed previously. The authors sought to provide insight into the development of more evidence-based early care and education disinfection regulations and guidelines, though they did not independently conduct any analytical studies regarding the safety of disinfectants.

With respect to quats, the authors note that some are “mutagenic and have been shown to damage animal DNA and DNA in human lymphocytes at much lower levels than are present in cleaning chemicals (as low as 0.3 mg/L).” The authors refer to three reports that suggest that occupational exposures increase the risk of rhinitis and asthma. I note that at least the statistical data calls into question the reliability of the underlying studies to draw causation conclusions and occupational exposures are different than consumer exposures. Nonetheless, quats “are on the Association of Occupational and Environmental Clinics list of asthmagens and may be a more potent asthmagen than bleach” according to the authors of the 2019 article noted above. [emphasis added]

Given the increased frequency, regularity, and proximity to high contact surfaces, consumers should be mindful to use cleaning products in accordance with the manufacturer’s directions. The scientific literature with respect to quats and those conditions they have been reported in association with is not extensive, nor does it appear to adequately address any concerns in consumer uses. However, we anticipate further studies regarding the safety of disinfectants will be forthcoming in the near future.



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