5. This work showed that cleaning exposures are a function
of the way that tasks are performed, as well as product
formulations
A comprehensive approach to exposure prevention will
account for the method with which a product is applied
and the task requirements, as well as assessing of the
chemical ingredients and implementation of safer alternatives
to cleaning products.
Limitations
The results of this work are based on a small number of
products. While we selected a few representative hospitals,
it is possible that other products with additional ingredients
are used elsewhere.
This study does not address the lack of quantitative data
in the literature regarding the concentrations of cleaning
compounds in workplace air. Quantitative characterization
of exposures would better identify activities that produce
the highest exposure, important for control
measures. This work serves as preparation for a detailed quantitative assessment of airborne exposures from cleaning
tasks.
Conclusion
This study found that cleaning products are mixtures of
many chemical ingredients of concern that may impact
worker health through air and dermal exposures. Because
cleaning exposures are a function of both product formulations
and product application procedures, a combination
of product evaluation and workplace exposure data is
necessary to develop strategies for protecting workers
from cleaning hazards. The task based assessment conducted
here allowed classification of cleaning tasks in different
exposure categories, a strategy that can be employed
by epidemiological investigations of the impact of cleaning
on health. The methods presented here can also be
used by occupational and environmental health practitioners
to identify workplace interventions for improving
health.
Abbreviations
MSDSs: materials safety data sheets; RTU: ready to use;
CAS: chemical abstract services; HSDB: hazardous substances
data bank; ACGIH: American Conference of Governmental
Industrial Hygienists; OSHA: Occupational
Safety and Health Administration; NIOSH: National Institute
for Occupational Safety and Health; TLV: Threshold
Limit Values; REL: Recommended Exposure Limit; PEL:
Permissible Exposure Levels; BEI: Biological Exposure
Indexes; VOC: volatile organic compounds; DREAM: dermal
exposure assessment method; BP: boiling point; 2-BE:
2-butoxyethanol.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
AB led the design of the research, drafted the paper, carried
out the workplace interviews and observations, and
performed exposure assessment analyses. MMQ co-led
the design of the research, guided paper writing, facilitated
workplace connections and conducted paper revisions.
MJP and DKM provided critical input on criteria for
product selection, representative data collection in the
workplace, adapting the DREAM method for cleaning
tasks and contributed to paper revisions. All authors
approved the final manuscript.