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Feb
Increased Accumulation of Disinfectant Chemicals in the Body during the Pandemic Threatens Health, Despite Available Alternatives
(Beyond Pesticides, February 1, 2022) A study published in Environmental Science and Technology finds that concentrations of quaternary ammonium compounds (QUATs or QACs) in the human body have increased during the COVID-19 pandemic, raising health and safety concerns. QACs include a variety of chemicals in personal care, pharmaceutical, and medical products used as disinfectants, sanitizers, antimicrobials. However, over the past 70 years, large-scale production and use of these compounds led to accumulation in the environment, including surface water, sediment, and soil. 
Previously, researchers thought most QACs lack the potential to bioaccumulate, as the chemicals are highly water-soluble, while dermal and oral absorption rates are low. However, emerging evidence demonstrates that specific QACs bioaccumulate in blood and other body tissues and can cause a range of toxic effects. Therefore, studies like this highlight the significance of monitoring chemical exposure for adverse health effects. The researchers note, “Further efforts are needed to explore the relationship between the use of QAC-containing products and the levels of QACs in human blood or of their metabolites in urine. Considering the increased use of some QACs as a result of the Covid-19 pandemic, our findings warrant further exposure and epidemiological research focused on QACs.”
Amidst the outbreak of SARS-CoV-2 (COVID-19), the global demand for disinfectants and sanitizers has increased substantially as a means of preventing illness in residential and non-residential settings. Initially, public health officials considered disinfecting highly trafficked areas as the most effective way to combat COVID-19. This notion has led to dangerous disinfectant practices in many countries where trucks, drones, or robots disperse massive amounts of disinfectants into public areas. Furthermore, the Centers for Disease Control (CDC) has reported a sharp increase in calls to Poison Control Centers regarding illnesses resulting from the use or misuse of toxic disinfectants during the pandemic. The World Health Organization (WHO) and other infectious disease specialists condemn indiscriminate and vast amounts of disinfectant spraying in public areas, deeming it ineffective and a health hazard on contact or when combined with other disinfectants.
The researchers performed an in vitro—in vivo extrapolation (IVIVE) model to determine the bioaccumulation potential of 18 QACs in blood samples from the liver, before (2019) and during (2020) the COVID-19 pandemic. The model determines the clearance rate in vivo (in the body), in which a slower clearance rate means higher bioaccumulation potential. The results show 15 out of the 18 QACs are detectable in blood samples, with QAC concentrations significantly higher during the pandemic than prior to it. The main routes of exposure include diet, inhalation, ingestion, or the skin.
More than a third of U.S. residents participate in high-risk COVID-19 practices, misusing toxic disinfectant cleaners and disinfectants to prevent infection. Quaternary ammonium compounds are among some of the most harmful disinfectants, as their “long-lasting” properties have adverse impacts on human health, which has extensive documentation in the scientific literature. Effects include mutations, lower fertility, and increased antibiotic resistance. QAC disinfectants’ overuse in U.S. Immigration and Custom Enforcement (ICE) detainment centers caused nose bleeds and other adverse health effects. Furthermore, Beyond Pesticides receives questions from concerned teachers asking for less harmful disinfectants to use in the classroom, especially as many are experiencing adverse impacts of disinfectant use (e.g., chemical skin burns, respiratory issues). Since QACs are in most disinfectant products, it remains ubiquitous in the environment as misuse continues.
Although disinfectants, like QACs, kill viruses, bacteria, and other microbes via cell wall and protein destruction, they can also negatively affect the immune system, thus reducing resistance to disease. People who have a preexisting condition or are of advanced age, who may have a weakened immune or respiratory system, are more vulnerable to the effects of the virus. When managing viral and bacterial infections, chemicals that exacerbate the risk to vulnerable individuals are of serious concern.
QACs are harmful to the respiratory system and have a long list of adverse effects from cancer and genetic mutations to lower fertility and increase antibiotic resistance. Most recently, the QAC antimicrobial cetylpyridinium chloride (CPC) has raised concerns. The compound is present in mouthwashes, lozenges, toothpaste, and nasal sprays and is thus commonly encountered orally. A recent study finds CPCs have associations with adverse respiratory effects (e.g., lung inflammation). Moreover, acute oral inhalation can be fatal. Although CPC also has uses as an “inert” or undisclosed ingredient in pesticide products, recent findings demonstrate CPC has more biological potential. The respiratory system is essential to human survival, regulating gas exchange (oxygen-carbon dioxide) in the body to balance acid and base tissue cells for normal function. Considering COVID-19 is a systemic (general) disease that overwhelmingly impacts the respiratory system of many patients, exposure to CPCs present a heightened risk of co-occurring symptoms. Damage to the respiratory system can also trigger the development of extra-respiratory systemic manifestations like rheumatoid arthritis, and cardiovascular disease.
While EPA has certified several disinfectants as effective against COVID-19 (List N), many of these chemicals are hazardous. These chemicals include QACs and other toxic compounds documented on Beyond Pesticides’ list of “Disinfectants to Avoid.” Although disinfection can kill pathogens, one must consider guidelines associated with proper selection and use of products. Conveniently, several safer disinfectants on EPA’s list are effective against the virus, including citric acid, ethanol, isopropanol, L-lactic acid, hydrogen peroxide, sodium bisulfate, dodecylbenzene sulfonic acid, and thymol. These chemicals are present on Beyond Pesticides’ “good” list of “Disinfectants to Look for” as natural-based substances tend to be safer while still effective at eliminating the virus on surfaces. Beyond Pesticides has said, “It is important during public health emergencies involving infectious diseases to scrutinize practices and products very carefully so that hazards presented by the crisis are not elevated because of the unnecessary threat introduced with toxic chemical use… There is tremendous pressure to use toxic disinfectants, despite the availability of safer products. In fact, while [CDC] is recommending 70% alcohol for surface disinfection, [EPA’s] Office of Pesticide Programs is advising the use of unnecessarily toxic substances, and reducing standards that govern their allowance on the market.”
This study is the first to comprehensively assess the bioaccumulation of QACs in blood via biomonitoring, demonstrating a difference in chemical concentrations before and during the pandemic. The study notes that frequent detection of QACs in blood reveals widespread exposure among the general population. The major QAC groups include benzylalkyldimethylammonium compounds (BACs), dialkyldimethylammonium compounds (DDACs), and alkyltrimethylammonium compounds (ATMACs). The results show that, of the three groups, ATMACs are most abundant in blood samples. The authors conclude, “[T]he higher QAC concentrations in blood collected during the pandemic suggest increased exposure during this period, possibly due to the increased disinfection of the indoor and outdoor environment.”
As the U.S. COVID-19 cases continue to rise, there is an urgent need to evaluate the effect pesticide exposure and uses have on health. Although some practices and products can prevent coronavirus infections, the continued use of toxic pesticides in the surrounding environment increases disease risk factors. When managing viral and bacterial infections, advocates say that we must not exacerbate the risk to animals and humans, while avoiding or controlling the threat. In the case of COVID-19, there exists measures of protection—both practices and products—that can prevent infection without using toxic products that increase risk factors.
Advocates maintain that individuals and government officials alike should assess all risks associated with pesticide use, including the mode of action. However, EPA’s failure to respond to current science is a significant shortcoming of its risk assessment process, especially regarding disease implications. Individuals and government officials should observe all chemical ingredients on the disinfectant and sanitizer product labels and look at the use instructions to ensure that the method of use is safe for you. Beyond Pesticides tracks the most recent health studies related to pesticide exposure through our Pesticide-Induced Diseases Database (PIDD). This database supports the clear need for strategic action to shift away from pesticide dependency. For more information on harms associated with pesticide exposure, see PIDD pages on asthma/respiratory effects and other diseases. Additionally, learn how to protect yourself from COVID-19 safely by visiting Beyond Pesticides’ webpage on Disinfectants and Sanitizers for more information.
All unattributed positions and opinions in this piece are those of Beyond Pesticides.
