Chronic obstructive pulmonary disorder (COPD) is a progressive lung disease that is characterized by feelings of breathlessness. Individuals with the disease often find it difficult to complete normal daily tasks like walking up stairs, gardening, or standing up. COPD causes damage and destruction of the lung tissue resulting in loss difficulty moving air into and out of the lungs. There are about 175 million people affected by COPD worldwide and is the 4th leading cause of death. Smoking is the biggest risk factor for COPD with around 25% of smokers going on to develop the disease. Other risk factors include pollution, cooking fires/indoor fires (third world), and genetics. New research presented at the European Respiratory Society Congress in Milan, Italy suggests that prolonged exposure to workplace disinfectants is associated with an increased risk for COPD in nurses.
Disinfectants, like bleach and hydrogen peroxide, have been linked with an increased risk for developing asthma among professional cleaners. The irritant nature of many disinfectants makes it a likely candidate for contributing to lung disease like COPD but little data currently exists. In this new study, ~55,000 female nurses currently practicing and with no history of COPD in 2009 were asked about their exposure to disinfectants at work. In the 8-year follow-up (May 2017), 663 of the nurses were diagnosed by a physician with COPD. Taking into account smoking status and frequency, age, body weight, and ethnicity, the researchers found that weekly exposure to disinfectants was associated with 22% increased risk of having COPD. High exposure to specific disinfectants, gluteraldehyde, bleach, hydrogen peroxide, was associated with between 24% and 32% increased risk of COPD.
The work suggests that precautions in the workplace are needed when nurses work with disinfectants. These results are still preliminary and still need to be put through the peer-review process but it does raise a number of interesting questions. Is this association also seen in men? Is there an association with other professions (professional cleaners)? Was the association only seen in people who smoke or everyone? This is an important question because smoking is the biggest risk factor for COPD and so if the disinfectants interact with the cigarette smoke in some way we need to know. Finally, keep in mind that this is an observational study and can only show us associations and cannot prove cause and effect. We still don’t know if exposure to disinfectants causes COPD in these nurses directly or if it is something else in their environment. Further study in other populations of people is needed and in depth studies into the mechanisms at play here are needed.
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