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A comprehensive health effects assessment of the use of sanitizers and disinfectants during COVID-19 pandemic: a global survey

Hashemi F 1 , Hoepner L 2 , Hamidinejad FS 3 , Haluza D 4 , Afrashteh S 5 , Abbasi A 1 Show all authors , Omeragić E 6 , Imamović B 6 , Rasheed NA 7 , Taher TMJ 8 , Kurniasari F 9 , Wazqar DY 10 , Apalı ÖC 11 , Yildirim AD 12 , Zhao B 13 , Kalikyan Z 14 , Guo C 15 , Valbuena AC 16 , Mititelu M 17 , Pando CM 18 , Saridi M 19 , Toska A 19 , Cuba ML 20 , Kwadzokpui PK 21 , Tadele N 22 , Nasibova T 23 , Harsch S 24 , Munkh-Erdene L 25 , Menawi W 26 , Evangelou E 27 , Dimova A 28 , Marinov D 29 , Dimitrova T 29 , Shalimova A 30 , Fouly H 31 , Suraya A 32 , da Silva Faquim JP 33 , Oumayma B 34 , Annunziato MA 35 , Lalo R 36 , Papastavrou E 37 , Ade AD 38 , Caminada S 39 , Stojkov S 40 , Narvaez CG 41 , Mudau LS 42 , Rassas I 43 , Michel D 44 , Kaynar NS 45 , Iqbal S 46 , Elshwekh H 47 , Hossain I 48 , Al-Fayyadh S 49 , Sydorchuk A 50 , Alnusairat DMH 51 , Abdullahi AM 52 , Iqbal N 53 , Pandey A 54 , Gómez-Gómez B 55 , Akyildiz AG 56 , Morosan E 17 , Dwarica D 57 , Dorj G 58 , Hasan SY 59 , Al-Shdayfat NM 60 , Knezevic B 61 , Valladares W 62 , Severi C 63 , Fuentes SC 64 , Augusto S 65 , Sidorova E 66 , Moelyaningrum AD 67 , Alawad T 68 , Khalid A 69 , Elehamer NMK 70 , Mihaylova A 71 , Tsigengagel O 72 , Menouni A 73 , Wojtecka A 74 , Hod R 75 , Idayat YB 76 , Othman K 77 , Harfouch RM 78 , Paunov T 29 , Omar M 79 , Benderli NC 80 , Nurika G 67 , Amjad S 81 , Elnoamany S 82 , Elesrigy F 82 , Shaban MM 83 , Acevedo-López D 84 , Kartashova M 85 , Khalaf A 86 , Jaafar SA 87 , Kadhim TA 87 , Hweissa NA 88 , Teng Y 89 , Mohammed FE 90 , Sasikumar T 91 , Hikaambo CN 92 , Kharat A 93 , Lyamtseva U 94 , Aldeeb MA 95 , Pawlas N 96 , Khorolsuren L 97 , Koonjul RP 98 , Maïnassara HB 99 , Chahal P 100 , Wangeci RW 101 , Kumar AB 102 , Zamora-Corrales I 103 , Gracy S 104 , Mahamat M 105 , Adamczyk J 106 , Rahman HA 107 , Matiashova L 108 , Elsherif OE 109 , Alkhateeb NE 110 , Aleaga Y 111 , Bahrami S 112 , Al-Salihy SR 113 , Cabrera-Galeana P 114 , Lalic-Popovic M 115 , Brown-Myrie E 116 , Bhandari D 117 , Mayaboti CA 118 , Stanišić S 119 , Pestic SK 120 , Bektay MY 121 , Al Sabbah H 122 , Hashemi S 123 , Assia B 124 , Merritt AS 125 , Ramzi Z 126 , Baboolal H 57 , Isstaif J 127 , Shami R 128 , Saad R 129 , Nyirongo T 130 , Hoseini M 131

Affiliations 

  • 1 Department of Environmental Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  • 2 Department of Environmental and Occupational Health Sciences, School of Public Health, SUNY Downstate Health Sciences Center, Brooklyn, NY, USA
  • 3 Department of Medicine, O.O. Bogomolets National Medical University, Kyiv, Ukraine
  • 4 Center for Public Health, Department for Environmental Medicine, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
  • 5 Department of Biostatistics and Epidemiology, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
  • 6 Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
  • 7 Department of Medical Laboratory Technology, College of Health and Medical Technology Shekhan, Duhok Polytechnic University, Duhok, Kurdistan Region, Iraq
  • 8 Family and Community Medicine Department, College of Medicine, University of Wasit, Kut, Wasit, Iraq
  • 9 Department of Environmental Health, Faculty of Public Health, University of Indonesia, Jakarta, Indonesia
  • 10 Department of Medical-Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
  • 11 Faculty of Medicine, Hacettepe University, Ankara, Turkey
  • 12 Midwifery Department, Üsküdar Universty, Istanbul, Turkey
  • 13 Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-Gicl, Wonju, Gangwon-do, 26493, South Korea
  • 14 Department of Clinical Immunology and Allergology, Yerevan State Medical University, Yerevan, Armenia
  • 15 Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China
  • 16 Division of Epidemiology, Public Health Center of Valencia, Valencia, Spain
  • 17 Department of Clinical Laboratory and Food Safety, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  • 18 Department of Medicine, University of Granada, Granada, Spain
  • 19 School of Social Sciences, Hellenic Open University, Patras, Greece
  • 20 Department of Pathology, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
  • 21 Department of Medical Laboratory Science, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
  • 22 Department of Nursing, School of Nursing & Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
  • 23 General and Toxicological Chemistry Department, Azerbaijan Medical University, Baku, Azerbaijan
  • 24 Institute of Sociology, University of Education Freiburg, Freiburg, Germany
  • 25 Department of Health Policy, School of Public Health, Mongolian National University of Medical Sciences, Ulan Bator, Mongolia
  • 26 Public Health Management Program, Faculty of Graduate Studies, An-Najah University, Nablus, State of Palestine
  • 27 Nursing Department Limassol, Cyprus University of Technology, Limassol, Cyprus
  • 28 Faculty of Public Health, Medical University Varna, 55 Marin Drinov Street, 9002, Varna, Bulgaria
  • 29 Department of Hygiene and Epidemiology, Faculty of Public Health, Medical University of Varna, Varna, Bulgaria
  • 30 Internal Medicine N1, Kharkiv National Medical University, Kharkiv, Ukraine
  • 31 Reproductive Health Nursing (Gynecology and Obstetrics Nursing), Faculty of Nursing, Assiut University, Asyut, Egypt
  • 32 CIHLMU Center for International Health, University Hospital, LMU, Munich, Germany
  • 33 Technical School of Health, Federal University of Uberlândia (UFU), Uberlândia, MG, Brazil
  • 34 National School of Applied Sciences of Al Hoceima, Abdelmalek Essaadi University, Tetouan, Morocco
  • 35 Venezuelan and Latin American Association of Clinical Nanomedicine, Caracas, Venezuela
  • 36 Department of Health Care, Faculty of Public Health, The University of Vlore "Ismail Qemali", Vlore, Albania
  • 37 Cyprus University of Technology, Limassol, Cyprus
  • 38 Department of Community Medicine, SVIMS, Sri Padamavathi Medical College, Tirupati, Andhra Pradesh, India
  • 39 Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
  • 40 Department of Social Pharmacy, Faculty of Pharmacy, University Business Academy in Novi Sad, Novi Sad, Serbia
  • 41 Facultad de Ciencias de la Salud, Universidad del Desarrollo, Concepción, Chile
  • 42 Department of Environmental Health, Faculty of Science, Tshwane University of Technology, Pretoria, South Africa
  • 43 Department of Occupational Medicine and Ergonomics, Faculty of Medicine, University of Monastir, Monastir, Tunisia
  • 44 West Department, Quisqueya University, Port-au-Prince, Haiti
  • 45 Public Health Nursing Department, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
  • 46 Department of Public Health and Nutrition, Al Ain University, Abu Dahbi, United Arab Emirates
  • 47 Department of Genetic Engineering, The Biotechnology Research Center, Tripoli, Libya
  • 48 Department of Occupational and Environmental Health (OEH), NIPSOM, Mohakhali, Dhaka, Bangladesh
  • 49 Adult Nursing Department, College of Nursing, University of Baghdad, Baghdad, Iraq
  • 50 Department of Infectious Diseases and Epidemiology, Bukovinian State Medical University, Chernivtsi, Ukraine
  • 51 Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
  • 52 School of Medicine and Health Science, Simad University, Mogadishu, Somalia
  • 53 Environmental Epidemiology Group, UK Health Security Agency, Chilton, Oxon, UK
  • 54 Maharajgunj Nursing Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
  • 55 Department of Infectious Diseases, Centro Médico ABC, Mexico City, Mexico
  • 56 Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Bezmialem Vakif University, Istanbul, Turkey
  • 57 Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago
  • 58 Department of Epidemiology and Biostatistics, School of Public Health, Mongolian National University of Medical Sciences, Ulan Bator, Mongolia
  • 59 Department of Natural Resources and Environment, College of Graduate Studies, Arabian Gulf University, Manama, Bahrain
  • 60 Community and Mental Health Department, Al al-Bayt University, Mafraq, Jordan
  • 61 University Hospital Centre Zagreb, Zagreb, Croatia
  • 62 Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras
  • 63 Department of Preventive Medicine, Faculty of Medicine, University of the Republic, Montevideo, Uruguay
  • 64 Faculty of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
  • 65 EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
  • 66 Moscow State Medical University, Sechenov University, Moscow, Russia
  • 67 Public Health Faculty, Environmental Health and Occupational Health and Savety Departement, University of Jember, Jember, Indonesia
  • 68 Faculty of Public and Environmental Health, University of Khartoum, Khartoum, Sudan
  • 69 Sahiwal Medical College, University of Health Sciences, Lahore, Pakistan
  • 70 Department of Health Education, University of Khartoum, Khartoum, Sudan
  • 71 Medical College, Medical University of Plovdiv, Plovdiv, Bulgaria
  • 72 Department of Public Health, NCJSC "Semey Medical University", Semey, Kazakhstan
  • 73 Environment and Health Unit, Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium
  • 74 Department of Public Health and Social Medicine, Medical University of Gdansk, Gdansk, Poland
  • 75 Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia, Bangi, Malaysia
  • 76 Department of Environmental Health Sciences, University of Ibadan, Ibadan, Nigeria
  • 77 Ministry of Foreign Affairs and East African Cooperation, Dodoma, Tanzania
  • 78 Department of Microbiology and Biochemistry, Al Sham Private University, Latakia, Syria
  • 79 Department of Population Health and Social Sciences, Kazakhstan's Medical University School of Public Health, Almaty, Kazakhstan
  • 80 Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
  • 81 Department of Obstetrics and Gynaecology, University of Alberta, Edmonton, Canada
  • 82 Family Medicine Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
  • 83 Community Health Nursing Department, Faculty of Nursing, Cairo-University, Cairo, Egypt
  • 84 Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia
  • 85 Department of Human Pathology, Sechenov University, Moscow, Russia
  • 86 Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
  • 87 College of Nursing, University of Al-Muthanna, Samawah, Iraq
  • 88 Department of Public Health, Faculty of Medical Technology, Zawia University, Zawia, Libya
  • 89 Department of Korean Language and Literature, Graduate School, Yonsei University, Gangwon-do, South Korea
  • 90 Faculty of Medicine, University of Khartoum, Khartoum, Sudan
  • 91 Institute of Medicine, University of Colombo, Colombo, Sri Lanka
  • 92 Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
  • 93 College of Pharmacy, University of Utah, Salt Lake City, UT, USA
  • 94 Department of Medicine of the Future, Sechenov University, Moscow, Russia
  • 95 Hamad Medical Corporation, Doha, Qatar
  • 96 Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
  • 97 Institute of Public Health, Mongolian National University of Medical Sciences, Ulan Bator, Mongolia
  • 98 Department of Medicine, University of Mauritius, Moka, Mauritius
  • 99 Conseils Etudes Enquêtes Recherches Formation en Epidémiologie (CEERFE), Niamey, Niger
  • 100 S. Tentishev Asian Medical Institute, Kant, Kyrgyzstan
  • 101 Health Sciences, School of Public Health, University of Nairobi, Nairobi, Kenya
  • 102 Department of Health Policy and Management, School of Public Health, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
  • 103 School of Public Health, University of Costa Rica, San José, Costa Rica
  • 104 Department of Biomedical Sciences, University of Asmara, Asmara, Eritrea
  • 105 Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, Yaounde General Hospital, Yaounde, Cameroon
  • 106 Faculty of Health Sciences, Jan Długosz University of Humanities and Life Sciences, Czestochowa, Poland
  • 107 Department of Environmental and Health Sciences, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
  • 108 T Malaya Therapy National Institute, National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
  • 109 Cairo University Hospitals, Cairo, Egypt
  • 110 Department of Medical Education, College of Medicine, Hawler Medical University, Erbil, Iraq
  • 111 Department of Clinical Microbiology, Institute of Tropical Medicine "Pedro Kouri", Havana, Cuba
  • 112 Shiraz University of Medical Sciences, Shiraz, Iran
  • 113 Microbiology Department, College of Medicine, University of Diyala, Diyala, Iraq
  • 114 Instituto Nacional de Cancerología, Mexico City, Mexico
  • 115 Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
  • 116 Department of Pharmaceutics, School of Pharmacy, College of Health Sciences, University of Technology, Kingston, Jamaica
  • 117 Medical Governance Research Institute, Tokyo, Japan
  • 118 University of Oslo, Oslo, Norway
  • 119 Singidunum University, Belgrade, Serbia
  • 120 Family Medicine Department, Medical School, University of Tuzla, Tuzla, Bosnia and Herzegovina
  • 121 Clinical Pharmacy Department, Faculty of Pharmacy, Marmara University, Istanbul, Turkey
  • 122 Department of Health Sciences, Zayed University, Dubai, United Arab Emirates
  • 123 Department of Chemical Engineering, Faculty of Engineering, University of Kurdistan, Sanandaj, Iran
  • 124 Peadiatric's Infectious diseases, Hospital of Canastel and Faculty of Medicine, Oran, Algeria
  • 125 Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  • 126 College of Nursing, University of Sulaimani, Kurdistan, Sulaimani, Iraq
  • 127 Department of Neurology, Faculty of Medicine, Damascus University, Damascus, Syria
  • 128 Department of Public Health, College of Health Sciences, Qatar University, Doha, Qatar
  • 129 Department of Public Health, Qatar University, Doha, Qatar
  • 130 Environmental Health, Rusangu University, Monze, Zambia
  • 131 Research Center for Health Sciences, Institute of Health, Shiraz, Iran. [email protected]
Environ Sci Pollut Res Int, 2023 Jun;30(28):72368-72388.
PMID: 37166731 DOI: 10.1007/s11356-023-27197-6

Abstract

COVID-19 has affected all aspects of human life so far. From the outset of the pandemic, preventing the spread of COVID-19 through the observance of health protocols, especially the use of sanitizers and disinfectants was given more attention. Despite the effectiveness of disinfection chemicals in controlling and preventing COVID-19, there are critical concerns about their adverse effects on human health. This study aims to assess the health effects of sanitizers and disinfectants on a global scale. A total of 91,056 participants from 154 countries participated in this cross-sectional study. Information on the use of sanitizers and disinfectants and health was collected using an electronic questionnaire, which was translated into 26 languages via web-based platforms. The findings of this study suggest that detergents, alcohol-based substances, and chlorinated compounds emerged as the most prevalent chemical agents compared to other sanitizers and disinfectants examined. Most frequently reported health issues include skin effects and respiratory effects. The Chi-square test showed a significant association between chlorinated compounds (sodium hypochlorite and per-chlorine) with all possible health effects under investigation (p-value <0.001). Examination of risk factors based on multivariate logistic regression analysis showed that alcohols and alcohols-based materials were associated with skin effects (OR, 1.98; 95%CI, 1.87-2.09), per-chlorine was associated with eye effects (OR, 1.83; 95%CI, 1.74-1.93), and highly likely with itching and throat irritation (OR, 2.00; 95%CI, 1.90-2.11). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92-2.44). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92-2.44). The use of sodium hypochlorite and per-chlorine also had a high chance of having respiratory effects. The findings of the current study suggest that health authorities need to implement more awareness programs about the side effects of using sanitizers and disinfectants during viral epidemics especially when they are used or overused.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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