Cleaning can be particularly important in healthcare facilities,
to limit the spread of infection, as well as for aesthetic considerations. To
ensure that the job is done effectively, facilities rely on a wide variety
of potent chemicals to attack and remove contaminants.
Cleaning chemicals in common use in healthcare facilities
fall into several product categories including:
- Air fresheners
- Bathroom and tile cleaners
- Dusting aids
- Fabric protectants
- Floor polishes/waxes
- Furniture maintenance products (aerosols)
- General purpose cleaners
- Glass cleaners
While these chemicals may be beneficial when acting on their
intended targets, they may also have the capacity to cause inadvertent damage
to people (both to those using them and to bystanders exposed to them), and
to other creatures and objects in the environment. It is advisable to
know what to look for when purchasing or specifying cleaning chemicals, and
what to watch out for when using them.
Cleaning chemicals can cause damage by direct contact with
skin, eyes, or other sensitive tissue, or through inhalation of vapors. This
section lists a number of specific risks involved in using various types of
A good source of information on specific risks is the Material
Safety Data Sheet (MSDS). The US Occupational Health and
Safety Administration (OSHA) requires the manufacturer of any hazardous chemical
sold in the US to provide an MSDS listing items such as:
- physical and chemical characteristics
- potential hazardous effects
- recommendations for appropriate protective measures
- recommendations for disposal
Your vendor should be able to supply you with an MSDS for
any cleaning product you purchase.
Skin and Eye Irritants: Many cleaning chemicals
are either mildly or strongly irritating to the skin and/or eyes. Check
the pH level (on the MSDS), check the “Health Hazard” and “Special
Protection” sections of the MSDS, product label or other technical product
information. Check for products that:
that are the least irritating — those listed as "mild irritants" on
the MSDS in preference to those listed as "severe
Toxic Chemicals: Check the “Ingredients” section
of the MSDS to determine whether a cleaning product contains toxic chemicals
that can impact human health of workers, patients and visitors.
- If any of the listed ingredients are identified as carcinogens,
it would be advisable to look for alternative products
- Look for any ingredient subject to SARA (or Toxic Release
- Look at attached links to determine toxicity of ingredients
- Some cleaning chemicals present particular problems. Examples
- Quaternary ammonium compounds. Long-term
exposure to disinfectants containing quaternary ammonium compounds
may lead to occupational asthma and hypersensitivity syndrome.
- Floor strippers and Polishing Compounds. Chemicals
in these products include diethylene glycol ethyl ether, aliphatic
petroleum distillates and nonyl-phenol ethoxylate, ethanolamine (a
known sensitizer), butoxyethanol, and sodium hydroxide. Exposure
to these chemicals may cause headaches, eye irritation, dizziness,
nausea, difficulty concentrating, fatigue, wheezing, coughing, asthma
attacks, respiratory infections, hypersensitivity pneumonitis, and
nose, throat and skin irritation.
VOC Content: Volatile organic compounds (VOCs) are
a significant source of indoor air pollution and photochemical smog . The VOC
level should be listed on the MSDS, or the manufacturer should be able to supply
a technical data sheet that includes the concentration of VOCs in a product's
formulation. Choose the product with the lowest VOC level.
Dyes: Dyes are sometimes added to cleaning
products to help housekeeping staff identify a particular product, and
to keep them from confusing it with another similar product, which under some
circumstances can have dangerous results. However, many dyes are
environmental toxicants, and some are even carcinogens. Some in the medical
community advocate removing dyes and instead using alternative packaging that
clearly identifies the product to housekeeping staff.
Packaging: Certain forms of packaging can actually
reduce occupational exposure to the worker. There is also packaging that works
toward environmental sustainability by offering recyclable, refillable, reusable
packaging, cleaning products offered in bulk or concentrated form, or packaging
made of recycled content.
Certain Occupational Safety
and Health Administration (OSHA) regulations relate to cleaning chemicals:
- OSHA's Hazard Communication Standard
(HazCom), requires that information concerning any associated health or
physical hazards be transmitted to employees via comprehensive hazard communication
programs (Go to HERC HazCom page).
The programs must include:
- Written Program. A written that meets
the requirements of the Hazard
Communication Standard (HazCom).
- Labels. In-plant containers of hazardous
chemicals must be labeled, tagged, or marked with the identity of the
material and appropriate hazard warnings.
- Material Safety Data Sheets. Employers must
have an MSDS for each hazardous chemical which they use and MSDSs must
be readily accessible to employees when they are in their work areas
during their workshifts.
- Employee Information and Training. Each
employee who may be “exposed” to hazardous chemicals when
working must be provided information and be trained prior to initial
assignment to work with a hazardous chemical, and whenever the hazard
- Depending on the ingredients contained in the cleaner
and its manner of use, employee protection may be required, including ventilation
controls, personal protective equipment, clothing or gloves, or other applicable
precautions. This assessment should be made by the employer, again, based
on the unique conditions of use of the product at that establishment.
- Where the eyes or body of any person may be exposed to
injurious corrosive materials, employers must provide suitable mechanisms
for quick drenching or flushing of the eyes and body within the work area
for immediate emergency use [1910.151(c)].
Certain Environmental Protection
Agency (EPA) regulations may also apply to cleaning chemicals:
Some cleaning chemicals are considered hazardous
wastes, and are regulated under RCRA.
- If the sole active ingredient of a cleaning chemical
is a P or U-listed waste (this
information is available on the MSDS) the product itself must be managed
as a hazardous waste.
- A cleaning chemical might also have to be considered
a characteristic hazardous
waste due to:
It is important to check the pH level of the cleaning product. Many
cleaning products have pHs higher than 11 or lower than 2. A cleaning
product may be considered hazardous if it has a pH of less than 2 or
greater than 12.5. This information can be determined form the MSDS
under the “Physical Data” category.
Look for products that are certified to meet certain environmental
and health and safety criteria. There are several accrediting bodies that make
determinations about whether cleaning chemicals have met environmental criteria.
- Green Seal
- Canada’s Environmental Choice Program
- New American Dream
- State Programs
Check to see if end product being used (after dilution)
is to be managed under RCRA. If not, most cleaning solutions can be disposed
of to the sanitary sewer, so long as the local POTW permits it. Check with
POTW to determine feasibility of sending cleaning chemical residuals to sanitary
Chemical Use in Hospitals Fact Sheet. Found in Health Care Without Harm’s 10 Ways to Find Safer, Greener Cleaners.
Products Database. The National Institutes of Health Information Household
Products Database is taken from a variety of publicly available sources,
including brand-specific labels and Material Safety Data Sheets (MSDS) prepared
by manufacturers. You can search by product category or by ingredient, and
it gives you MSDSs plus other information. It’s geared toward household
products, but it includes some cleaning chemicals used at healthcare facilities.