What protective measures should I take while using disinfectants?

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General precautions
What to do if you accidentally get exposed
Additional precautions for commonly used disinfectants
Editor's Note

Author: Staff Writer

Health and Wellness
Coronavirus

May 18, 2020

While people are being told there’s no antiviral drug to prevent or treat COVID-19, they’re simultaneously learning that disinfectants can kill the coronavirus.

But as disinfectants can kill a virus on surfaces, they can harm and kill people when improperly used or ingested, says Avraham Cooper, MD, a pulmonologist and intensive care physician at The Ohio State University Wexner Medical Center and assistant professor in the Ohio State College of Medicine. “They’re dangerous, so be sure to take precautions when using them.”

Cooper specializes in the care of patients with asthma but also treats a wide variety of general pulmonary issues. He cares for patients who’ve been hospitalized with respiratory illnesses as well as those who are critically ill in the intensive care unit, including those impacted by COVID-19. There are two ways that COVID-19 and other respiratory viruses can spread, Cooper says. One is through respiratory droplets, or mucous membrane exposure. The other is by picking up the virus from a surface. That’s the purpose of using disinfectants—to reduce the risk of picking up the virus from a surface. The Centers for Disease Control has ratings for ones that are good to kill viruses, and instructions for how long to leave the disinfectant on surfaces to kill the virus. But users should administer the products appropriately and be careful to wipe up the remnants of any surface disinfectant. The CDC reported that poison control centers in the United States experienced a 20% increase in calls from January through March, compared to 2019, for exposure to chemicals in cleaning products. “Ingesting these in any way is absolutely dangerous and shouldn’t be done. They’re meant for cleaning surfaces,” Cooper says. For instance, people might spray surfaces then place food on those surfaces. That should not be done, as disinfectants can wreak havoc on your body. Consumption of bleach and isopropyl alcohol can lead to kidney failure and liver failure, among other life-threatening ailments.

“Bleach itself is extremely toxic if it’s ingested,” Cooper says. But alcohol and bleach are acceptable chemical disinfectants, if used appropriately.

Here are a few general tips for using disinfectants:

Always read and follow directions on the label.
Use only water at room temperature for dilution (unless stated otherwise on the label).
Avoid mixing chemical products.
Wear eye and skin protection (avoid touching the eyes).
Ensure adequate ventilation.
Store chemicals out of the reach of children.

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Chemical disinfectants such as chlorine, ethanol, and hydrogen peroxide kill microorganisms. However, these chemicals can also be harmful to humans if used incorrectly. Accidental exposures to cleaning and disinfection products have increased in the USA and in France during the COVID-19 outbreak. When promoting safe surface disinfection, it is important to address the critical safety issues related to their storage and use.

For any chemical disinfectant, users should follow instructions provided on the label or packaging. In addition, a Safety Data Sheet (SDS) should be available from the supplier that describes in more detail the risks associated with use, recommended precautions, and first aid procedures in case of incidents such as inhalation, ingestion, or eye and skin contact. See this SDS example for household bleach and this website that explains how to read a SDS.

General precautions

The below are general recommendations for precautions applicable to commonly used disinfectants:

Keep all chemical disinfectants in correctly labelled containers
Do not mix chemical disinfectants together or with other cleaning products
Avoid splashes and spills by handling chemical disinfectants with care
Do not breathe vapour/gas or spray; prepare and use chemical disinfectants in well ventilated areas
Only use water at room temperature for dilutions (unless specified otherwise in users’ instructions)
Do not eat, drink, or smoke when using chemical disinfectants
Wear personal protective equipment (protective clothing, gloves and goggles) if available when handling chemical disinfectants
Store chemical disinfectants out of reach of children and in a cool and dry place, protected from heat and sunlight.
Wash your hands thoroughly with soap and water after handling chemical disinfectants
Do not use environmental/surface chemical disinfectants for personal hygiene (hand disinfection or bathing).

In addition, any specific precautions recommended on product packaging or the SDS should always be followed.

What to do if you accidentally get exposed

The following actions can be taken in case of accidental exposure to a chemical disinfectant via:

Mouth: Immediately rinse mouth out with water. Do not induce vomiting.
Skin: Immediately flush the skin with water for 15 min and remove any contaminated clothes.
Eyes: Immediately rinse eyes with slow-running clean water for at least 15 minutes. Push the eyes open. Avoid splashing the uncontaminated eye with the wash water while rinsing the contaminated eye. Remove contact lenses if present and possible.
Inhalation: Immediately move to an area with open-air or a well-ventilated location. Administer mouth-to-mouth resuscitation if the injured person has difficulty breathing or stops breathing.
If the exposed person is unconscious or having trouble breathing, seek emergency medical help immediately.

In addition, any specific emergency actions recommended on product packaging or the SDS should always be followed.

Additional precautions for commonly used disinfectants

The table below summarizes the main risks and recommended precautions for commonly used disinfectants at typical, commercially available concentrations: chlorine (bleach), ethanol, and hydrogen peroxide.

1 SDS for bleach (5-10% sodium hypochlorite)

2 SDS for 70% ethanol

3 SDS for hydrogen peroxide (15%)

Please note all general recommendations above apply as well; this is a non-exhaustive summary and the Safety Data Sheet (SDS) should be used as reference for precautions to be taken when using any chemical product.

Editor's Note

Author: Karin Gallandat
Review: Karen Levy, Jacqueline Knee
Last Update: 11.05.2020

To help prevent the spread of COVID-9, it is important to clean and disinfect surfaces such as countertops, faucet handles and doorknobs.

However, you must be cautious. Disinfectants contain Environmental Protection Agency (EPA)-registered pesticides that can cause harm, especially if not used as directed.

TURI recommends the following guidelines:

Use disinfectants that contain safer active ingredients. TURI reviewed the list of EPA-registered disinfectants that are effective on COVID-19 and identified products that contain active safer ingredients.
Avoid using disinfectants that contain toxic chemicals such as quaternary ammonium compounds, which can cause contact dermatitis, asthma and other health impacts.
NEVER mix cleaning/disinfecting chemicals. Mixing chemicals can cause very dangerous reactions. For example, if bleach and ammonia are mixed together, they produce toxic gases that can be lethal. Combining bleach with other chemicals, such as hydrogen peroxide or vinegar, is also dangerous. For more information, see TURI’s webpage on the dangers of mixing cleaning chemicals.
Wear rubber gloves and eye protection when using toxic disinfectants. Open windows and turn on exhaust fans to dissipate the toxic fumes. Precautions must be followed to minimize exposure to these harmful chemicals. Keep these products away from children, and open windows or turn on exhaust fans when using.
Dilute bleach with water before using. Bleach, or sodium hypochlorite, is an effective disinfectant, but it must be diluted before using. Bleach is highly toxic. It can cause respiratory, skin and eye irritation, and can cause or exacerbate asthma.
Don't over use disinfectants. Although we are in a crisis situation with COVID-19, remember that disinfecting kills all microorganisms, good and bad. Overuse can contribute to unintended consequences, such as causing health effects and promoting the growth of antibiotic resistance organisms.
Clean before you disinfect. If there is dirt on a surface, clean it off with soap and water before you apply any disinfectant. Removing dirt makes the disinfection more effective.