Objectives While there is evidence of asthma and other respiratory illness among workers performing cleaning and disinfecting (C and D) of environmental surfaces in healthcare and in residential and institutional settings, quantitative measurements of C and D exposures are limited. Previously, we found that 80% of home care (HC) aide visits to clients’ homes involve C and D; commonly-used C and D products contain bleach, a respiratory irritant. Objectives of this study were to measure quantitatively airborne exposures generated during C and D tasks performed by HC aides using a bleach-containing product. The work reported here is part of a larger evaluation of exposures and respiratory effects of a range of C and D products and practices and their efficacy in reducing pathogens in HC.

Methods A bathroom was constructed in a laboratory according to home building construction specifications. Twenty HC aides were recruited from employer agencies to perform C and D tasks for 20 min sessions in the bathroom following typical HC practices using a C and D spray product containing bleach (1%–5% by weight sodium hypochlorite). Aides wore a vest holding a direct-reading instrument to measure chlorine breathing-zone concentrations as they performed C and D on tub/shower, toilet, and sink.

Results Maximum chlorine concentrations generated during the 20 min sessions ranged from 0.35ppm to 3.40ppm. The tub/shower C and D task produced the highest exposures. The US Occupational Safety and Health Administration ceiling limit for chlorine is 1 ppm; nearly 70% of the aides conducted a C and D session exceeding this value.

Conclusions C and D in HC using a product containing bleach can produce over-exposure to chlorine, a respiratory irritant.