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Insufficient respiratory hazard identification in the safety data sheets for cleaning and disinfection products used in healthcare organisations across England and Wales
  1. Sewon Lee,
  2. Andrew C Povey,
  3. Martin J Seed,
  4. Martie van Tongeren
  1. Centre for Occupational and Environmental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
  1. Correspondence to Professor Martie van Tongeren, Centre for Occupational and Environmental Health, University of Manchester, Manchester M13 9PL, UK; martie.j.van-tongeren{at}


Background Exposure to cleaning and disinfection products has been associated with respiratory disorders such as asthma in cleaning and healthcare workers. Safety data sheets (SDSs) provide information on hazardous chemicals that are present in products to help users with risk assessment and implement appropriate control measures. However, they have potential limitations in identifying respiratory hazards due to a lack of regulatory test methods for respiratory sensitisation and irritation of chemicals.

Methods SDSs were first used to identify chemicals on the database as respiratory sensitisers and irritants. A quantitative structure–activity relationship (QSAR) model and an asthmagen list established by the Association of Occupational and Environmental Clinics (AOEC) were used to identify potential respiratory sensitisers and irritants (by the AOEC list only) in the cleaning and disinfection products.

Results From a total of 459 cleaning and disinfection products used in healthcare organisations across England and Wales, 35 respiratory sensitisers not labelled as such on the SDS were identified by QSAR or AOEC. Only 2% of cleaning and disinfection products contained at least one respiratory sensitiser as identified by their SDSs; this was increased to 37.7% of products when the QSAR or the AOEC list was used.

Conclusions A significantly higher proportion of cleaning products contain respiratory hazardous chemicals, particularly respiratory sensitisers than would be expected from the information provided by SDSs alone. Cleaners and healthcare workers may, therefore, be insufficiently protected.

  • hygiene / occupational hygiene
  • occupational asthma
  • chemical hazard release

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  • Contributors All authors contributed to all aspects of the study, including design, data collection, statistical analysis and development of the paper. SL collected and analysed the data, and drafted and revised the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Data availability statement Data are available on reasonable request. Data on cleaning products approved for use in the NHS, such as product name and safety data sheets, are publicly available through the NHS supply chain catalogue website. Any researchers who are interested in reviewing and analysing the data used in this publication can request the database from SL, the first author of this paper (ORCID

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