Introduction Certain cleaning and disinfecting products are used extensively in healthcare and associated with asthma and respiratory symptoms. However, quantitative exposures to these products are not well-characterized. The objective of this study was to characterize exposures to cleaning and disinfecting chemicals in healthcare occupations.

Methods Exposure assessments were conducted at five hospitals targeted 14 healthcare occupations. Mobile-area and personal real-time and time-integrated air monitoring was conducted for volatile organic compounds (VOCs), and 14 specific VOCs were quantified, including total VOCs (TVOCs). Quaternary ammonium compounds (QACs) were quantified at one hospital. Exposure data were summarized by occupation and geometric means (GMs) and geometric standard deviations (GSDs) were calculated. GM exposure estimates for product-application tasks were obtained from linear regression models.

Results The GMs for TVOCs were highest among nursing assistants, licensed practical nurses, and medical equipment preparers (range: 4367–2142 ppb), followed by respiratory therapists, pharmacy technicians, registered nurses, housekeepers, floor strippers/waxers, and dental assistants (range: 2120–1565 ppb); GSDs varied from 1.06 to 9.01. GMs for selected VOCs were: ethanol (1.54–2594 ppb), acetone (18.5–70.6 ppb), chloroform (0.09–0.57 ppb), α-pinene (0.04–0.19 ppb), and d-limonene (0.12–4.23 ppb). Real-time TVOC GMs were the highest for the product-application tasks of using skin wipes containing QACs, using enzymatic cleaners, using glass-cleaning products, cleaning instruments with high-level disinfectants, and using detergents to clean surfaces (2091–1049 ppb). Specific VOC levels were strongly associated with product-application tasks; using products containing bleach or QACs predicted levels of chloroform and d-limonene, respectively. Concentrations of QACs were low in short-duration (0.23–1.5 µg/m³) and full-shift (0.006–0.028 µg/m³) area air samples.

Conclusions Exposure levels of total and specific VOCs varied by occupations and tasks. These estimates can be used to generate a job-task exposure matrix for use in epidemiologic studies.