A comprehensive health effects assessment of the use of sanitizers and disinfectants during COVID-19 pandemic: a global survey

Hashemi F. Hoepner L. Hamidinejad F.S. Haluza D. Afrashteh S. Abbasi A. Omeragić E. Imamović B. Rasheed N.A. Taher T.M.J. Kurniasari F. Wazqar D.Y. Apalı Ö.C. Yildirim A.D. Zhao B. Kalikyan Z. Guo C. Valbuena A.C. Mititelu M. Pando C.M. Saridi M. Toska A. Cuba M.L. Kwadzokpui P.K. Tadele N. Nasibova T. Harsch S. Munkh-Erdene L. Menawi W. Evangelou E. Dimova A. Marinov D. Dimitrova T. Shalimova A. Fouly H. Suraya A. da Silva Faquim J.P. Oumayma B. Annunziato M.A. Lalo R. Papastavrou E. Ade A.D. Caminada S. Stojkov S. Narvaez C.G. Mudau L.S. Rassas I. Michel D. Kaynar N.S. Iqbal S. Elshwekh H. Hossain I. AL-Fayyadh S. Sydorchuk A. Alnusairat D.M.H. Abdullahi A.M. Iqbal N. Pandey A. Gómez-Gómez B. Akyildiz A.G. Morosan E. Dwarica D. Dorj G. Hasan S.Y. Al-Shdayfat N.M. Knezevic B. Valladares W. Severi C. Fuentes S.C. Augusto S. Sidorova E. Moelyaningrum A.D. Alawad T. Khalid A. Elehamer N.M.K. Mihaylova A. Tsigengagel O. Menouni A. Wojtecka A. Hod R. Idayat Y.B. Othman K. Harfouch R.M. Paunov T. Omar M. Benderli N.C. Nurika G. Amjad S. Elnoamany S. Elesrigy F. Shaban M.M. Acevedo-López D. Kartashova M. Khalaf A. Jaafar S.A. Kadhim T.A. Hweissa N.A. Teng Y. Mohammed F.E. Sasikumar T. Hikaambo C.N. Kharat A. Lyamtseva U. Aldeeb M.A. Pawlas N. Khorolsuren L. Koonjul R.P. Maïnassara H.B. Chahal P. Wangeci R.W. Kumar A.B. Zamora-Corrales I. Gracy S. Mahamat M. Adamczyk J. Rahman H.A. Matiashova L. Elsherif O.E. Alkhateeb N.E. Aleaga Y. Bahrami S. Al-salihy S.R. Cabrera-Galeana P. Lalic-Popovic M. Brown-Myrie E. Bhandari D. Mayaboti C.A. Stanišić S. Pestic S.K. Bektay M.Y. Al Sabbah H. Hashemi S. Assia B. Merritt A.-S. Ramzi Z. Baboolal H. Isstaif J. Shami R. Saad R. Nyirongo T. Hoseini M.
June 2023 Springer Science and Business Media Deutschland GmbH

Environmental Science and Pollution Research
2023 #30 Issue 28 72368 - 72388 pp.

COVID-19 has affected all aspects of human life so far. From the outset of the pandemic, preventing the spread of COVID-19 through the observance of health protocols, especially the use of sanitizers and disinfectants was given more attention. Despite the effectiveness of disinfection chemicals in controlling and preventing COVID-19, there are critical concerns about their adverse effects on human health. This study aims to assess the health effects of sanitizers and disinfectants on a global scale. A total of 91,056 participants from 154 countries participated in this cross-sectional study. Information on the use of sanitizers and disinfectants and health was collected using an electronic questionnaire, which was translated into 26 languages via web-based platforms. The findings of this study suggest that detergents, alcohol-based substances, and chlorinated compounds emerged as the most prevalent chemical agents compared to other sanitizers and disinfectants examined. Most frequently reported health issues include skin effects and respiratory effects. The Chi-square test showed a significant association between chlorinated compounds (sodium hypochlorite and per-chlorine) with all possible health effects under investigation (p-value <0.001). Examination of risk factors based on multivariate logistic regression analysis showed that alcohols and alcohols-based materials were associated with skin effects (OR, 1.98; 95%CI, 1.87–2.09), per-chlorine was associated with eye effects (OR, 1.83; 95%CI, 1.74–1.93), and highly likely with itching and throat irritation (OR, 2.00; 95%CI, 1.90–2.11). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92–2.44). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92–2.44). The use of sodium hypochlorite and per-chlorine also had a high chance of having respiratory effects. The findings of the current study suggest that health authorities need to implement more awareness programs about the side effects of using sanitizers and disinfectants during viral epidemics especially when they are used or overused.

COVID-19 , Health protocols , Sanitizers and disinfectants , Side effects

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Department of Environmental Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
Department of Environmental and Occupational Health Sciences, School of Public Health, SUNY Downstate Health Sciences Center, Brooklyn, NY, United States
Department of Medicine, O.O. Bogomolets National Medical University, Kyiv, Ukraine
Department of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Center for Public Health, Department for Environmental Medicine, Medical University of Vienna, Kinderspitalgasse 15, Vienna, 1090, Austria
Department of Biostatistics and Epidemiology, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Department of Medical Laboratory Technology, College of Health and Medical Technology Shekhan, Duhok Polytechnic University, Kurdistan Region, Duhok, Iraq
Family and Community Medicine Department, College of Medicine, University of Wasit, Wasit, Kut, Iraq
Department of Environmental Health, Faculty of Public Health, University of Indonesia, Jakarta, Indonesia
Department of Medical-Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
Faculty of Medicine, Hacettepe University, Ankara, Turkey
Midwifery Department, Üsküdar Universty, Istanbul, Turkey
Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-Gicl, Gangwon-do, Wonju, 26493, South Korea
Department of Clinical Immunology and Allergology, Yerevan State Medical University, Yerevan, Armenia
Department of Urban Planning and Design, The University of Hong Kong, Hong Kong
Division of Epidemiology, Public Health Center of Valencia, Valencia, Spain
Department of Clinical Laboratory and Food Safety, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of Medicine, University of Granada, Granada, Spain
School of Social Sciences, Hellenic Open University, Patras, Greece
Department of Pathology, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
Department of Medical Laboratory Science, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
Department of Nursing, School of Nursing & Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
General and Toxicological Chemistry Department, Azerbaijan Medical University, Baku, Azerbaijan
Institute of Sociology, University of Education Freiburg, Freiburg, Germany
Department of Health Policy, School of Public Health, Mongolian National University of Medical Sciences, Ulan Bator, Mongolia
Public Health Management Program, Faculty of Graduate Studies, An-Najah University, Nablus, Palestine
Nursing Department Limassol, Cyprus University of Technology, Limassol, Cyprus
Faculty of Public Health, Medical University Varna, 55 Marin Drinov Street, Varna, 9002, Bulgaria
Department of Hygiene and Epidemiology, Faculty of Public Health, Medical University of Varna, Varna, Bulgaria
Internal Medicine N1, Kharkiv National Medical University, Kharkiv, Ukraine
Reproductive Health Nursing (Gynecology and Obstetrics Nursing), Faculty of Nursing, Assiut University, Asyut, Egypt
CIHLMU Center for International Health, University Hospital, LMU, Munich, Germany
Occupational Safety and Health Department, Binawan University, East Jakarta, Indonesia
Technical School of Health, Federal University of Uberlândia (UFU), MG, Uberlândia, Brazil
National School of Applied Sciences of Al Hoceima, Abdelmalek Essaadi University, Tetouan, Morocco
Venezuelan and Latin American Association of Clinical Nanomedicine, Caracas, Venezuela
Department of Health Care, Faculty of Public Health, The University of Vlore “Ismail Qemali”, Vlore, Albania
Cyprus University of Technology, Limassol, Cyprus
Department of Community Medicine, SVIMS, Sri Padamavathi Medical College, Andhra Pradesh, Tirupati, India
Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
Department of Social Pharmacy, Faculty of Pharmacy, University Business Academy in Novi Sad, Novi Sad, Serbia
Facultad de Ciencias de la Salud, Universidad del Desarrollo, Concepción, Chile
Department of Environmental Health, Faculty of Science, Tshwane University of Technology, Pretoria, South Africa
Department of Occupational Medicine and Ergonomics, Faculty of Medicine, University of Monastir, Monastir, Tunisia
West Department, Quisqueya University, Port-au-Prince, Haiti
Public Health Nursing Department, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
Department of Public Health and Nutrition, Al Ain University, Abu Dahbi, United Arab Emirates
Department of Genetic Engineering, The Biotechnology Research Center, Tripoli, Libya
Department of Occupational and Environmental Health (OEH), NIPSOM, Mohakhali, Dhaka, Bangladesh
Adult Nursing Department, College of Nursing, University of Baghdad, Baghdad, Iraq
Department of Infectious Diseases and Epidemiology, Bukovinian State Medical University, Chernivtsi, Ukraine
Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
School of Medicine and Health Science, Simad University, Mogadishu, Somalia
Environmental Epidemiology Group, UK Health Security Agency, Oxon, Chilton, United Kingdom
Maharajgunj Nursing Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
Department of Infectious Diseases, Centro Médico ABC, Mexico City, Mexico
Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Bezmialem Vakif University, Istanbul, Turkey
Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago
Department of Epidemiology and Biostatistics, School of Public Health, Mongolian National University of Medical Sciences, Ulan Bator, Mongolia
Department of Natural Resources and Environment, College of Graduate Studies, Arabian Gulf University, Manama, Bahrain
Community and Mental Health Department, Al al-Bayt University, Mafraq, Jordan
University Hospital Centre Zagreb, Zagreb, Croatia
Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras
Department of Preventive Medicine, Faculty of Medicine, University of the Republic, Montevideo, Uruguay
Faculty of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
Moscow State Medical University, Sechenov University, Moscow, Russian Federation
Public Health Faculty, Environmental Health and Occupational Health and Savety Departement, University of Jember, Jember, Indonesia
Faculty of Public and Environmental Health, University of Khartoum, Khartoum, Sudan
Sahiwal Medical College, University of Health Sciences, Lahore, Pakistan
Department of Health Education, University of Khartoum, Khartoum, Sudan
Medical College, Medical University of Plovdiv, Plovdiv, Bulgaria
Department of Public Health, NCJSC “Semey Medical University”, Semey, Kazakhstan
Environment and Health Unit, Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium
Department of Public Health and Social Medicine, Medical University of Gdansk, Gdansk, Poland
Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia, Bangi, Malaysia
Department of Environmental Health Sciences, University of Ibadan, Ibadan, Nigeria
Ministry of Foreign Affairs and East African Cooperation, Dodoma, Tanzania
Department of Microbiology and Biochemistry, Al Sham Private University, Latakia, Syrian Arab Republic
Department of Population Health and Social Sciences, Kazakhstan’s Medical University School of Public Health, Almaty, Kazakhstan
Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
Department of Animals Biology and Physiology, University of Yaoundé I, Yaoundé, Cameroon
Department of Obstetrics and Gynaecology, University of Alberta, Edmonton, Canada
Family Medicine Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Community Health Nursing Department, Faculty of Nursing, Cairo-University, Cairo, Egypt
Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia
Department of Human Pathology, Sechenov University, Moscow, Russian Federation
Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
College of Nursing, Sultan Qaboos University, Muscat, Oman
College of Nursing, University of Al-Muthanna, Samawah, Iraq
Department of Public Health, Faculty of Medical Technology, Zawia University, Zawia, Libya
Department of Korean Language and Literature, Graduate School, Yonsei University, Gangwon-do, South Korea
Faculty of Medicine, University of Khartoum, Khartoum, Sudan
Institute of Medicine, University of Colombo, Colombo, Sri Lanka
Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
College of Pharmacy, University of Utah, Salt Lake City, UT, United States
Department of Medicine of the Future, Sechenov University, Moscow, Russian Federation
Hamad Medical Corporation, Doha, Qatar
Damascus University, Damascus, Syrian Arab Republic
Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
Institute of Public Health, Mongolian National University of Medical Sciences, Ulan Bator, Mongolia
Department of Medicine, University of Mauritius, Moka, Mauritius
Conseils Etudes Enquêtes Recherches Formation en Epidémiologie (CEERFE), Niamey, Niger
S. Tentishev Asian Medical Institute, Kant, Kyrgyzstan
Health Sciences, School of Public Health, University of Nairobi, Nairobi, Kenya
Department of Health Policy and Management, School of Public Health, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
School of Public Health, University of Costa Rica, San José, Costa Rica
Department of Biomedical Sciences, University of Asmara, Asmara, Eritrea
Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, Yaounde General Hospital, Yaounde, Cameroon
Faculty of Health Sciences, Jan Długosz University of Humanities and Life Sciences, Czestochowa, Poland
Department of Environmental and Health Sciences, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
T Malaya Therapy National Institute, National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
Cairo University Hospitals, Cairo, Egypt
Department of Medical Education, College of Medicine, Hawler Medical University, Erbil, Iraq
Department of Clinical Microbiology, Institute of Tropical Medicine “Pedro Kouri”, Havana, Cuba
Shiraz University of Medical Sciences, Shiraz, Iran
Microbiology Department, College of Medicine, University of Diyala, Diyala, Iraq
Instituto Nacional de Cancerología, Mexico City, Mexico
Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Department of Pharmaceutics, School of Pharmacy, College of Health Sciences, University of Technology, Kingston, Jamaica
Medical Governance Research Institute, Tokyo, Japan
University of Oslo, Oslo, Norway
Singidunum University, Belgrade, Serbia
Family Medicine Department, Medical School, University of Tuzla, Tuzla, Bosnia and Herzegovina
Clinical Pharmacy Department, Faculty of Pharmacy, Marmara University, Istanbul, Turkey
Department of Health Sciences, Zayed University, Dubai, United Arab Emirates
Department of Chemical Engineering, Faculty of Engineering, University of Kurdistan, Sanandaj, Iran
Peadiatric’s Infectious diseases, Hospital of Canastel and Faculty of Medicine, Oran, Algeria
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
College of Nursing, University of Sulaimani, Kurdistan, Sulaimani, Iraq
Department of Neurology, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
Department of Public Health, College of Health Sciences, Qatar University, Doha, Qatar
Department of Public Health, Qatar University, Doha, Qatar
Environmental Health, Rusangu University, Monze, Zambia
Research Center for Health Sciences, Institute of Health, Shiraz, Iran
Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Razi Blvd, Kuye-Zahra Ave, Shiraz, 1417653861, Iran

Department of Environmental Health Engineering
Department of Environmental and Occupational Health Sciences
Department of Medicine
Department of Medicine
Center for Public Health
Department of Biostatistics and Epidemiology
Faculty of Pharmacy
Department of Medical Laboratory Technology
Family and Community Medicine Department
Department of Environmental Health
Department of Medical-Surgical Nursing
Faculty of Medicine
Midwifery Department
Department of Health Administration
Department of Clinical Immunology and Allergology
Department of Urban Planning and Design
Division of Epidemiology
Department of Clinical Laboratory and Food Safety
Department of Medicine
School of Social Sciences
Department of Pathology
Department of Medical Laboratory Science
Department of Nursing
General and Toxicological Chemistry Department
Institute of Sociology
Department of Health Policy
Public Health Management Program
Nursing Department Limassol
Faculty of Public Health
Department of Hygiene and Epidemiology
Internal Medicine N1
Reproductive Health Nursing (Gynecology and Obstetrics Nursing)
CIHLMU Center for International Health
Occupational Safety and Health Department
Technical School of Health
National School of Applied Sciences of Al Hoceima
Venezuelan and Latin American Association of Clinical Nanomedicine
Department of Health Care
Cyprus University of Technology
Department of Community Medicine
Department of Public Health and Infectious Diseases
Department of Social Pharmacy
Facultad de Ciencias de la Salud
Department of Environmental Health
Department of Occupational Medicine and Ergonomics
West Department
Public Health Nursing Department
Department of Public Health and Nutrition
Department of Genetic Engineering
Department of Occupational and Environmental Health (OEH)
Adult Nursing Department
Department of Infectious Diseases and Epidemiology
Clinical Sciences Department
School of Medicine and Health Science
Environmental Epidemiology Group
Maharajgunj Nursing Campus
Department of Infectious Diseases
Department of Pharmaceutical Toxicology
Faculty of Medical Sciences
Department of Epidemiology and Biostatistics
Department of Natural Resources and Environment
Community and Mental Health Department
University Hospital Centre Zagreb
Microbiology Research Institute
Department of Preventive Medicine
Faculty of Medicine
EPIUnit-Institute of Public Health
Moscow State Medical University
Public Health Faculty
Faculty of Public and Environmental Health
Sahiwal Medical College
Department of Health Education
Medical College
Department of Public Health
Environment and Health Unit
Department of Public Health and Social Medicine
Department of Community Health
Department of Environmental Health Sciences
Ministry of Foreign Affairs and East African Cooperation
Department of Microbiology and Biochemistry
Department of Population Health and Social Sciences
Biotechnology Center
Department of Animals Biology and Physiology
Department of Obstetrics and Gynaecology
Family Medicine Department
Community Health Nursing Department
Faculty of Medicine
Department of Human Pathology
Faculty of Health Sciences
College of Nursing
College of Nursing
Department of Public Health
Department of Korean Language and Literature
Faculty of Medicine
Institute of Medicine
Department of Pharmacy
College of Pharmacy
Department of Medicine of the Future
Hamad Medical Corporation
Damascus University
Department of Pharmacology
Institute of Public Health
Department of Medicine
Conseils Etudes Enquêtes Recherches Formation en Epidémiologie (CEERFE)
S. Tentishev Asian Medical Institute
Health Sciences
Department of Health Policy and Management
School of Public Health
Department of Biomedical Sciences
Department of Internal Medicine and Specialties
Faculty of Health Sciences
Department of Environmental and Health Sciences
T Malaya Therapy National Institute
Cairo University Hospitals
Department of Medical Education
Department of Clinical Microbiology
Shiraz University of Medical Sciences
Microbiology Department
Instituto Nacional de Cancerología
Department of Pharmacy
Department of Pharmaceutics
Medical Governance Research Institute
University of Oslo
Singidunum University
Family Medicine Department
Clinical Pharmacy Department
Department of Health Sciences
Department of Chemical Engineering
Peadiatric’s Infectious diseases
Institute of Environmental Medicine
College of Nursing
Department of Neurology
Department of Public Health
Department of Public Health
Environmental Health
Research Center for Health Sciences
Department of Environmental Health

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