Why Parents Should Be Cautious When Using Household Disinfectants
Disinfecting wipes can help eliminate some germs, but they also contain EPA-registered pesticides
With the coronavirus continuing to spread, you may be a little more diligent than usual about anti-infection measures. But while you may be reaching for your cleaning supplies a bit more often, it’s important to exercise some caution when using items labeled as “disinfecting,” particularly if you have children.
These items, such as the easy-to-grab disinfecting wipes sold in cylindrical canisters, aren’t simply cleaners. What many people may not know is that they contain Environmental Protection Agency-registered pesticides.
Used properly, these products are helpful in killing germs, and are even employed for infection control in certain healthcare settings. But it’s important to handle them appropriately.
Some commonly used active ingredients in these products have been linked with health problems such as asthma—with long-term exposure. And experts we spoke with said that such risks may be greater for young children.
Here’s what you need to know about these germ-killing products.
What’s in a Disinfectant?
Whether a product is a wipe, spray, liquid, or powder, those whose labels say they “disinfect” are legally distinct from those whose labels claim only to clean. To be able to call their product a disinfectant, manufacturers must prove that the active ingredients kill specific bacteria, such as Staphylococcus aureus (which can cause dangerous blood, lung, bone, and heart valve infections) on surfaces. Manufacturers must also prove any label claims about specific viruses.
Bleach (or sodium hypochlorite) is one active ingredient you may see in some disinfecting products. Hydrogen peroxide is another.
Quaternary ammonium compounds—QACs or “quats” for short—are also among the active ingredients that may be found in household cleaning products such as disinfecting wipes. They appear on labels with names such as alkyl dimethyl benzyl ammonium chloride, and other types of “benzyl ammonium chloride.”
Wipes containing quats may be of particular concern for children, according to Dawn Gouge, Ph.D., a public health entomologist with the University of Arizona, because they’re sometimes styled as classroom-friendly products. “They’re marketed to schools. They’re marketed to teachers,” Gouge says.
Quats, just like other EPA-registered pesticides, are usually required to bear a caution: “Keep out of reach of children.”
What are the potential health harms of disinfectants? Bleach is well-known as a possible cause of asthma, and quats have also been found to have the potential to set off the condition.
Much of the evidence about human health effects comes from studies of adults who work with disinfectants, in addition to research in labs. According to a 2019 analysis of the EPA Pesticide Product Labeling System and other studies, published in the American Journal of Infection Control (AJIC), asthma occurs at higher rates in adults who use disinfectants and cleaners regularly for their jobs—such as janitors and healthcare workers—than in other workers.
But some older research has linked disinfectants to health effects in children. In a 2005 study published in JAMA, researchers with the Centers for Disease Control and Prevention and other institutions reviewed case reports on pesticide-related illnesses in schools and child care centers from 1998 to 2002. They found that disinfectants, including bleach and quats, were implicated in 830 out of 2,593 pesticide-related illnesses or injuries—such as eye, skin, or upper respiratory irritation—in school children.
The problems these chemicals may cause in adults can occur in kids, too, says Susan Pacheco, M.D., associate professor of pediatrics at the University of Texas McGovern Medical School and a spokesperson for the American Academy of Pediatrics, Council on Environmental Health. Quats, for example, can facilitate development of allergies and trigger asthma attacks, in children, she says.
In fact, the experts we spoke with say that the active ingredients in disinfectant wipes may be more concerning for children. “Kids breathe more air per pound of body weight than an adult does. Their exposure will be greater in terms of inhalation than an adult exposure would be,” says Jerome Paulson, M.D., a pediatrician and emeritus professor at George Washington University.
How to Clean and Disinfect Safely
In your efforts to protect yourself and your family from germs, consider the following:
Clean instead of disinfect. Disinfecting is critical to limiting the spread of infection in settings such as healthcare and early childhood-care facilities. But for most people at home, cleaning alone—meaning the removal of dirt and other substances from a surface via scrubbing with soap and water—will remove plenty of worrisome germs.
In settings where people aren’t required to disinfect, cleaning is really more important than disinfecting, says Stephanie Holm, M.D., M.P.H., co-director of the Western States Pediatric Environmental Health Specialty Unit, assistant clinical professor at UCSF, and lead author of the 2019 AJIC study.
The EPA maintains a list of cleaning products considered to be safer than others—the standard the agency uses screens out any products linked to asthma or breathing difficulties.
When you need to disinfect, do it properly. Certain situations call for the use of a disinfectant at home to prevent the spread of infection. An example, according to the CDC, is if someone in your house contracts the highly contagious and misery-inducing stomach bug norovirus. Any mess from vomit or diarrhea on a surface should be cleaned and then disinfected.
If you decide to use disinfectant, be aware that surfaces you intend to disinfect should be cleaned first of any debris. Skin cells, for instance, a component of dust, can reduce the effectiveness of some disinfectants, Holm says—so if you don’t clean off the dust first, your disinfectant may not work as well.
To kill certain germs, disinfectants must be left wet on the surface for a number of minutes—check the product’s label for specific instructions on how long. That means you have to use enough of the product to keep the surface wet long enough for the active ingredients to take effect.
Use disinfectants away from kids. Make sure young children are out of the room when you’re using disinfectants, and for a little while afterward. (Gouge says the amount of time might vary based on a product’s active ingredient and the level of ventilation in the room.) This will keep small hands from touching drying disinfecting fluid, and potentially getting it in their mouths. And be aware that the fumes that these products give off—which can potentially trigger respiratory irritation and asthma—remained detectable in the air for about 20 minutes, according to one study in the journal Environmental Health.
And keep in mind that some schools may request disinfecting wipes as back-to-school supplies or during cold and flu season. If your school is one of those, it’s worth calling the school to find out whether the wipes will be stored out of reach of children, recommends CR’s senior scientist Michael Hansen, Ph.D. Make sure adults, and not kids, will be the only people handling the products.
In one case in Massachusetts, officials from the state’s Department of Agricultural Resources sent a warning letter to a school where teachers had given disinfecting wipes to children for the purpose of cleaning desks, computers, and tables. Any cleaning tasks undertaken by children should be done only with regular soap and water.
If your child has asthma, the school administrators, your child’s teacher, and the school nurse, if there is one, should be aware of your pediatrician’s action plan for treatment in case of an attack. It’s reasonable to ask your pediatrician to include a note on the action plan that says disinfectant wipes shouldn’t be used in your child’s vicinity, Pacheco says.
Consider safer disinfecting products. In the 2019 AJIC article, Holm and her team found that disinfecting products that used hydrogen peroxide were linked with fewer negative health effects than those with bleach or quats. If you want to use a disinfecting product, consider looking for one whose active ingredient is hydrogen peroxide.