Studies on Health Impacts of QACs and Chlorine-based Disinfectants

Quaternary Ammonium Compounds (QAC) are prevalent in EPA’s List N disinfectants—nearly half of the listed disinfectants contain a Quaternary Ammonium Compound. The chemicals are considered a registered pesticide and increasingly, studies are resulting in health warnings about exposure to QACs. Chlorine-based disinfectants are also linked to respiratory illness. Here are some of the studies concerning QAC and chlorine exposure and health impacts.

  • Mount Sinai Selikoff Centers for Occupational Health report on Quaternary Ammonium Compounds for health professionals cautions QAC exposure from cleaning products for triggering asthma symptoms even in people with no prior asthma history, among other serious harmful impacts.

  • Exposure to disinfectants also causes respiratory irritation and illness. For example, Nurses' regular use of disinfectants is associated with developing COPD, 24-32% higher.

  • “Chlorine gas is a pulmonary irritant with intermediate water solubility that causes acute damage in the upper and lower respiratory tract. Exposure to low concentrations of chlorine for prolonged periods may have destructive effects, as might very short-term exposure to high concentrations.” 1

  • Many pesticides (disinfectants) are sensitizers or irritants capable of directly damaging the bronchial mucosa, thus making the airway very sensitive to allergens or other stimuli. Pesticides may increase the risk of developing asthma, exacerbate a previous asthmatic condition or even trigger asthma attack by increasing bronchial hyper-responsiveness.” 2

  • 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. 3

  • Consumer Reports issued a warning about using disinfecting wipes because they contain EPA-registered pesticides, which can be hazardous to young children and states… “Recent increases in the concentration of EPA-registered bleach products make diluting bleach correctly more confusing and difficult. More concentrated bleach products also expose staff to more bleach vapors when using the products.” 4

  • The California Department of Pesticide Regulation outlines asthma-related concerns related to using bleach as disinfectant:

  • QACs: a review on occurrence, fate and toxicity in the environment:

  • Google search on QACs:

1 Gerald F O’Malley, Chlorine Toxicity, Medscape, Updated May 13, 2019.

2 Hernandez AF, Parron T, Alarcon R., Pesticides and asthma. Curr Opin Al.

3 Catherine Roberts, Why Parents Should Be Cautious When Using Household Disinfectants, Consumer Reports Feb 05, 2020.

4 Consumer Reports (CR), 2013 update: Bleach-free Disinfection and Sanitizing for Child Care, Green Cleaning, Sanitizing, and Disinfecting: A toolkit for Early Care and Education.