VCOM Research Day Program Book 2023

Medical Student Research Cl inical 04 Covid-19 Pandemic Impacts on Use of Quaternary Ammonium Compound (Qac) Disinfectants in Private Practice Clinics

Kathrine A Gaiko; Sara A Worrill; Ankita Naphade; Thi Lovo; Nicole Spiezio; Theresa J McCann; Terry C Hrubec Corresponding author: anaphade@vcom.edu

Edward Via College of Osteopathic Medicine-Virginia Campus

Since the onset of the COVID-19 pandemic, disinfection procedures and products within healthcare facilities have changed. SARS-CoV-2 has the ability to persist on surfaces and to be shed from asymptomatic persons, necessitating regular disinfecting for infection control. Of the many products listed by the United States Environmental Protection Agency (EPA) as effective against SARS CoV-2, over half contain a Quaternary Ammonium Compound (QAC) as the active ingredient. QACs are present in a wide variety of consumer and industrial products: surface disinfectants, detergents, preservatives, emulsifying agents, deodorizers, as well as hair and laundry products. Though widely considered safe, QACs have been linked to medical complications such as asthma and contact dermatitis. Developmental, reproductive, and immune toxicity is documented from animal studies. Evaluation of

population wide exposure has found that 80% of individuals contain QAC residues in their blood. These exposed individuals demonstrated a dose dependent increase in markers of inflammation and a decline in mitochondrial function with increasing blood QAC concentration. This study assesses the changes in disinfectant procedures and product usage in private medical office settings in response to the COVID-19 pandemic. Eight states were chosen as representative of the country based on the ranking of 28 health metrics (Kaiser Family Foundation database). Practices are being surveyed by telephone and email with a goal of 100 responses. Offices are being asked a standardized set of questions regarding the types of disinfectants being used, changes in cleaning products due to the COVID-19 pandemic, as well as changes in the frequency of cleaning and cleaning procedures during the pandemic. To date,

884 private practices have been contacted with response rate of 5.09%. The majority (65%) used QAC based disinfectants. Interim results indicate 100% of practices increased the frequency of disinfection with the main increases in spraying and wiping. The high use of QAC disinfectants coupled with increased application likely results in increased QAC exposure to medical personnel. This ongoing research project was funded in part by VCOM and is IRB exempt.

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