VCOM Research Day Program Book 2023

Medical Student Research Publ ic Health

09 Impact Of COVID-19 Pandemic on the Use of Quaternary Ammonium Compound Disinfectants in Hospitals

Sara Safford; Yasaman Dasteh Goli; Theresa J McCann; Terry C Hrubec Corresponding author: ssafford@vcom.edu

Edward Via College of Osteopathic Medicine-Virginia Campus

Disinfection is necessary in hospital settings to prevent the spread of diseases; however, it results in exposure of healthcare workers and patients to the disinfectants used. Of particular interest are Quaternary Ammonium Compounds (QACs), a group of chemicals used in many disinfectants in healthcare settings. QACs have recently been shown in animal models to alter immune function, reduce fertility, and have teratogenic effects. These effects may be mediated by proinflammatory cytokines, decreased mitochondrial function, and impaired sterol biosynthetic pathways; all of which are affected in a dose-dependent manner with QAC concentration in chronically exposed people and animals. Thus, exposure in humans may be of concern, especially due to indoor exposure to QAC compounds during the COVID-19 pandemic. This study surveyed

hospitals of various sizes within 8 states chosen as representative of the country based on the ranking of 28 health metrics (Kaiser Family Foundation database). The survey questions are a combination of multiple-choice and open-ended questions intended to understand how disinfection practices have changed with the onset of the COVID-19 pandemic. Questions determine the hospitals’ general disinfection protocols and disinfectant usage in labor and delivery, intensive care units (ICUs), and inpatient wards. The response rate for the hospital group is 9.9% which is higher than the national average of 6% for phone surveys. The study identified QAC-based disinfectants as being used by more facilities than other disinfectants. The results show that 76.5% of hospitals changed disinfection practices with a 62.5% increase in frequency from the start of the COVID-19

pandemic. Overall, the increased use of QACs during the pandemic has likely resulted in greater human exposure. Because studies have linked QAC exposure to deleterious effects in mice and humans this rise in QAC use may pose a significant risk and should be further studied. This study was funded in part by VCOM and is IRB exempt.

162