Virginia Research Day 2021

Medical Student Research Cl inical

12 Changes in Use Of Quaternary Ammonium Compound (QAC) Disinfectants in Private Practice Clinics Due to the COVID-19 Pandemic

Richard Antoun 1 ; Caroline G Horne 1 ; Rachel A Hall 1 ; Tyler Steve 1 ; Chang Xu 1 ; Brooke D Burwell 1 ; Alekhya Peruri 1 ; Theresa J McCann 1 ; Terry C Hrubec 1 Corresponding author: rantoun@vt.vcom.edu

1 Via College of Osteopathic Medicine-Virginia Campus

With the onset of the COVID-19 pandemic, disinfection procedures and products within

continued exposure. Asthma and contact dermatitis have been associated with QAC contact in people, and animal studies have identified developmental, reproductive and immune toxicity. Evaluation of population wide exposure has found that 80% of individuals contain QAC residues in their blood, with markers of inflammation & mitochondrial function varying in a dose dependent manner with blood QAC concentration. Recent studies have found that the COVID-19 pandemic has increased indoor exposure to QAC compounds. Our study will assess the changes in disinfectant procedures and product usage in medical office settings to determine if there is an increased use of QAC containing compounds. The project will focus on disinfection procedures in patient exam and waiting rooms in response to the COVID-19 pandemic. Approximately 500 medical offices will be surveyed throughout the United States by telephone. Offices will be asked an IRB approved 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/disinfecting procedures during the pandemic. Descriptive statistics with means and proportions will be used to describe the data. Normality and distribution of data will be assessed. Paired t-tests or non-parametric equivalents will be used to compare changes in disinfection practices. All analyses will be 2-tailed with statistical significance set at p<.05, and 95% confidence intervals will be provided for outcomes. We hypothesize that the use of disinfectant practices have increased in medical offices throughout the nation due to the COVID-19 pandemic, and this has resulted in an increased use of QAC containing products.

healthcare facilities have been widely re-evaluated and adjusted. With the ability of SAR-CoV-2 to persist on surfaces for up to 3 days and for viral particles to be shed by asymptomatic persons, regular disinfecting of common areas is essential for infection control. Of the 516 products listed by the United States Environmental Protection Agency (EPA) as effective against SARS-CoV-2, 241 products contain a Quaternary Ammonium Compound (QAC) as the active ingredient. Since their discovery in 1915, QACs have increased in use and application. QACs are active ingredients in a wide variety of consumer and industrial products, including surface disinfectants, detergents, emulsifying agents, deodorizers, and hair products. QAC based disinfectants are often used in preference to other disinfectants due to their low cost, non-corrosive properties, and perceived safety. Though widely considered safe, QACs have been linked to medical complications with

This study was funded in part by the VCOM One Health Seed Grant.

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