Virginia Research Day 2021

Medical Student Research Cl inical

13 Changes in Use of Quaternary Ammonium Compound (QAC) Disinfectants in Hospitals Due to the COVID-19 Pandemic

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

1 Via College of Osteopathic Medicine - Virginia Campus

Disinfection is necessary in hospital settings to prevent spread of diseases but results in exposure of healthcare workers and patients to the disinfectants used. With the onset of the COVID-19 pandemic, changes in use of disinfecting products must be examined. Quaternary Ammonium Compounds (QACs) are a group of chemicals used in many disinfectants in the healthcare settings. Of the 516 disinfectants approved by the Environmental Protection Agency (EPA) for use against COVID-19, 241 contain QACs as the active ingredient. In fact, since the pandemic began, studies have found increased indoor exposure to QAC compounds. While they historically were considered safe, recent studies have suggested that QAC-containing disinfectants may have teratogenic effects, and also impair reproductive and immune functions secondary to the synergism of two or more QACs in

the newer disinfect products. These effects may be mediated by decreased mitochondrial function and impaired sterol biosynthetic pathways, which are impaired in a dose-dependent relationship with QAC concentration in chronically exposed individuals. This study will survey 500 hospitals of various sizes from across the United States to better understand how disinfection practices have changed with the onset of the Covid-19 pandemic. IRB approved survey questions will be a combination of multiple choice and open-ended questions to determine disinfectant use in specific locations within the hospital and identify changes in disinfectant protocols in response to 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 hypothesized that the use and exposure to disinfectants, specifically QACs, has increased since the beginning of the COVID-19 pandemic. This is the first study to survey hospitals on a national level to measure the changes in disinfectant use in response to the COVID-19 pandemic.

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

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