Studies Associated With Cleaning Products

 

A review of the studies:

 

Toxicology and Applied Pharmacology 1984- Musk Ambrette, a commonly used fragrance ingredient, has been found to cause serious brain damage in laboratory animals.

 

Drs. P.S. Spencer, M.C. Bischoff-Fenton, O.M. Moreno, D.L Opdyke, R.A. Ford Toxicology and               Applied Pharmacology, Volume 75:571-575 (1984)

 

Clinical and Experimental Allergy 1997 – Asthma prevalence in schools has been associated with higher relative air humidity, higher concentrations of volatile organic compounds, and mold or bacteria.

 

Smedje.G., Norback D., and Edling C. 1997 Asthma among secondary schoolchildren in relation to the school environment. Clinical and Experimental Allergy, 27(11):1270-8.

 

New Scientist 1999 -Frequent use of air fresheners and aerosol sprays in the home contributed to 25% more headaches and 19% more incidence of depression in mothers and 30% more ear infections and 22% greater incidence of diarrhea in infants less than six months of age.

 

Edwards R. Far from Fragrant: Disguising nasty smells could damage your health. New Scientist. 1999 Sept. 4:17. 

 

 

The Eighth International Conference on Indoor Air Quality and Climate 1999 – Floor cleaning products were found to be a cause of occupational asthma.

 

Mendell M, Heath G. Do Indoor Environments in Schools Influence Student Performance? A Review of the Literature. The Eighth International Conference on Indoor Air Quality and Climate 1999. 

 

 

European Respiratory Journal 2000 – Acute short-term exposure to common cleaning chemicals was found to cause a severe asthmatic attack and adult respiratory distress syndrome in an asthmatic subject.

 

Mapp C, Pozzato V, Pavoni V, Gritti G. Case Study: Severe asthma and ARDS triggered by acute short-term exposure to commonly used cleaning detergents. European Respiratory Journal. 2000; 16(3):570. 

 

 

Scandanavian Journal of Workers Environmental Health  2001 - Asthma prevalence in cleaners of private homes was 1.7 times higher than found in a control group.  This incidence was related to kitchen cleaning and furniture polishing.

 

Karjalainen, A. et al. Prevalence of asthma and other allergic diseases in private homes.

Scandinavian Journal of Workers Environmental Health. 2001;28(1):49–57.

 

American Journal of Industrial Medicine 2001 - Janitors and cleaners (625/million) and firefighters (300/million) in California had the highest reported rates of work-related asthma. Half of all work-related asthma cases were associated with agents not known to be allergens.

 

F. Reinisch, R.J. Harrison, S. Cussler, et al.Physician Report of Work-Related Asthma in California, 1993-1996 American Journal of Industrial Medicine 39, 1 (January 2001): 72-83

 

European Respiratory Journal 2002 – A 22-year comparative study of cleaning women and administrative workers found that cleaners had an increased risk of developing persistent adult-onset asthma.

 

Karjalainen, A., et. al., “Asthma among Finnish Cleaners Employed in Different Industries”,

 European Respiratory Journal, January 2002, 19: 90-95.

 

Journal of Occupational and Environmental Medicine 2003 - A study of confirmed cases of work-related asthma in four states found that 12% were associated with exposure to cleaning chemicals.  80% of these were new-onset cases and 20% were work-aggravated cases.


Rosenman K, Reilly M, Schill D. Cleaning Products and Work-Related Asthma.

        Journal of Occupational & Environmental Medicine. 2003; 45(5):556-563.

 

Thorax 2003 – Asthma was found to be more prevalent in women previously or currently employed as domestic cleaners as compared to women who had never worked in the cleaning industry.  Domestic cleaning work may have a serious public health impact that affects both professional cleaners and people cleaning their own homes.

 

      Medina-Ramon, M. et.al., “Asthma Symptoms in Women Employed in  Domestic Cleaning, “

         Thorax 2003, 58:950-954.

 

Thorax 2004 - Children living in homes with higher levels of volatile organic chemicals (VOCs) showed a marked increase in their risk of asthma.  VOCs are emitted by cleaning products, air fresheners and building products.

Rumchev K. Association of Domestic Exposure to Volatile Organic Compounds with Asthma in Young Children. Thorax. 2004; 59(9):746-751.

 

 

Thorax  2005 - Pre-natal exposure to the use of disinfectants, bleach, carpet cleaner, window cleaner, air fresheners, paints, dry cleaning fluid, aerosols, and pesticides increased the risk that the young child would have persistent wheezing.  Scientists determined that the more frequently the chemicals were used, the greater the risk of persistent wheezing, which can be a precursor to asthma.

 

Sherriff A, Farrow A, Golding J, Henderson J. Frequent use of chemical household products is associated with persistent wheezing in pre-school. Thorax. 2005; 60:45-49.

 

 

Environmental Health Perspectives 2005 - 85 mothers and sons were tested for phthalates in their urine.  The mothers with the highest levels of phthalates in their urine late in their pregnancy produced babies with genital abnormalities.  This same effect has been seen in rats, but this is the first evidence that phthalates are causing a similar effect in humans.  The “phthalate syndrome” in rats causes a decrease in testosterone levels, lower sperm counts, infertility and testicular abnormalities in the mature animal.

 

Shanna H, Swan S, Main K, Liu F, et al. Decrease in anogenital distance among male infants with prenatal phthalate exposure. Environmental Health Perspectives. 13(8).

 

 

15th Annual Congress of the European Respiratory Society 2005 – Asthma and housework: a few home truths.  The authors presented the results of a study that linked household sprays and new-onset asthma.  4,200 subjects who cleaned their own homes took part in the study, with 3,500 participants initially asthma free.  After nine years, the data showed that the incidence of asthma was greater in participants who used sprays more frequently.  “Between 11% and 18% of new asthma cases can be attributed to frequent use of household aerosols.”  The most hazardous of the sprays used were room sprays, furniture and window sprays. The use of ammonia, bleach or dye solvents were also found to put people at risk for developing asthma.

           

Jaakkola, Maritta, 15th Annual Congress of the European Respiratory Society 2005

 

Occupational and Environmental Medicine 2005 - Asthma symptoms in domestic cleaning women are associated with exposure to bleach and possibly other irritant agents. The public health impact of the use of irritant cleaning products could be widespread since the use of these products is common both in the workplace and at home.

Medina-Ramon M, Zock JP et al. Asthma, chronic bronchitis, and exposure to irritant agents in                           occupational domestic cleaning: a nested case-control study. Occupational and Environmental Medicine. 2005 September; 62(9):598-606

Connecticut School Indoor Environment Resource Team

Cleaning for Health Program Description

The Connecticut School Indoor Environment Resource Team is now offering a special program on
“green” cleaning, entitled Cleaning for Health. This program was developed by INFORM, an
organization devoted to educating the public on sustainable practices and policies to protect both the
environment and health.
 

The Cleaning for Health program was developed to reduce asthma triggers and other health effects
from institutional cleaning. Ingredients in common cleaning products have been directly linked to
asthma, with custodians experiencing one of the highest rates of occupational asthma. Other health
problems linked to cleaning chemicals include chronic respiratory illnesses, building-related symptoms,
allergies and sensitivities.
Cleaning for Health is an educational and technical assistance program designed to help schools
transition to the new generation of less-toxic cleaning chemicals and to adopt state-of-the-art cleaning
practices. It focuses on three key concepts:

    • less-toxic cleaning products that are certified by a third-party as environmentally preferable
    • high filtration cleaning equipment
    • best practices

     

The program includes an overview of the reasons for implementing “green” cleaning, the components of
a Cleaning for Health program, and technical assistance to make the switch. Technical assistance
begins with a Cleaning Products and Practices Evaluation. The Evaluation will be conducted at your
facility by trained industrial hygienists from the University of Connecticut Health Center, Yale
University and other organizations. It may take up to 3 hours and includes:

  • meeting with your school district facilities manager and/or custodial supervisor to discuss
    cleaning products and practices
  • reviewing the current inventory of cleaning products
  • providing a checklist with resources and recommendations to improve your school’s cleaning
    practices and products in cost-effective ways.

Join the Green Cleaning Revolution! Contact Kenny Foscue or Joan Simpson at 860-509-7740 to find
out more about this program.

Note: This program is offered on a first come-first serve basis with the priority
given to districts that have implemented and maintained the Tools for Schools
program.


Implementing Environmentally Preferable Cleaning Practices:
An Eight Step Plan



The following eight steps are essential to making this project successful, and INFORM can assist you with these
steps by providing technical support and offering in-person meetings and trainings.
1. Adopt an environmentally preferable (EP) cleaning policy
2. Establish an Environmental Health and Safety Committee
3. Evaluate your current cleaning products, methods, and equipment
4. Design and implement a pilot project to test methods and products
5. Educate building occupants and custodial staff about the policy and pilot project
6. Phase in “green” products
7. Watch for new opportunities to make environmentally preferable purchasing changes
8. Reward the staff for participating

Adopt a policy.
Establish your priority—cleaning for health first—by adopting an EP cleaning practices policy. This tells the
building occupants and staff that you value their health and safety and that you are willing to make changes to
protect it. Tailor your policy to your organization’s goals, which could be as simple as complying with legislation
or pursuing broad environmental sustainability.
Establish an Environmental Health and Safety Committee.
Establish an Environmental Health and Safety (EH&S) Committee that includes representative groups of people
likely to be affected by the change, including the administration, custodial staff, building occupants, healthcare
staff, and unions. Let the committee know that it will be responsible for representing its constituents and will
need to raise concerns, answer questions, and otherwise participate in developing and implementing a
successful “green” cleaning program. As committee members, participants will be involved in evaluating the
efficacy of EP cleaning methods, how a change impacts their constituency, and the overall success of the
project.
Evaluate current products and practices.
Audit products, equipment, and practices facility-wide to evaluate them from an environmental and human
health standpoint. Identify which products contain hazardous substances and can be replaced by healthier
alternatives. Examine processes and procedures, and determine where improvements can be made. Compare
the ingredient lists of products to INFORM’s list of “Toxic Ingredients to Avoid,” and share the list of hazardous
substances and their associated health effects with the custodial staff.
Design a pilot project.
Select a location in the facility for a pilot project. Work with the EH&S Committee to select a location based on
what you want to accomplish with the pilot: Do you want to clean only one of the most common interior finishes,
see how the pilot works in a high traffic area, work with multiple finishes and products, or have the pilot program
encompass one building on a campus? Identify EP products that are likely to meet the needs of the facility, and
begin a one-to-three month product test in the pilot project area. Try several different products to compare their
performance, unless staff are committed to working with an existing vendor’s product. Work with vendors of EP
products to identify those that meet your facility’s cleaning needs. Ask for product samples and equipment
demonstrations. Arrange for training on the new products, procedures, and equipment.
Educate, educate, educate.
Have the EH&S Committee educate building occupants and custodial staff by disseminating information about
why EP cleaning is important. Bring the EP cleaning policy to their attention, and let them know that the pilot
testing of products and methods is underway. Support your efforts with signs posted throughout the facility
describing the new policy and how building occupants can support it. (For example, ask building occupants to
use products supplied by the facility instead of bringing in products from their homes.) Make sure that building
occupants know who their representative is on the EH&S Committee so they can approach that person with
comments and concerns.
Choose and phase in “green” products.
Have the EH&S Committee design an evaluation form it can use to rate the success of the products, practices,
and project overall. Review the results of the evaluations, and identify the products that perform best in your
facility. Phase in the use of the safer products. Start the phase-in by properly disposing of any chemicals the
facility has but isn’t using. Use up stores of some of the most common chemicals before purchasing the EP
alternatives. Choose new equipment that will replace existing equipment when it reaches the end of its useful
life.
Monitor the project.
Review the project periodically to ensure its continued success, and assess new opportunities to expand the
program. Ask product vendors to keep staff up to date on new products and procedure improvements. Work
with INFORM staff to determine the amount of toxic chemicals avoided because of the switch to EP products.
Reward the custodial staff.
Making changes can be difficult. It is important to make the custodial staff part of the process and to reward
them for their participation. Present certificates, give out “green team” tee shirts or hats, hold a special lunch,
etc. Show them that you appreciate their help and willingness to implement the project.

For more information, contact
Cameron S. Lory
Senior Associate
Chemical Hazards Prevention Program Coordinator
212-361-2400, ext. 232
lory@informinc.org
Carol Westinghouse
Senior Consultant
Cleaning for Health
802-626-8643
westies@ecoisp.com


Environmentally Preferable Cleaning Products
Sample Specifications

 
Statement of Policy
Many cleaning products contain chemicals that can be hazardous to custodial workers and building
occupants. These chemicals can be acutely dangerous, causing respiratory irritation, chemical
burns, or asthma attacks in children and adults, and/or they can be chronically hazardous to
individuals who are exposed to them over a long period of time. Cost-competitive, environmentally
preferable alternatives that meet performance specifications are readily available, and generally,
products that are safer for people are safer for the environment as well.
In order to minimize the health and environmental impacts of maintaining _________________,
______________________ is electing to purchase environmentally preferable cleaning products.
________________________________________will specify, buy, and use, where feasible, only
environmentally preferable custodial cleaning products.
Purpose
This policy is adopted to eliminate or reduce toxics that create hazards to workers and the
environment. Some chemicals used in common cleaning products have been shown to cause
adverse health effects and negatively affect indoor air quality. A growing body of research clearly
shows a correlation between cleaning chemicals and asthma cases. This suggests that to minimize
the potential for health and safety risks from cleaning products, the least toxic product that can
perform the job should be purchased. In addition, toxic chemicals require special handling, storage,
and disposal, which add to the cost of using, keeping, and disposing of these products.
Products
Bidders are to supply the following products:
1. General Purpose Cleaners
2. Bathroom Cleaners
3. Glass Cleaners
4. Carpet Cleaners
5. Disinfectants / Sanitizers
6. Floor-Care Products (all must be provided)
a. Floor Finishes
b. Floor Strippers
7. Hand Soaps
Training
The manufacturer, its distributor, or a third party must offer on-site (or at a designated site) training
in the proper use of the product. This must include step-by-step instructions for the proper dilution,
use, and disposal and for the use of equipment. In support of this training, the manufacturer or its
distributor must provide a phone number that departments can call to receive instructions and
assistance on product use.
Health and Environmental Specifications
The above products must meet the following health and safety specification:
A. The undiluted product must not be toxic to humans.
B. The undiluted product must not contain any ingredients that are carcinogens or that are
known to cause reproductive toxicity, unless present in concentrations below the
applicable maximum contaminant levels in drinking water.
C. The undiluted product must not be corrosive to the skin or eyes, nor be a skin sensitizer.
D. The undiluted product must not be combustible.
E. The product as used must not contain substances that contribute significantly to the
production of photochemical smog, tropospheric ozone, and poor indoor air quality. The
volatile organic compound (VOC) of the product used must be less than 0.1% by weight.
The product as used must not be toxic to aquatic life.
F. The product as used must not contain more than 0.5% by weight of total phosphorus.
G. Each of the organic ingredients must be readily biodegradable.
H. The product must be a concentrate, except for FIFRA-registered bathroom cleaners.
I. Manufacturers must identify any fragrances on their MSDSs, and they should follow the
Code of Practice of the International Fragrance Association.
J. The product must not contain the following ingredients:
o Alkylphenol ethoxylates
o Dibutyl phthalate
o Heavy metals, including arsenic, lead, cadmium, cobalt, chromium, mercury,
nickel, or selenium
o Ozone-depleting compounds
K. In addition, vendors shall provide information as to whether their products contain
ingredients that may be identified as asthmagens (asthma-causing agents), such as:
o Monoethanolamine (CAS 141-43-5)
o Tall oil or rosin (CAS 8002-26-4)
o Chlorhexidine (CAS 55-56-1)
o Chloramine T (CAS 127-65-1)
o Ammonium quaternary disinfectants (not limited to the following CAS numbers:
8001-54-5, 121-54-0, 122-18-9, 8044-71-1, 124-03-5, 122-19-0)
Full listing available at http://www.aoec.org/tools.htm
All products shall meet the Green Seal Industrial and Institutional Cleaners Standard (GS-
37) or Green Seal Floor Care Standards (GS-40) criteria or have undergone testing to
demonstrate compliance with Green Seal’s GS-37 or GS-40 criteria.
Labeling
The manufacturer’s label must state clearly and prominently that dilution with water from the cold
tap is recommended and shall state the recommended level of dilution. The manufacturer shall
also include detailed instructions for proper use and disposal and for the use of personal protective
equipment.
Product Specific Requirements
Carpet Cleaners
Carpet cleaners must meet Health and Environmental Specifications established above. Carpet
cleaners must exhibit a VOC limit of not greater than 0.1%.
Disinfectants / Sanitizers
Disinfectants / sanitizers must meet the Health and Environmental Specifications established
above, EXCEPT for the active ingredients with respect to biodegradability.
Disinfectants / sanitizers must exhibit a VOC limit of not greater than 0.1%.
Disinfectants / sanitizers must be registered by the US Environmental Protection Agency.
Floor-Care Products (all must be provided)
a. Floor Finishes
b. Floor Strippers
c. Maintenance Products
All floor-care products must be free of zinc and other heavy metals.
Floor-care products must not contain phthalates.
Floor-care products must not contain glycol ethers or ammonia.
It is preferable that the floor finish does not need to be stripped prior to reapplications of the floor
finish.
Floor strippers must exhibit a VOC limit of not greater than 0.1%.
Maintenance products must exhibit a VOC limit of not greater than 0.1%.
Hand Soaps
These products must not be anti-microbial (a low-level preservative is permissible, however, to
prevent bacterial growth). Non-scented is preferred.
Non-animal testing
It is required that bidders’ products not be tested on animals. To discourage animal testing, the
results of past peer-reviewed or standard tests demonstrating compliance with a criterion will be
accepted. In addition, a mixture need not be tested (or retested) if existing information
demonstrates that each of the ingredients complies with a criterion.
Priorities
The health and safety of workers and citizens is of utmost importance and takes precedence over
all other policies.
This policy shall not be construed as requiring a department, purchaser, or contractor to procure
products that do not perform adequately for their intended use, exclude adequate competition, or
are not available at a reasonable price in a reasonable period of time.
Program Evaluation
The _______________________________________ shall review this policy on an annual basis to
evaluate the success of the policy’s implementation.
Definitions
“Asthmagens” are chemicals known to cause asthma in a person who never had asthma prior to
exposure. A list of asthmagens is available at the following Association of Occupational and
Environmental Clinics (AOEC) website: http://www.aoec.org/tools.htm
Asthmagens are listed with the Exposure Code “A.”
“Environmentally Preferable Cleaning Products” are defined as products that have a lesser or
reduced effect on human health and the environment when compared with competing products or
services that serve the same purposes.
Resources
INFORM, Inc., offers a Cleaning for Health Guide: http://www.informinc.org/cfh_00.php.
Center for the New American Dream provides information about products that meet the above
specifications: http://www.newdream.org/procure/products/approved.php
Green Seal provides information about less toxic cleaning products:
http://www.greenseal.org/certproducts.htm#cleaners 
The US Environmental Protection Agency’s Environmentally Preferable Purchasing Program
website provides general information about environmentally preferable purchasing at
http://www.epa.gov/oppt/epp, guidance on specific products at
http://www.epa.gov/epp/pubs/pfs.htm, and a database of environmental information for products
and services at http://yosemite1.epa.gov/oppt/eppstand2.nsf/pages/search.html?open.
Examples of specifications written by state purchasing agencies are available at:
Commonwealth of Massachusetts: http://www.mass.gov/epp 
State of Connecticut: http://www.das.state.ct.us/rfpdoc/004_0070.pdf
State of Vermont: http://www.bgs.state.vt.us/pca

Switching to safer cleaning products will significantly reduce the negative health and environmental impacts of
the cleaning chemicals you use to maintain your facility. INFORM is available to help you through the process of
changing products.

 
Respiratory Hazards and Restroom Deodorant Blocks

 
Why are deodorant blocks hazardous?
Some restroom and urinal deodorant blocks contain paradichlorobenzene (p-dichlorobenzene, 1,4-
dichlorobenzene, or “para”), a respiratory irritant that can trigger an asthma attack in a person who already
has asthma. Exposure to paradichlorobenzene occurs primarily indoors, from products such as deodorant
blocks and mothballs.1 Para persists in the environment, and the National Toxicology Program reports that
it is reasonably anticipated to be a human carcinogen.2 Many other restroom and urinal deodorizing blocks
that do not contain paradichlorobenzene contain ammonium quaternary compounds (“quats”), disinfectants
that are known to cause asthma when used in cleaners.3
What alternatives exist?
Deodorant blocks that contain surfactants or bacterial cultures can be just as effective as para-based or
quaternary ammonium-based blocks. In addition, autoflush toilets and urinals may eliminate the need for
deodorant blocks in certain situations, while more frequent cleaning of regular toilets and urinals may
reduce the need for them.
Do alternative deodorant blocks cost more?
The para-free deodorizers that Erie County (NY) chose to use in some of its facilities cost approximately
$10 more per dozen, a minimal increase relative to the county’s overall facilities operational budget.
However, the 8-ounce enzyme-based blocks lasted almost three times longer than the para-based product.
Where can I get deodorant blocks that do not contain paradichlorobenzene or ammonium
quaternary compounds?
Many vendors supply alternative products. A few brand-name deodorant blocks that do not contain
paradichlorobenzene or ammonium quaternary compounds are listed below.

Impact Products
http://www.impact-products.com/Catalog1.asp
9400 and 9423 Series
Para-Free Urinal Screens
Nilodor
http://www.nilodor.com
Screen with 8 oz. Non-Para
Block #8000
Hospital Specialty Company
http://www.hospeco.com/products.asp
Health Gards Toilet Rim Cage
Triple S
http://www.triple-s.com/
X-Duty Urinal Screen with
Enzyme Block


Who else is using urinal blocks without paradichlorobenzene or ammonium quaternary
compounds?

Erie County (NY) pilot-tested three alternative urinal blocks in 2001 and found two brands that were
acceptable. The county now has only non-para blocks on contract and estimates that using these
alternative products prevents 1 ton of paradichlorobenzene emissions per year. (For a case study, see
http://www.informinc.org/fserie.pdf.) Other jurisdictions, including San Francisco and the State of New York
Department of Corrections, have also stopped using paradichlorobenzene blocks.
What about the urinal screens that come with the blocks?
Because of the environmental problems associated with polyvinyl chloride (PVC), INFORM recommends
buying urinal screens that are not made from PVC. Screens made of polyethylene and other plastics are
widely available.
Recommended purchasing contract specification
Urinal blocks may not contain
D Paradichlorobenzene (CAS 106-46-7)
D Quaternary ammonium compounds, including, but not limited to, the following chemicals:
G Parasterol or benzalkonuim chloride (CAS 8001-54-5)
G Benzethonium chloride (CAS 121-54-0)
G Cetalkonium chloride (CAS 122-18-9)
G Cetrimide (CAS 8044-71-1)
G Cetylpyridinium chloride (CAS 123-03-5)
G Benzyldimethylstearylammonium chloride (CAS 122-19-0)
Urinal screens may not be made from PVC.
Notes
1 US Department of Health and Human Services, Agency for Toxic Substances and Disease Registry,
“Toxicological Profile for Dichlorobenzenes,” November 22, 2004, available at http://www.atsdr.cdc.gov/
toxprofiles/tp10.html.
2 US Department of Health and Human Services, National Toxicology Program, “Reasonably Anticipated to
Be Human Carcinogens,” in Report on Carcinogens, 11th ed., January 31, 2005, available at
http://ntp.niehs.nih.gov/ntp/roc/toc11.html.
3 A. Purohit, et al., “Quaternary Ammonium Compounds and Occupational Asthma,” International Archives
of Occupational and Environmental Health 73, 6 (August 2000): 423–27; J. A. Bernstein, et al., “A
Combined Respiratory and Cutaneous Hypersensitivity Syndrome Induced by Work Exposure to
Quaternary Amines,” Journal of Allergy and Clinical Immunology 94, 2 (August 1994): 257–59; P. S. Burge
and M. N. Richardson, “Occupational Asthma due to Indirect Exposure to Lauryl Dimethyl Benzyl
Ammonium Chloride Used in a Floor Cleaner,” Thorax 49, 8 (August 1994): 842–43.

For more information, contact
Cameron S. Lory Carol Westinghouse
Senior Associate Senior Consultant
Chemical Hazards Prevention Program Coordinator Cleaning for Health
212-361-2400, ext. 232 802-626-8643
lory@informinc.org westies@ecoisp.com