BACKGROUND: The Connecticut Poison Control Center (CT PCC) collects passive phoned-in data on potential poisonings. When appropriate, CT PCC investigates cases in a follow-up process that can extend over several days. While CT PCC data is not specific to occupational health, it includes an indicator for occupational exposures as a categorical variable. However, more detailed occupational health information such as product identification and industrial sector data are not generally recorded. Despite the absence of an occupational health focus in the categorized CT PCC data, it still can be used to follow job-related chemical exposures when conjoined to supplemental case notes.
METHODS: Between 1/1/2013 and 12/31/2015, 1,097 work-related exposures were identified in CT PCC data. Cases without an inhalation exposure route (n=570) were excluded from the total group for purposes of this analysis. Twenty-two (22) inhalation exposures were also excluded because the reported effect appeared unrelated to the exposure. The 505 remaining exposed cases were further reviewed for the presence of a cleaning product exposure by using a “substance” variable to classify exposures. This variable had several classes including a chemical (ex. “hypochlorite”), a trademarked product (ex. “Lemon-Eze”), or by generic description, such as “oven cleaner” or “other fume, gas or vapor.” Because some cleaning products have non-cleaning applications, case notes were used for purposes of product clarification and description of its applied use.
RESULTS: After applying filters, 84 inhalation exposures from cleaning products were identified. Chlorine compounds were found in 38 of 84 (45%) reported exposures. Common household bleach accounted for 15 of those 38 (40%). Among the non-chlorine compounds, 26 exposures were attributable to household, commercial and all-purpose cleaning agents and 20 exposures were to industrial cleaners, solvents and degreasers.
CONCLUSIONS: Inhalational exposures to bleach and other chlorine products were more frequent than anticipated. Chlorine bleach is a significant respiratory irritant, and its use in poorly-ventilated areas without protective equipment can be a serious hazard. However, warning labels on chlorine-containing products tend to focus on chloramine formation. As a strong oxidizer, chlorine reacts directly with biological tissue and often creates hazardous byproducts (chlorine gas). Significant data was available to evaluate chlorine exposures independently; however, less chemical information was available for other cleaning products. Future research, including more years of CT PCC data, could expand on this analysis.