Editing Quaternary ammonium cation (section)

== Health effects ==
Quaternary ammonium compounds can display a range of health effects, amongst which are mild skin and respiratory irritation <ref>{{cite journal | vauthors = Bello A, Quinn MM, Perry MJ, Milton DK | title = Characterization of occupational exposures to cleaning products used for common cleaning tasks--a pilot study of hospital cleaners | journal = Environmental Health | volume = 8 | pages = 11 | date = March 2009 | pmid = 19327131 | pmc = 2678109 | doi = 10.1186/1476-069X-8-11 | doi-access = free }}</ref> up to severe caustic burns on skin and the [[gastrointestinal wall]] (depending on concentration), gastrointestinal symptoms (e.g., nausea and vomiting), coma, convulsions, hypotension and death.<ref>{{cite web | url = http://www.inchem.org/documents/pims/chemical/pimg022.htm#SectionTitle:2.1%20%20Main%20risk%20and%20target%20organs | title = Quaternary ammonium | id = PIM G022 | work = Internationally Peer Reviewed Chemical Safety Information (INCHEM) | publisher = World Health Organization }}</ref>

They are thought to be the chemical group responsible for [[anaphylactic reaction]]s that occur with use of [[neuromuscular blocking drug]]s during [[general anaesthesia]] in [[surgery]].<ref>{{cite journal | vauthors = Harper NJ, Dixon T, Dugué P, Edgar DM, Fay A, Gooi HC, Herriot R, Hopkins P, Hunter JM, Mirakian R, Pumphrey RS, Seneviratne SL, Walls AF, Williams P, Wildsmith JA, Wood P, Nasser AS, Powell RK, Mirakhur R, Soar J | display-authors = 6 | title = Suspected anaphylactic reactions associated with anaesthesia | journal = Anaesthesia | volume = 64 | issue = 2 | pages = 199–211 | date = February 2009 | pmid = 19143700 | pmc = 3082210 | doi = 10.1111/j.1365-2044.2008.05733.x }}</ref> [[Quaternium-15]] is the single most often found cause of allergic [[contact dermatitis]] of the hands (16.5% in 959 cases).<ref>{{cite journal | vauthors = Warshaw EM, Ahmed RL, Belsito DV, DeLeo VA, Fowler JF, Maibach HI, Marks JG, Toby Mathias CG, Pratt MD, Rietschel RL, Sasseville D, Storrs FJ, Taylor JS, Zug KA | display-authors = 6 | title = Contact dermatitis of the hands: cross-sectional analyses of North American Contact Dermatitis Group Data, 1994-2004 | journal = Journal of the American Academy of Dermatology | volume = 57 | issue = 2 | pages = 301–314 | date = August 2007 | pmid = 17553593 | doi = 10.1016/j.jaad.2007.04.016 }}</ref>

===Possible reproductive effects in laboratory animals===
Quaternary ammonium-based disinfectants (Virex and Quatricide) were tentatively identified as the most probable cause of jumps in birth defects and fertility problems in caged lab mice. The quat ingredients in the disinfectants include [[alkyl dimethyl benzyl ammonium chloride]] (ADBAC) and [[Didecyldimethylammonium chloride|didecyl dimethyl ammonium chloride]] (DDAC).<ref name="mice">{{cite journal | vauthors = Hunt P | title = Lab disinfectant harms mouse fertility. Patricia Hunt interviewed by Brendan Maher | journal = Nature | volume = 453 | issue = 7198 | pages = 964 | date = June 2008 | pmid = 18563110 | doi = 10.1038/453964a | doi-access = free }}</ref><ref>{{cite journal | vauthors = Melin VE, Potineni H, Hunt P, Griswold J, Siems B, Werre SR, Hrubec TC | title = Exposure to common quaternary ammonium disinfectants decreases fertility in mice | journal = Reproductive Toxicology | volume = 50 | pages = 163–170 | date = December 2014 | pmid = 25483128 | pmc = 4260154 | doi = 10.1016/j.reprotox.2014.07.071 | bibcode = 2014RepTx..50..163M }}</ref> A similar link was tentatively identified in nurses.<ref>{{cite journal | vauthors = Gaskins AJ, Chavarro JE, Rich-Edwards JW, Missmer SA, Laden F, Henn SA, Lawson CC | title = Occupational use of high-level disinfectants and fecundity among nurses | journal = Scandinavian Journal of Work, Environment & Health | volume = 43 | issue = 2 | pages = 171–180 | date = March 2017 | pmid = 28125764 | pmc = 5840865 | doi = 10.5271/sjweh.3623 }}</ref> The studies contradict earlier toxicology data reviewed by the U.S. Environmental Protection Agency (U.S. EPA) and the EU Commission.<ref>{{cite journal| vauthors = ((Office of Prevention, Pesticides and Toxic Substances, US EPA)) |title=Reregistration Eligibility Decision for Aliphatic Alkyl Quaternaries (DDAC)|journal=Epa739-R-06-008|date=August 2006}}</ref>