Editing Disinfectant

{{Short description|Antimicrobial agent that inactivates or destroys microbes}}
{{redirect|Sanitizers|the software|AddressSanitizer}}
{{about|antimicrobial agents|the Macintosh anti-virus software|Disinfectant (software)}}
{{Use dmy dates|date=November 2017}}
{{cs1 config|name-list-style=vanc|display-authors=6}}
[[File:Disinfection with mop.jpg|thumb|Disinfection of a floor using disinfectant liquid applied using a [[mop]].]]
[[File:Resistance of Microbes to Disinfectants.png|thumb|Levels of resistance of microbes to disinfectants.]]

A '''disinfectant''' is a [[chemical]] substance or compound used to inactivate or destroy [[microorganism]]s on inert surfaces.<ref name="cdc">{{cite web|url=https://www.cdc.gov/oralhealth/infectioncontrol/glossary.htm|access-date=19 April 2016|title=Division of Oral Health - Infection Control Glossary|publisher=U.S. Centers for Disease Control and Prevention|url-status=live|archive-url=https://web.archive.org/web/20160413120331/http://www.cdc.gov/oralhealth/infectioncontrol/glossary.htm|archive-date=13 April 2016|df=dmy-all}}</ref> Disinfection does not necessarily kill all microorganisms, especially resistant [[endospore|bacterial spores]]; it is less effective than [[sterilization (microbiology)|sterilization]], which is an extreme physical or chemical process that kills all types of life.<ref name="cdc"/> Disinfectants are generally distinguished from other [[antimicrobial agents]] such as [[antibiotic]]s, which destroy microorganisms within the body, and [[antiseptic]]s, which destroy microorganisms on living [[biological tissue|tissue]]. Disinfectants are also different from [[biocide]]s—the latter are intended to destroy all forms of life, not just microorganisms.
Disinfectants work by destroying the cell wall of microbes or interfering with their metabolism. It is also a form of decontamination, and can be defined as the process whereby physical or chemical methods are used to reduce the amount of pathogenic microorganisms on a surface.<ref>{{cite journal | vauthors = Loveday HP, Wilson JA, Pratt RJ, Golsorkhi M, Tingle A, Bak A, Browne J, Prieto J, Wilcox M | title = epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England | journal = The Journal of Hospital Infection | volume = 86 | issue = Suppl 1 | pages = S1-70 | date = January 2014 | pmid = 24330862 | pmc = 7114876 | doi = 10.1016/S0195-6701(13)60012-2 }}</ref><ref>{{cite journal | vauthors = Slater K, Cooke M, Fullerton F, Whitby M, Hay J, Lingard S, Douglas J, Rickard CM | title = Peripheral intravenous catheter needleless connector decontamination study-Randomized controlled trial | journal = American Journal of Infection Control | volume = 48 | issue = 9 | pages = 1013–1018 | date = September 2020 | pmid = 31928890 | doi = 10.1016/j.ajic.2019.11.030 | s2cid = 210193248 }}</ref>

Disinfectants can also be used to destroy microorganisms on the skin and mucous membrane, as in the medical dictionary historically the word simply meant that it destroys microbes.<ref>{{cite journal | vauthors = Rabenau HF, Kampf G, Cinatl J, Doerr HW | title = Efficacy of various disinfectants against SARS coronavirus | journal = The Journal of Hospital Infection | volume = 61 | issue = 2 | pages = 107–111 | date = October 2005 | pmid = 15923059 | pmc = 7132504 | doi = 10.1016/j.jhin.2004.12.023 }}</ref><ref name=":5">{{cite journal | vauthors = Story P | title = Testing of skin disinfectants | journal = British Medical Journal | volume = 2 | issue = 4794 | pages = 1128–1130 | date = November 1952 | pmid = 12987777 | pmc = 2021886 | doi = 10.1136/bmj.2.4794.1128 }}</ref><ref>{{cite book | author = Society for Applied Bacteriology |title=Disinfectants: Their Use and Evaluation of Effectiveness |date=1981 |publisher=Academic Press |isbn=978-0-12-181380-2 }}{{page needed|date=January 2021}}</ref>

Sanitizers are substances that simultaneously clean and disinfect.<ref name="FSA">{{cite web|url=https://www.food.gov.uk/safety-hygiene/cleaning|title=Cleaning|publisher=Fodd Standards Agency|access-date=12 December 2019}}, (2009), ''[[Mid Sussex District|Mid Sussex District Council]]'', UK.</ref> Disinfectants kill more germs than sanitizers.<ref>{{cite web |title=Green Cleaning, Sanitizing, and Disinfecting: A Curriculum for Early Care and Education |url=https://www.epa.gov/sites/production/files/documents/ece_curriculum_7.2013_for_uploading.pdf |access-date=8 April 2019}}</ref> Disinfectants are frequently used in hospitals, dental surgeries, kitchens, and bathrooms to kill infectious organisms. Sanitizers are mild compared to disinfectants and are used primarily to clean things that are in human contact, whereas disinfectants are concentrated and are used to clean surfaces like floors and building premises.{{citation needed|date=January 2021}}<ref>{{Cite web| vauthors = Roberts H |date=April 2020|title=The difference between sanitizing and disinfecting. One kills more germs than the other.|url=https://www.insider.com/the-difference-between-sanitizer-and-disinfectant|archive-url=|archive-date=|access-date=|website=Insider}}</ref>

Bacterial [[endospore]]s are most resistant to disinfectants, but some [[fungi]], [[virus]]es and [[bacteria]] also possess some resistance.<ref>{{cite journal | vauthors = Yeung YW, Ma Y, Liu SY, Pun WH, Chua SL | title = Prevalence of alcohol-tolerant and antibiotic-resistant bacterial pathogens on public hand sanitizer dispensers | journal = The Journal of Hospital Infection | volume = 127 | pages = 26–33 | date = September 2022 | pmid = 35690267 | pmc = 9176178 | doi = 10.1016/j.jhin.2022.05.017 }}</ref>

[[File:DISINFECTANT PIC.svg|thumb|Disinfectants are used to rapidly kill bacteria. They kill off the bacteria by causing the proteins to become damaged and the outer layers of the bacteria cell to rupture. The DNA material subsequently leaks out.{{citation needed|date=January 2021}}]]

In [[sewage treatment|wastewater treatment]], a disinfection step with [[chlorine]], [[Ultra-violet radiation|ultra-violet (UV) radiation]] or [[ozonation]] can be included as tertiary treatment to remove [[pathogens]] from wastewater, for example if it is to be discharged to a river or the sea where there body contact immersion recreations is practiced (Europe) or reused to irrigate golf courses (US). An alternative term used in the [[sanitation]] sector for disinfection of waste streams, [[sewage sludge]] or [[septage|fecal sludge]] is '''sanitisation''' [[American and British English spelling differences|or]] '''sanitization'''.{{citation needed|date=January 2021}}

==Definitions==
The Australian [[Therapeutic Goods Act 1989|Therapeutic Goods Order No. 54]] defines several grades of disinfectant as will be used below.<ref name="govau">{{cite news |title=Therapeutic Goods Order No. 54 — Standard for Disinfectants and Sterilants as amended made under section 10 of the Therapeutic Goods Act 1989 |url=https://www.legislation.gov.au/Details/F2009C00327/bd2c6695-86a5-4eef-9ca6-387bb0514be5 |agency=Federal Register of Legislative Instruments |issue=F2009C00327 |publisher=legislation.gov.au |date=25 March 2009}} [[File:CC-BY icon.svg|50px]]  Text was copied from this source, which is available under a [https://creativecommons.org/licenses/by/4.0/  Creative Commons Attribution 4.0 International License].</ref>

===Sterilant===
'''Sterilant''' means a chemical agent which is used to sterilize critical medical devices or medical instruments. A sterilant kills all micro-organisms with the result that the sterility assurance level of a microbial survivor is less than 10^-6. Sterilant gases are not within this scope.{{cn|date=November 2023}}

===Low level disinfectant===
'''Low level disinfectant''' means a disinfectant that rapidly kills most [[Vegetative reproduction|vegetative bacteria]] as well as medium-sized [[Viral envelope|lipid containing viruses]], when used according to labelling. It cannot be relied upon to destroy, within a practical period, [[bacterial endospores]], [[mycobacteria]], [[fungi]], or all small [[Viral envelope|nonlipid viruses]].{{cn|date=November 2023}}

===Intermediate level disinfectant===
'''Intermediate level disinfectant''' means a disinfectant that kills all microbial pathogens except bacterial endospores, when used as recommended by the manufacturer. It is [[bactericidal]], [[tuberculocidal]], [[fungicidal]] (against asexual spores but not necessarily dried [[chlamydospores]] or [[sexual spores]]), and [[virucidal]].{{cn|date=November 2023}}

===High level disinfectant===
'''High level disinfectant''' means a disinfectant that kills all [[microbial pathogens]], except large numbers of bacterial endospores when used as recommended by its manufacturer.{{cn|date=May 2024}}

===Instrument grade===
'''Instrument grade disinfectant''' means:
# a disinfectant which is used to reprocess reusable therapeutic devices; and
# when associated with the words "low", "intermediate" or "high" means "low", "intermediate" or "high" level disinfectant respectively.

===Hospital grade===
Hospital grade means a disinfectant that is suitable for general purpose disinfection of building and fitting surfaces, and purposes not involving instruments or surfaces likely to come into contact with broken skin:{{cn|date=June 2022}}
# in premises used for:
#* the investigation or treatment of a disease, ailment or injury; or
#* procedures that are carried out involving the penetration of the human skin; or,
# in connection with:
#* the business of beauty therapy or hairdressing; or
#* the practice of podiatry;

but does not include :
# Instrument grade disinfectants; or
# sterilant; or
# an antibacterial clothes preparation; or
# a sanitary fluid; or
# a sanitary powder; or
# a sanitiser.

===Household/commercial grade===
'''Household/commercial grade disinfectant''' means a disinfectant that is suitable for general purpose disinfection of building or fitting surfaces, and for other purposes, in premises or involving procedures other than those specified for a hospital-grade disinfectant, but is not:{{cn|date=November 2023}}
# an antibacterial clothes preparation; or
# a sanitary fluid; or
# a sanitary powder; or
# a sanitiser

==Measurements of effectiveness==
One way to compare disinfectants is to compare how well they do against a known disinfectant and rate them accordingly. Phenol is the standard, and the corresponding rating system is called the "[[Phenol coefficient]]". The disinfectant to be tested is compared with phenol on a standard microbe (usually ''[[Salmonella typhi]]'' or ''[[Staphylococcus aureus]]''). Disinfectants that are more effective than phenol have a coefficient &gt; 1. Those that are less effective have a coefficient &lt; 1.{{cn|date=June 2022}}

The standard European approach for disinfectant validation consists of a basic suspension test, a quantitative suspension test (with low and high levels of organic material added to act as 'interfering substances') and a two part simulated-use surface test.<ref name=Sandle>{{cite book | editor = Sandle T | title = The CDC Handbook: A Guide to Cleaning and Disinfecting Cleanrooms  | edition = 1st | publisher = Grosvenor House Publishing Limited | year = 2012 | isbn = 978-1781487686}}</ref>

A less specific measurement of effectiveness is the [[United States Environmental Protection Agency]] (EPA) classification into either ''high'', ''intermediate'' or ''low'' levels of disinfection. "High-level disinfection kills all organisms, except high levels of bacterial spores" and is done with a chemical germicide marketed as a sterilant by the U.S. [[Food and Drug Administration]] (FDA). "Intermediate-level disinfection kills mycobacteria, most viruses, and bacteria with a chemical germicide registered as a 'tuberculocide' by the Environmental Protection Agency. Low-level disinfection kills some viruses and bacteria with a chemical germicide registered as a hospital disinfectant by the EPA."<ref>{{cite web |url=https://www.cdc.gov/HAI/prevent/sd_medicalDevices.html |title=Sterilization or Disinfection of Medical Devices |author=Centers for Disease Control and Prevention<!--Staff writer(s); no by-line.--> |date=21 December 2012 |website=CDC |access-date=20 July 2013 |url-status=live |archive-url=https://web.archive.org/web/20130720040938/http://www.cdc.gov/HAI/prevent/sd_medicalDevices.html |archive-date=20 July 2013 |df=dmy-all }}</ref>

An alternative assessment is to measure the Minimum inhibitory concentrations (MICs) of disinfectants against selected (and representative) microbial species, such as through the use of microbroth dilution testing.<ref>{{cite journal | vauthors = Vijayakumar R, Kannan VV, Sandle T, Manoharan C | title = In vitro Antifungal Efficacy of Biguanides and Quaternary Ammonium Compounds against Cleanroom Fungal Isolates | journal = PDA Journal of Pharmaceutical Science and Technology | volume = 66 | issue = 3 | pages = 236–242 | date = May 2012 | pmid = 22634589 | doi = 10.5731/pdajpst.2012.00866 | doi-broken-date = 19 November 2024 | s2cid = 40400887 }}</ref> However, those methods are obtained at standard inoculum levels without considering the inoculum effect. More informative methods are nowadays in demand to determine the minimum disinfectant dose as a function of the density of the target microbial species.<ref>{{cite journal | vauthors = García MR, Cabo ML | title = Optimization of <i>E. coli</i> Inactivation by Benzalkonium Chloride Reveals the Importance of Quantifying the Inoculum Effect on Chemical Disinfection | journal = Frontiers in Microbiology | volume = 9 | pages = 1259 | date = June 2018 | pmid = 29997577 | pmc = 6028699 | doi = 10.3389/fmicb.2018.01259 | doi-access = free }}</ref>

==Properties==
A perfect disinfectant would also offer complete and full microbiological [[sterilization (microbiology)|sterilisation]], without harming humans and useful form of life, be inexpensive, and noncorrosive. However, most disinfectants are also, by nature, potentially harmful (even [[toxic]]) to humans or animals. Most modern household disinfectants contain [[denatonium]], an exceptionally bitter substance added to discourage ingestion, as a safety measure. Those that are used indoors should never be mixed with other cleaning products as [[chemical reaction]]s can occur.<ref>{{cite web |url=http://www.state.nj.us/health/eoh/cehsweb/bleach_fs.pdf |access-date=19 April 2016 |title=Common Cleaning Products May Be Dangerous When Mixed |publisher=New Jersey Department of Health and Senior Services |url-status=live |archive-url=https://web.archive.org/web/20160323153736/http://www.state.nj.us/health/eoh/cehsweb/bleach_fs.pdf |archive-date=23 March 2016 |df=dmy-all }}</ref> The choice of disinfectant to be used depends on the particular situation. Some disinfectants have a wide spectrum (kill many different types of microorganisms), while others kill a smaller range of disease-causing organisms but are preferred for other properties (they may be non-corrosive, non-toxic, or inexpensive).<ref>{{cite web |url=http://www.health.ny.gov/professionals/protocols_and_guidelines/antibiotic_resistance/docs/hospital_disinfectants_for_general_disinfection_of_environmental_surfaces.pdf |access-date=19 April 2016 |title=Hospital Disinfectants for General Disinfection of Environmental Surfaces |publisher=New York State Department of Health |url-status=dead |archive-url=https://web.archive.org/web/20150924025446/http://www.health.ny.gov/professionals/protocols_and_guidelines/antibiotic_resistance/docs/hospital_disinfectants_for_general_disinfection_of_environmental_surfaces.pdf |archive-date=24 September 2015 |df=dmy-all }}</ref>

There are arguments for creating or maintaining conditions that are not conducive to bacterial survival and multiplication, rather than attempting to kill them with chemicals. Bacteria can increase in number very quickly, which enables them to [[evolution|evolve]] rapidly. Should some bacteria survive a chemical attack, they give rise to new generations composed completely of bacteria that have resistance to the particular chemical used. Under a sustained chemical attack, the surviving bacteria in successive generations are increasingly resistant to the chemical used, and ultimately the chemical is rendered ineffective. For this reason, some question the wisdom of impregnating cloths, [[cutting board]]s and worktops in the home with [[bactericidal]] chemicals.{{Citation needed|date=December 2012}}

==Types==

===Air disinfectants===
{{see also|Air sanitizer}}
Air disinfectants are typically chemical substances capable of disinfecting microorganisms suspended in the air. Disinfectants are generally assumed to be limited to use on surfaces, but that is not the case.  In 1928, a study found that airborne microorganisms could be killed using mists of dilute bleach.<ref>{{cite journal | vauthors = Robertson OH, Bigg E, Puck TT, Miller BF | title = The Bactericidal Action of Propylene Glycol Vapor on Microorganisms Suspended in Air. I | journal = The Journal of Experimental Medicine | volume = 75 | issue = 6 | pages = 593–610 | date = June 1942 | pmid = 19871209 | pmc = 2135271 | doi = 10.1084/jem.75.6.593 | citeseerx = 10.1.1.273.1031 }}</ref> An air disinfectant must be dispersed either as an [[aerosol]] or [[vapour]]<!--WP:ENGVAR: please WP:RETAIN--> at a sufficient concentration in the air to cause the number of viable infectious microorganisms to be significantly reduced.{{cn|date=May 2024}}

In the 1940s and early 1950s, further studies showed inactivation of diverse [[bacteria]], [[influenza virus]], and ''[[Penicillium chrysogenum]]'' (previously ''P. notatum'') [[Mold (fungus)|mold]] [[fungus]] using various glycols, principally [[propylene glycol]] and [[triethylene glycol]].<ref name="bactericidaleffects">For a review through 1952 see: {{cite journal | vauthors = Lester W, Dunklin E, Robertson OH | title = Bactericidal Effects of Propylene and Triethylene Glycol Vapors on Airborne Escherichia coli | journal = Science | volume = 115 | issue = 2988 | pages = 379–382 | date = April 1952 | pmid = 17770126 | doi = 10.1126/Science.115.2988.379 | bibcode = 1952Sci...115..379L }}</ref>  In principle, these chemical substances are ideal air disinfectants because they have both high lethality to microorganisms and low mammalian toxicity.<ref name="propyleneglycol">For a review of the toxicity of propylene glycol, see:  {{cite report |author= United States Environmental Protection Agency |title= Reregistration eligibility decision for propylene glycol and dipropylene glycol |id = EPA 739-R-06-002 |date=September 2006}}</ref><ref name="triethyleneglycol">For a review of the toxicity of triethylene glycol, see:  {{cite report |author= United States Environmental Protection Agency |title= Reregistration eligibility decision for triethylene glycol |id = EPA 739-R-05-002 |date=September 2005 | url = }}</ref>

Although glycols are effective air disinfectants in controlled laboratory environments, it is more difficult to use them effectively in real-world environments because the disinfection of air is sensitive to continuous action.  Continuous action in real-world environments with outside air exchanges at door, HVAC, and window interfaces, and in the presence of materials that absorb and remove glycols from the air, poses engineering challenges that are not critical for surface disinfection.  The engineering challenge associated with creating a sufficient concentration of the glycol vapours in the air have not to date been sufficiently addressed.<ref name="progressincontrol">{{cite journal | vauthors = Langmuir AD, Ingraham HS, Brandt AD, Lester W, Loosli CG, Parkins JE, Robertson OH, Shaffer TE, Wells WF, Whittaker HA, Yaglou CP | title = PROGRESS in the control of air-borne infections | journal = American Journal of Public Health and the Nation's Health | volume = 40 | issue = 5 Pt 2 | pages = 82–88 | date = May 1950 | pmid = 15418852 | pmc = 1528669 | doi = 10.2105/AJPH.40.5_Pt_2.82 }}</ref><ref name="factorsofimportance">{{cite journal | vauthors = Lester W, Kaye S, Robertson OH, Dunklin EW | title = Factors of importance in the use of triethylene glycol vapor for aerial disinfection | journal = American Journal of Public Health and the Nation's Health | volume = 40 | issue = 7 | pages = 813–820 | date = July 1950 | pmid = 15425663 | pmc = 1528959 | doi = 10.2105/AJPH.40.7.813 }}</ref>

===Alcohols===
{{see also|Hand sanitizer}}
[[File:Stiopa-dozownik.jpg|thumb|Alcohol hand sanitizer dispenser in an office in Poland ]]
[[Alcohol (chemistry)|Alcohol]] and alcohol plus [[Quaternary ammonium cation]] based compounds comprise a class of proven surface sanitizers and disinfectants approved by the [[EPA]] and the [[Centers for Disease Control]] for use as a hospital grade disinfectant.<ref name="cdc.gov">{{cite web | url=https://www.cdc.gov/infectioncontrol/guidelines/disinfection/index.html | title=Disinfection & Sterilization Guidelines | publisher=CDC | work=Guidelines Library: Infection Control | date=December 28, 2016 | access-date=January 12, 2018 | url-status=live | archive-url=https://web.archive.org/web/20180112160244/https://www.cdc.gov/infectioncontrol/guidelines/disinfection/index.html | archive-date=12 January 2018 | df=dmy-all }}</ref> Alcohols are most effective when combined with [[distilled water]] to facilitate diffusion through the cell membrane; 100% alcohol typically denatures only external membrane proteins.<ref name="foodsafety">{{cite web |url=http://vm.cfsan.fda.gov/~dms/a2z-b.html |title= Food Safety A to Z Reference Guide-B | publisher=[[FDA]] [[CFSAN]]|access-date=10 September 2009 |url-status=dead |archive-url=https://web.archive.org/web/20060103105715/http://vm.cfsan.fda.gov/~dms/a2z-b.html |archive-date=3 January 2006 }}</ref>  A mixture of 70% ethanol or [[isopropanol]] diluted in water is effective against a wide spectrum of bacteria, though higher concentrations are often needed to disinfect wet surfaces.<ref name="alcoholreview">{{cite journal | vauthors = Moorer WR | title = Antiviral activity of alcohol for surface disinfection | journal = International Journal of Dental Hygiene | volume = 1 | issue = 3 | pages = 138–142 | date = August 2003 | pmid = 16451513 | doi = 10.1034/j.1601-5037.2003.00032.x }}</ref>  Additionally, high-concentration mixtures (such as 80% ethanol + 5% isopropanol) are required to effectively inactivate lipid-enveloped viruses (such as [[HIV]], [[hepatitis B]], and [[hepatitis C]]).<ref name="foodsafety"/><ref name="alcoholreview"/><ref name="virucidal">{{cite journal | vauthors = van Engelenburg FA, Terpstra FG, Schuitemaker H, Moorer WR | title = The virucidal spectrum of a high concentration alcohol mixture | journal = The Journal of Hospital Infection | volume = 51 | issue = 2 | pages = 121–125 | date = June 2002 | pmid = 12090799 | doi = 10.1053/jhin.2002.1211 }}</ref><ref>{{cite journal | vauthors = Lages SL, Ramakrishnan MA, Goyal SM | title = In-vivo efficacy of hand sanitisers against feline calicivirus: a surrogate for norovirus | journal = The Journal of Hospital Infection | volume = 68 | issue = 2 | pages = 159–163 | date = February 2008 | pmid = 18207605 | doi = 10.1016/j.jhin.2007.11.018 }}</ref>

The efficacy of alcohol is enhanced when in solution with the wetting agent [[dodecanoic acid]] (coconut soap).  The synergistic effect of 29.4% ethanol with dodecanoic acid is effective against a broad spectrum of bacteria, fungi, and viruses.  Further testing is being performed against [[Clostridioides difficile (bacteria)|Clostridioides difficile]] (C.Diff) spores with higher concentrations of ethanol and dodecanoic acid, which proved effective with a contact time of ten minutes.<ref>{{cite web | url = http://www.urthpro.com | title = Clean & Disinfect Mold, Bacteria & Viruses in any Environment | publisher=UrthPRO| access-date = November 18, 2010| archive-url=https://web.archive.org/web/20110202151102/http://www.urthpro.com/| archive-date=February 2, 2011|url-status=dead}}</ref>

===Aldehydes===
[[Aldehyde]]s, such as [[formaldehyde]] and [[glutaraldehyde]], have a wide microbicidal activity and are [[sporicidal]] and [[fungicidal]]. They are partly inactivated by organic matter and have slight residual activity.{{cn|date=June 2022}}

Some bacteria have developed resistance to glutaraldehyde, and it has been found that glutaraldehyde can cause asthma and other health hazards, hence [[ortho-phthalaldehyde]] is replacing glutaraldehyde.{{Citation needed|date=March 2009}}

===Oxidizing agents===

[[redox|Oxidizing agents]] act by oxidizing the cell membrane of microorganisms, which results in a loss of structure and leads to cell [[lysis]] and death.  A large number of disinfectants operate in this way. [[Chlorine]] and [[oxygen]] are strong oxidizers, so their compounds figure heavily here.
* [[Electrolyzed water]] or "Anolyte" is an oxidizing, acidic hypochlorite solution made by [[electrolysis]] of [[sodium chloride]] into [[sodium hypochlorite]] and hypochlorous acid. Anolyte has an oxidation-reduction potential of +600 to +1200 mV and a typical pH range of 3.5––8.5, but the most potent solution is produced at a controlled pH 5.0–6.3 where the predominant oxychlorine species is [[hypochlorous acid]].
* [[Hydrogen peroxide]] is used in [[hospital]]s to disinfect surfaces and it is used in solution alone or in combination with other chemicals as a high level disinfectant. Hydrogen peroxide is sometimes mixed with [[colloidal silver]]. It is often preferred because it causes far fewer [[allergic]] reactions than alternative disinfectants. Also used in the [[food packaging]] industry to disinfect foil containers. A 3% solution is also used as an antiseptic.
* [[Vaporized hydrogen peroxide|Hydrogen peroxide vapor]] is used as a [[Sterilization (microbiology)|medical sterilant]] and as room disinfectant. Hydrogen peroxide has the advantage that it decomposes to form oxygen and water thus leaving no long term residues, but hydrogen peroxide as with most other strong oxidants is hazardous, and solutions are a primary irritant. The vapor is hazardous to the respiratory system and eyes and consequently the [[Occupational Safety and Health Administration|OSHA]] permissible exposure limit is 1 ppm (29 CFR 1910.1000 Table Z-1) calculated as an eight-hour time weighted average and the [[National Institute for Occupational Safety and Health|NIOSH]] immediately dangerous to life and health limit is 75 ppm.<ref name=":4">{{cite web |url=https://www.cdc.gov/niosh/idlh/intridl4.html |title=CDC - Immediately Dangerous to Life or Health Concentrations (IDLH): Chemical Listing and Documentation of Revised IDLH Values - NIOSH Publications and Products |publisher=Cdc.gov |date=31 July 2009 |access-date=10 November 2012 |url-status=live |archive-url=https://web.archive.org/web/20121117012820/http://www.cdc.gov/niosh/idlh/intridl4.html |archive-date=17 November 2012 |df=dmy-all }}</ref> Therefore, engineering controls, [[personal protective equipment]], gas monitoring etc. should be employed where high concentrations of hydrogen peroxide are used in the workplace. Vaporized hydrogen peroxide is one of the chemicals approved for decontamination of anthrax spores from contaminated buildings, such as occurred during the [[2001 anthrax attacks]] in the U.S. It has also been shown to be effective in removing exotic animal viruses, such as avian influenza and [[Newcastle disease]] from equipment and surfaces.
* The antimicrobial action of hydrogen peroxide can be enhanced by [[surfactant]]s and organic acids. The resulting chemistry is known as [[Accelerated hydrogen peroxide]]. A 2% solution, stabilized for extended use, achieves high-level disinfection in 5 minutes, and is suitable for disinfecting medical equipment made from hard plastic, such as in [[endoscope]]s.<ref>{{cite journal | vauthors = Omidbakhsh N | title = A new peroxide-based flexible endoscope-compatible high-level disinfectant | journal = American Journal of Infection Control | volume = 34 | issue = 9 | pages = 571–577 | date = November 2006 | pmid = 17097451 | doi = 10.1016/j.ajic.2006.02.003 }}</ref>  The evidence available suggests that products based on Accelerated Hydrogen Peroxide, apart from being good germicides, are safer for humans and benign to the environment.<ref>{{cite journal |vauthors = Sattar SA, Springthorpe VS, Rochon M | title= A product based on accelerated hydrogen peroxide: Evidence for broad-spectrum activity |journal=Canadian Journal of Infection Control |pages=123–130 |date=Winter 1998 | url = https://www.solutionsdesignedforhealthcare.com/wp-content/uploads/2021/11/1-A-product-based-on-accelerated-and-stabilized-hydrogen-peroxide_Evidence-for-broadspectrum-germicidal-activity.pdf }}</ref>
* [[Ozone]] is a gas used for disinfecting water, laundry, foods, air, and surfaces. It is chemically aggressive and destroys many organic compounds, resulting in rapid decolorization and deodorization in addition to disinfection. Ozone decomposes relatively quickly. However, due to this characteristic of ozone, tap water chlorination cannot be entirely replaced by ozonation, as the ozone would decompose already in the water piping. Instead, it is used to remove the bulk of oxidizable matter from the water, which would produce small amounts of [[organochloride]]s if treated with chlorine only. Regardless, ozone has a very wide range of applications from municipal to industrial water treatment due to its powerful reactivity.
* [[Potassium permanganate]] (KMnO<sub>4</sub>) is a purplish-black crystalline powder that colours everything it touches, through a strong oxidising action. This includes staining "stainless" steel, which somewhat limits its use and makes it necessary to use plastic or glass containers.  It is used to disinfect [[aquarium]]s and is  used in some community swimming pools as a foot disinfectant before entering the pool. Typically, a large shallow basin of KMnO<sub>4</sub> / water solution is kept near the pool ladder. Participants are required to step in the basin and then go into the pool. Additionally, it is widely used to disinfect community water ponds and wells in tropical countries, as well as to disinfect the mouth before pulling out teeth. It can be applied to wounds in dilute solution.

=== Peroxy and peroxo acids ===
[[Peroxy acid|Peroxycarboxylic acids and inorganic peroxo acids]] are strong oxidants and extremely effective disinfectants.{{cn|date=June 2022}}
* [[Peroxyformic acid]]
* [[Peracetic acid]]
* [[Peroxypropionic acid]]
* [[Monoperoxyglutaric acid]]
* [[Monoperoxysuccinic acid]]
* [[Peroxybenzoic acid]]
* [[Peroxyanisic acid]]
* [[meta-Chloroperoxybenzoic acid|Chloroperbenzoic acid]]
* [[Monoperoxyphthalic acid]]
* [[Peroxymonosulfuric acid]]

===Phenolics===
[[Phenols|Phenolics]] are active ingredients in some household disinfectants. They are also found in some mouthwashes and in disinfectant soap and handwashes. Phenols are toxic to cats<ref>{{cite web|url=http://www.peteducation.com/article.cfm?c=2+1677&aid=2243|title=Phenol and Phenolic Poisoning in Dogs and Cats|website=peteducation.com|url-status=live|archive-url=https://web.archive.org/web/20160919033206/http://www.peteducation.com/article.cfm?c=2+1677&aid=2243|archive-date=19 September 2016|df=dmy-all}}</ref> and newborn humans<ref>{{cite web|url=https://toxnet.nlm.nih.gov/cgi-bin/sis/search/a?dbs+hsdb:@term+@DOCNO+113|title=PHENOL - National Library of Medicine HSDB Database|website=toxnet.nlm.nih.gov|url-status=live|archive-url=https://web.archive.org/web/20171201031619/https://toxnet.nlm.nih.gov/cgi-bin/sis/search/a?dbs+hsdb:@term+@DOCNO+113|archive-date=1 December 2017|df=dmy-all}}</ref>
* [[Phenol]] is probably the oldest known disinfectant as it was first used by [[Joseph Lister, 1st Baron Lister|Lister]], when it was called carbolic acid. It is rather corrosive to the skin and sometimes toxic to sensitive people. Impure preparations of phenol were originally made from [[coal tar]], and these contained low concentrations of other [[aromatic hydrocarbon]]s including [[benzene]], which is an [[International Agency for Research on Cancer|IARC]] [[List of IARC Group 1 carcinogens|Group 1]] [[carcinogen]].
* [[2-Phenylphenol|''o''-Phenylphenol]] is often used instead of [[phenol]], since it is somewhat less corrosive.
* [[Chloroxylenol]] is the principal ingredient in [[Dettol]], a household disinfectant and [[antiseptic]].
* [[Hexachlorophene]] is a phenolic that was once used as a germicidal additive to some household products but was banned due to suspected harmful effects.
* [[Thymol]], derived from the herb thyme, is the active ingredient in some "broad spectrum" disinfectants that often bear ecological claims. It is used as a stabilizer in pharmaceutic preparations. It has been used for its antiseptic, antibacterial, and antifungal actions, and was formerly used as a vermifuge.<ref name="nih.gov">{{cite web|url=https://pubchem.ncbi.nlm.nih.gov|title=The PubChem Project|website=pubchem.ncbi.nlm.nih.gov|url-status=live|archive-url=https://web.archive.org/web/20140808222031/http://pubchem.ncbi.nlm.nih.gov/|archive-date=8 August 2014|df=dmy-all}}</ref>
* [[Amylmetacresol]] is found in [[Strepsils]], a throat disinfectant.
* Although not a phenol, [[2,4-dichlorobenzyl alcohol]] has similar effects as phenols, but it cannot inactivate viruses.

===Quaternary ammonium compounds===

[[Quaternary ammonium compounds]] ("quats"), such as [[benzalkonium chloride]], are a large group of related compounds. Some concentrated formulations have been shown to be effective low-level disinfectants. Quaternary ammonia at or above 200ppm plus alcohol solutions exhibit efficacy against difficult to kill non-enveloped viruses such as [[norovirus]], [[rotavirus]], or [[polio virus]].<ref name="cdc.gov"/>  Newer synergous, low-alcohol formulations are highly effective broad-spectrum disinfectants with quick contact times (3–5 minutes) against bacteria, enveloped viruses, pathogenic fungi, and [[mycobacteria]].  Quats are biocides that also kill algae and are used as an additive in large-scale industrial water systems to minimize undesired biological growth.{{cn|date=June 2022}}

=== Inorganic compounds ===
==== Chlorine ====
This group comprises aqueous solution of [[chlorine]], [[hypochlorite]], or [[hypochlorous acid]]. Occasionally, chlorine-releasing compounds and their salts are included in this group. Frequently, a concentration of < 1 ppm of available chlorine is sufficient to kill bacteria and viruses, spores and mycobacteria requiring higher concentrations.
Chlorine has been used for applications, such as the deactivation of pathogens in drinking water, swimming pool water and wastewater, for the disinfection of household areas and for textile bleaching<ref>{{Cite web|url=https://www.lenntech.com/processes/disinfection/chemical/disinfectants-chlorine.htm|title=chlorine as disinfectant for water|website=lenntech.com|access-date=2019-12-12}}</ref>
* [[Sodium hypochlorite]]
* [[Calcium hypochlorite]]
* [[Monochloramine]]
* [[Chloramine-T]]
* [[Trichloroisocyanuric acid]]
* [[Chlorine dioxide]]
* [[Hypochlorous acid]]

==== Iodine ====
* [[Iodine]]
* [[Iodophor]]s

==== Acids and bases ====
* [[Sodium hydroxide]]
* [[Potassium hydroxide]]
* [[Calcium hydroxide]]
* [[Magnesium hydroxide]]
* [[Sulfurous acid]]
* [[Sulfur dioxide]]
* [[phosphoric acid]]<ref name="starsan">{{cite web |title=Star San Safety Data Sheet |url=https://fivestarchemicals.com/mwdownloads/download/link/id/455/ |website=Five Star Chemicals |publisher=Five Star Chemicals & Supply, LLC. |access-date=31 October 2021}}</ref>
* [[dodecylbenzenesulfonic acid]]<ref name="starsan" />

====Metals====
{{main|Oligodynamic effect}}Most metals, especially those with high atomic weights can inhibit the growth of pathogens by disrupting their metabolism.{{cn|date=May 2024}}

=== Terpenes ===
* [[Thymol]]
* [[Pine oil]]

===Other===
The [[biguanide]] [[polymer]] [[polyaminopropyl biguanide]] is specifically bactericidal at very low concentrations (10&nbsp;mg/L). It has a unique method of action: The polymer strands are incorporated into the bacterial cell wall, which disrupts the membrane and reduces its permeability, which has a lethal effect to bacteria. It is also known to bind to bacterial DNA, alter its transcription, and cause lethal DNA damage.<ref>{{cite journal | vauthors = Allen MJ, White GF, Morby AP | title = The response of Escherichia coli to exposure to the biocide polyhexamethylene biguanide | journal = Microbiology | volume = 152 | issue = Pt 4 | pages = 989–1000 | date = April 2006 | pmid = 16549663 | doi = 10.1099/mic.0.28643-0 | doi-access = free }}</ref> It has very low toxicity to higher organisms such as human cells, which have more complex and protective membranes.

Common [[sodium bicarbonate]] (NaHCO<sub>3</sub>) has antifungal properties,<ref>{{cite journal | vauthors = Zamani M, Sharifi Tehrani A, Ali Abadi AA | title = Evaluation of antifungal activity of carbonate and bicarbonate salts alone or in combination with biocontrol agents in control of citrus green mold | journal = Communications in Agricultural and Applied Biological Sciences | volume = 72 | issue = 4 | pages = 773–777 | year = 2007 | pmid = 18396809 }}</ref> and some antiviral and antibacterial properties,<ref>{{cite journal | vauthors = Malik YS, Goyal SM | title = Virucidal efficacy of sodium bicarbonate on a food contact surface against feline calicivirus, a norovirus surrogate | journal = International Journal of Food Microbiology | volume = 109 | issue = 1–2 | pages = 160–163 | date = May 2006 | pmid = 16540196 | doi = 10.1016/j.ijfoodmicro.2005.08.033 }}</ref> though those are too weak to be effective at a home environment.<ref>{{cite journal | vauthors = Rutala WA, Barbee SL, Aguiar NC, Sobsey MD, Weber DJ | title = Antimicrobial activity of home disinfectants and natural products against potential human pathogens | journal = Infection Control and Hospital Epidemiology | volume = 21 | issue = 1 | pages = 33–38 | date = January 2000 | pmid = 10656352 | doi = 10.1086/501694 | publisher = The University of Chicago Press on behalf of The Society for Healthcare Epidemiology of America | s2cid = 34461187 | jstor = 10 }}</ref>

===Non-chemical===
[[Ultraviolet germicidal irradiation]] is the use of high-intensity shortwave [[ultraviolet light]] for disinfecting smooth surfaces such as dental tools, but not porous materials that are opaque to the light such as wood or foam. Ultraviolet light is also used for municipal [[water treatment]]. Ultraviolet light fixtures are often present in [[microbiology]] labs, and are activated only when there are no occupants in a room (e.g., at night).{{cn|date=May 2024}}

Heat treatment can be used for disinfection and sterilization.<ref>{{Cite web | url = https://ehs.research.uiowa.edu/87-heat-disinfection-and-sterilization | title = Heat Disinfection and Sterilization | publisher = [[University of Iowa]], Environmental Health & Safety | url-status = live | archive-url = https://web.archive.org/web/20170108190620/https://ehs.research.uiowa.edu/87-heat-disinfection-and-sterilization | archive-date = 8 January 2017 | df = dmy-all }}</ref>

{{anchor|Sunlight}}The phrase "sunlight is the best disinfectant" was [[Other People's Money and How the Bankers Use It|popularized in 1913]] by [[United States Supreme Court]] Justice [[Louis Brandeis]]<ref>{{cite journal | url = https://ia904606.us.archive.org/17/items/sim_harpers-weekly_1913-12-20_58_2974/sim_harpers-weekly_1913-12-20_58_2974.pdf | vauthors = Brandeis LD | date = December 1913 | title = What Publicity Can Do | journal = Harper's Weekly | volume = 58 | issue = 2974 | pages = 10–13 }}</ref> and later advocates of [[government transparency]]. While sunlight's ultraviolet rays can act as a disinfectant, the Earth's [[ozone layer]] blocks the rays' most effective wavelengths. Ultraviolet light-emitting machines, such as those used to disinfect some hospital rooms, make for better disinfectants than sunlight.<ref>{{Cite news | vauthors = McCarthy C |title=Is Sunlight Actually the Best Disinfectant? |work=Slate |date=9 August 2013 |url=http://www.slate.com/articles/health_and_science/explainer/2013/08/sunlight_is_the_best_disinfectant_not_exactly.html |issn=1091-2339 |df=mdy-all |url-status=live |archive-url=https://web.archive.org/web/20170305042551/http://www.slate.com/articles/health_and_science/explainer/2013/08/sunlight_is_the_best_disinfectant_not_exactly.html |archive-date=5 March 2017 }}</ref>

Since the mid-1990s [[cold plasma]] has been shown to be an efficient sterilization/disinfection agent.<ref>{{cite journal | vauthors = Laroussi M | title = Sterilization of contaminated matter with an atmospheric pressure plasma. | journal = IEEE Transactions on Plasma Science | date = June 1996 | volume = 24 | issue = 3 | pages = 1188–1191 | doi = 10.1109/27.533129 | bibcode = 1996ITPS...24.1188L }}</ref><ref>{{cite journal | vauthors = Laroussi M | title = Low temperature plasma-based sterilization: overview and state-of-the-art.| journal = Plasma Processes and Polymers | date = June 2005 | volume = 2 | issue = 5 | pages = 391–400 | doi = 10.1002/ppap.200400078 }}</ref> Cold plasma is an ionized gas that remains at room temperature. It generates reactive oxygen and reactive nitrogen species that interact with bacterial wall and membrane and cause oxidation of the lipids and proteins and can also lyse the cells. Cold plasma can inactivate bacteria, viruses, and fungi.

==Electrostatic disinfection==

There has been a rise in the use of electrostatic disinfectants in recent years.<ref>{{cite news |title=Demand For Commercial Electrostatic Spraying Services On The Rise | work = CleanLink |url=https://www.cleanlink.com/news/article/Demand-For-Commercial-Electrostatic-Spraying-Services-On-The-Rise--25818 |access-date=10 March 2022}}</ref> Electrostatic disinfection is a process achieved by use of electrostatic sprayers notable examples of which include the [[Vycel]] -Vycel 4 or the [[Techtronics]] Ryobi. Electrostatic Sprayers are a new technology for disinfecting surfaces. Unlike conventional spraying bottles or devices [[electrostatic sprayers]] apply a positive ionic charge to liquid disinfectants as they pass through the nozzle of the device. The positively charged disinfectant distributed through the nozzle of an electrostatic sprayer is attracted to negatively charged surfaces, which allows for efficient coating of disinfectant solutions on to hard nonporous surfaces.<ref>{{cite news | vauthors = Boylston D | date = 8 August 2024 |title=Electrostatic Sprayers: How Do They Work? | work = Sylvane |url=https://www.sylvane.com/how-do-electrostatic-sprayers-work.html |access-date=10 March 2022}}</ref> There are a number of specific disinfectants designed for use with electrostatic sprayers and these are often dissolved in solution or diluted with water. Notable disinfectant sprays that are designed for use with electrostatic sprayers include Citrox Disinfectant Solution and Vital Oxide Disinfectant Solution.{{cn|date=June 2022}}

== Health and safety concerns ==

=== Production ===
Individuals who work manufacturing disinfectants have higher exposure to the raw and harsh chemicals used in the production of disinfectants compared to the general population.<ref name=":2" /> This is due to the use of manual labor and automated machinery.<ref name=":14">{{Cite web |last=Showalter |first=Donna |title=Lysol |url=https://storymaps.arcgis.com/stories/90fa1c184d6840f29ae524d90d8c9af5}}</ref> However, the use of automated machinery does not dismiss any direct contact with the chemicals within the production of disinfectants.<ref name=":14" /><ref name=":15" /> Chemicals used in disinfectants vary in forms, such as gel, liquid, and powder.<ref name=":13">{{Cite web |last=CDC |title=Chemical Disinfectants |url=https://www.cdc.gov/infection-control/hcp/disinfection-sterilization/chemical-disinfectants.html}}</ref><ref name=":8">{{Cite web |last=University of Utah: Environmental Health and Safety |title=Fact Sheet: Chemical Disinfectants |url=https://ibc.utah.edu/_resources/documents/fact-sheets-and-sops/chemical-disinfectants_fact-sheet_2-26-21.pdf}}</ref> Minimal information remains about the health and safety of workers in other sectors of the production and manufacturing process of disinfectants. Inspection is a process of disinfectant manufacturing that only requires human intervention.<ref name=":14" /> Many workers in the inspection phase of mass production of disinfectants have reported accidental inhalation of fumes, direct dermal contact, eye irritation, and accidental ingestion of disinfectant substances.<ref name=":2" /><ref name=":8" /> Studies have shown reports of workers with short-term neurological impairments,<ref>{{Cite journal |last=Zeliger |first=Harold |date=2013 |title="Exposure to lipophilic chemicals as a cause of neurological impairments, neurodevelopmental disorders and neurodegenerative diseases." |journal=Interdisciplinary Toxicology |volume=6 |issue=3 |pages=103–110 |doi=10.2478/intox-2013-0018 |pmid=24678247 |pmc=3967436 }}</ref> dermal hypersensitivity,<ref name=":5" /> skin irritation,<ref name=":5" /><ref name=":2" /> chemical burns,<ref name=":5" /><ref name=":2" /> [[dermatitis]],<ref name=":5" /><ref name=":2" /> [[occupational asthma]] and work-related asthma,<ref name=":1" /><ref name=":9">{{Cite web |last=CDC |title=Asthma |url=https://www.cdc.gov/niosh/asthma/about/index.html}}</ref><ref>{{Cite web |last=Occupational Health Branch California Department of Public Health |title=Disinfectants and Work-Related Asthma |url=https://www.cdph.ca.gov/Programs/CCDPHP/DEODC/OHB/WRAPP/CDPH%20Document%20Library/DisinfectantsWRAWorkers.pdf}}</ref> mucus membrane (nasal)<ref name=":6">{{Cite web |last=Chemical Safety Facts |title=Quaternary Ammonium Compounds (Quats) |url=https://www.chemicalsafetyfacts.org/chemicals/quaternary-ammonium-compounds/#:~:text=Exposure%20to%20Quats,exposure%20may%20cause%20asthma%20symptoms.}}</ref> and lung irritation,<ref name=":2" /> and some types of cancer after direct and consistent contact with disinfectants.<ref name=":10">{{Cite journal |last=Shi |first=Jingyi |date=2024 |title="Exposure to disinfection by-products and risk of cancer: A systematic review and dose-response meta-analysis." |journal=Ecotoxicology and Environmental Safety |volume=270 |doi=10.1016/j.ecoenv.2023.115925 |pmid=38183752 |bibcode=2024EcoES.27015925S |url=https://www.sciencedirect.com/science/article/pii/S014765132301429X#:~:text=Disinfection%20by%2Dproduct%20exposure%20is,under%20the%20same%20trihalomethane%20exposure.|doi-access=free }}</ref><ref name=":4" /> 

The chemicals, quaternary ammonium compounds (QACs)<ref name=":2" /><ref name=":8" />[[Phenols|, phenolic compounds]],<ref name=":8" /> [[Iodophor|iodophors]],<ref name=":8" /> [[glutaraldehyde]],<ref name=":8" /> alcohols,<ref name=":8" /> and chlorine,<ref name=":8" /> were most associated with the previous health effects.<ref name=":13" /><ref name=":8" /><ref name=":9" /><ref name=":4" /><ref name=":6" /><ref name=":2" /><ref name=":5" /> This evidence of dermal exposure was associated with the misuse or lack of Personal Protective Equipment (PPE).<ref name=":10" /><ref name=":11">{{Cite web |last=OSHA |title=Person Protective Equipment |url=https://www.osha.gov/personal-protective-equipment}}</ref><ref name=":7" /> Cancer has been shown to only develop in consistent exposure, along with the lack of use of Personal Protective Equipment (PPE).<ref name=":10" /> Among these numerous health effects, evidence showed that dermal exposure was more hazardous than inhalation.<ref name=":13" /><ref name=":12">{{Cite web |last=OSHA |title=Dermal Exposure |url=https://www.osha.gov/dermal-exposure}}</ref> These health effects can be minimized with the implementation of guidelines from the CDC, NPIC, OSHA, and NIOSH.<ref name=":13" /><ref>{{Cite web |last=CDC |title=About Advanced Manufacturing |url=https://www.cdc.gov/niosh/manufacturing/about/index.html}}</ref><ref name=":7">{{Cite journal |last=Min |first=Gihong |date=2024 |title="Potential health risks to disinfection workers from exposure to active substances in COVID-19 biocidal products." |journal=Heliyon |volume=10 |issue=7 |pages=e28249 |doi=10.1016/j.heliyon.2024.e28249 |doi-access=free |pmid=38596037 |bibcode=2024Heliy..1028249M |pmc=11002044 }}</ref><ref name=":12" /><ref name=":11" /><ref name=":15">{{Cite web |last=National Pesticide Information Center |title=Disinfectant Safety for Workers |url=https://npic.orst.edu/health/workerdisinfect.html}}</ref>

=== Healthcare Settings ===
There is evidence that exposure to cleaning and disinfectant products can cause acute health effects on healthcare workers.<ref name="Quinn_2015">{{cite journal | vauthors = Quinn MM, Henneberger PK, Braun B, Delclos GL, Fagan K, Huang V, Knaack JL, Kusek L, Lee SJ, Le Moual N, Maher KA, McCrone SH, Mitchell AH, Pechter E, Rosenman K, Sehulster L, Stephens AC, Wilburn S, Zock JP | title = Cleaning and disinfecting environmental surfaces in health care: Toward an integrated framework for infection and occupational illness prevention | journal = American Journal of Infection Control | volume = 43 | issue = 5 | pages = 424–434 | date = May 2015 | pmid = 25792102 | doi = 10.1016/j.ajic.2015.01.029 | publication-date = 2015 }}</ref> Observed effects include eye irritation and watery eyes,<ref name="Mehler_2010">{{Cite journal | vauthors = Mehler L, Schwartz A, Diebolt-Brown B, Badakhsh R, Calvert G, Lee S |date=2010 |title=Acute Antimicrobial Pesticide-Related Illnesses Among Workers in Health-Care Facilities—California, Louisiana, Michigan, and Texas, 2002-2007 |journal=JAMA: The Journal of the American Medical Association |volume=304 |issue=2 |pages=152–154 | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5918a2.htm }}</ref><ref name=":0">{{Cite journal |last1=Casey |first1=Megan L. |last2=Hawley |first2=Brie |last3=Edwards |first3=Nicole |last4=Cox-Ganser |first4=Jean M. |last5=Cummings |first5=Kristin J. |date=October 2017 |title=Health problems and disinfectant product exposure among staff at a large multispecialty hospital |journal=American Journal of Infection Control |volume=45 |issue=10 |pages=1133–1138 |doi=10.1016/j.ajic.2017.04.003 |issn=0196-6553 |pmc=5685540 |pmid=28549881}}</ref> headaches,<ref name="Mehler_2010" /> dizziness,<ref name="Mehler_2010" /> throat irritation and wheezing,<ref name="Mehler_2010" /><ref name="Quinn_2015" /><ref name=":0" /> skin irritation,<ref name="Mehler_2010" /> and work-related asthma.<ref name="Arif_2012">{{cite journal | vauthors = Arif AA, Delclos GL | title = Association between cleaning-related chemicals and work-related asthma and asthma symptoms among healthcare professionals | journal = Occupational and Environmental Medicine | volume = 69 | issue = 1 | pages = 35–40 | date = January 2012 | pmid = 21602538 | doi = 10.1136/oem.2011.064865 }}</ref><ref name="Mehler_2010" /><ref name="Quinn_2015" /> Most of these have a low severity.<ref name="Mehler_2010" /> Some chemicals in cleaning and disinfectants that have been associated with health impacts include chlorine,<ref name="Quinn_2015" /> ammonia,[2]<ref name="Quinn_2015" /> ethanolamine,<ref name="Quinn_2015" /> 2-butoxyethanol,<ref name="Quinn_2015" /> quaternary ammonium compounds (QACs),<ref name="Mehler_2010" /><ref name="Quinn_2015" /> and [[bleach]].<ref name="Arif_2012" /><ref name="Mehler_2010" /><ref name="Quinn_2015" /> 

The adverse health impacts of disinfectants are still not well studied, which makes it difficult to develop guidelines for use in healthcare settings that take mind of potential effects.<ref name="Quinn_2015" /> There is also little information about how effective and safe alternative cleaning technology, so-called “green cleaning,” is.<ref name="Quinn_2015" /> New guidelines would need to maintain high hygiene standards and prevent healthcare-associated infections.<ref name="Quinn_2015" />

=== Professional Cleaning and Commercial Use ===
Professional and Industrial cleaners, despite being essential in maintaining hygiene and safety are one of the understudied occupational groups. Continuous exposure to cleaning agents containing ethanolamine,<ref name=":1">{{Cite journal |last1=Ahmed |first1=Amani Shawki |last2=Ibrahim |first2=Dalia Anas |last3=Hassan |first3=Tarek Hamdy |last4=Abd-El-Azem |first4=Wael Galal |date=2022-05-01 |title=Prevalence and predictors of occupational asthma among workers in detergent and cleaning products industry and its impact on quality of life in El Asher Men Ramadan, Egypt |journal=Environmental Science and Pollution Research |language=en |volume=29 |issue=23 |pages=33901–33908 |doi=10.1007/s11356-022-18558-8 |issn=1614-7499 |pmc=8761047 |pmid=35034305|bibcode=2022ESPR...2933901A }}</ref> chloramine-T,<ref name=":1" /> and Quaternary Ammonium Compounds (QACs)<ref name=":2">{{Cite journal |last1=Arnold |first1=William A. |last2=Blum |first2=Arlene |last3=Branyan |first3=Jennifer |last4=Bruton |first4=Thomas A. |last5=Carignan |first5=Courtney C. |last6=Cortopassi |first6=Gino |last7=Datta |first7=Sandipan |last8=DeWitt |first8=Jamie |last9=Doherty |first9=Anne-Cooper |last10=Halden |first10=Rolf U. |last11=Harari |first11=Homero |last12=Hartmann |first12=Erica M. |last13=Hrubec |first13=Terry C. |last14=Iyer |first14=Shoba |last15=Kwiatkowski |first15=Carol F. |date=2023-05-23 |title=Quaternary Ammonium Compounds: A Chemical Class of Emerging Concern |journal=Environmental Science & Technology |language=en |volume=57 |issue=20 |pages=7645–7665 |doi=10.1021/acs.est.2c08244 |issn=0013-936X |pmc=10210541 |pmid=37157132|bibcode=2023EnST...57.7645A }}</ref> was found to cause Occupational Asthma (OA) in cleaners.<ref name=":1" /> QAC was also found to be involved in developing antimicrobial resistance. Symptoms reported were dyspnea, cough, and wheezing. Females had more risk of acquiring OA due to higher exposures both at home and work.<ref name=":2" /><ref name=":3">{{Cite journal |last1=Makela |first1=R. |last2=Kauppi |first2=P. |last3=Suuronen |first3=K. |last4=Tuppurainen |first4=M. |last5=Hannu |first5=T. |date=2011-03-01 |title=Occupational asthma in professional cleaning work: a clinical study |url=https://academic.oup.com/occmed/article-lookup/doi/10.1093/occmed/kqq192 |journal=Occupational Medicine |language=en |volume=61 |issue=2 |pages=121–126 |doi=10.1093/occmed/kqq192 |pmid=21285030 |issn=0962-7480|url-access=subscription }}</ref> Exposures happen through dermal contact, hand-to-mouth, and inhalation of aerosolized quats. Researchers suggest continuous use of Personal Protective Equipment (PPE), periodic medical examinations, and guidelines on how to handle chemicals.<ref name=":3" />

Dermal, respiratory, immune, reproductive, and developmental effects of exposure are investigated but there is a currently limited scope of this study. Other concerns found were its impact on wastewater management, soil, and food especially in dissolved concentrations.<ref name=":3" /> In the United States, the Environmental Protection Agency (EPA), and Food and Drug Administration (FDA) regulate QACs depending on their intended purposes. Stricter regulations and policies are warranted for safer use and search for alternatives to limit exposures.<ref name=":3" />

== See also ==
* [[Drug resistance]]
* [[Diethylene glycol]] - a raw material for air [[sanitation]]
* [[Hand sanitizer]]
* [[Hygiene]]
* [[List of cleaning products]]
* [[Sanitation Standard Operating Procedures]]
* [[Virucide]]

== References ==
{{Reflist|30em}}

== Further reading ==
{{refbegin}}
* {{cite journal | vauthors = Ahmed AS, Ibrahim DA, Hassan TH, Abd-El-Azem WG | title = Prevalence and predictors of occupational asthma among workers in detergent and cleaning products industry and its impact on quality of life in El Asher Men Ramadan, Egypt | journal = Environmental Science and Pollution Research International | volume = 29 | issue = 23 | pages = 33901–33908 | date = May 2022 | pmid = 35034305 | pmc = 8761047 | doi = 10.1007/s11356-022-18558-8 | bibcode = 2022ESPR...2933901A }}
* {{cite journal | vauthors = Arnold WA, Blum A, Branyan J, Bruton TA, Carignan CC, Cortopassi G, Datta S, DeWitt J, Doherty AC, Halden RU, Harari H, Hartmann EM, Hrubec TC, Iyer S, Kwiatkowski CF, LaPier J, Li D, Li L, Muñiz Ortiz JG, Salamova A, Schettler T, Seguin RP, Soehl A, Sutton R, Xu L, Zheng G | title = Quaternary Ammonium Compounds: A Chemical Class of Emerging Concern | journal = Environmental Science & Technology | volume = 57 | issue = 20 | pages = 7645–7665 | date = May 2023 | pmid = 37157132 | pmc = 10210541 | doi = 10.1021/acs.est.2c08244 | bibcode = 2023EnST...57.7645A }}
* {{cite journal | vauthors = Mäkelä R, Kauppi P, Suuronen K, Tuppurainen M, Hannu T | title = Occupational asthma in professional cleaning work: a clinical study | journal = Occupational Medicine | volume = 61 | issue = 2 | pages = 121–126 | date = March 2011 | pmid = 21285030 | doi = 10.1093/occmed/kqq192 }}
* {{cite journal | vauthors = Soule H, Duc DL, Mallaret MR, Chanzy B, Charvier A, Gratacap-Cavallier B, Morand P, Seigneurin JM | title = [Virus resistance in a hospital environment: overview of the virucide activity of disinfectants used in liquid form] | language = fr | journal = Annales de Biologie Clinique | volume = 56 | issue = 6 | pages = 693–703 | date = Nov–Dec 1998 | pmid = 9853028 }}
* {{cite book | editor = Sandle, T. | title = The CDC Handbook: A Guide to Cleaning and Disinfecting Cleanrooms  | edition = 1st | publisher = Grosvenor House Publishing Limited | year = 2012 | isbn = 978-1781487686}}
{{refend}}

== External links ==
* [https://web.archive.org/web/20100724144955/http://www.mansfield.ohio-state.edu/~sabedon/black12.htm Ohio State University lecture on Sterilization and Disinfection]
* [http://www.housekeepingchannel.com/showarticle.php?id=253 What Germs Are We Killing? Testing and Classifying Disinfectants]
* [https://web.archive.org/web/20090823195546/http://www.bccdc.org/downloads/pdf/epid/reports/CDManual_DisinfectntSelectnGuidelines_sep2003_nov05-03.pdf Disinfectant Selection Guide]
* [http://www.newton.dep.anl.gov/askasci/chem03/chem03856.htm Disinfectant and Non-Chlorine Bleach] {{Webarchive|url=https://web.archive.org/web/20100601163950/http://www.newton.dep.anl.gov/askasci/chem03/chem03856.htm |date=1 June 2010 }}—Office of DOE Science Education
* [http://www.wien.gv.at/english/environment/protection/oekokauf/disinfectants/index.html The Viennese Database for Disinfectants (WIDES Database)]
* [https://www.cdc.gov/niosh/cleaning-custodial-services/about/index.html Cleaning and Custodial Services and Your Safety], by the [[National Institute for Occupational Safety and Health]]

{{Antiseptics and disinfectants}}

{{Authority control}}

[[Category:Disinfectants| ]]
[[Category:Hygiene]]
[[Category:Bactericides]]
[[Category:Occupational safety and health]]