Disinfectant

The Australian Therapeutic Goods Order No. 54 defines several grades of disinfectant as will be used below.{{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}} 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].

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 means a disinfectant that rapidly kills most vegetative bacteria as well as medium-sized 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 nonlipid viruses.{{cn|date=November 2023}}

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 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 disinfectant means:

1. a disinfectant which is used to reprocess reusable therapeutic devices; and
2. when associated with the words "low", "intermediate" or "high" means "low", "intermediate" or "high" level disinfectant respectively.

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}}

1. in premises used for:
2. * the investigation or treatment of a disease, ailment or injury; or
3. * procedures that are carried out involving the penetration of the human skin; or,
4. in connection with:
5. * the business of beauty therapy or hairdressing; or
6. * the practice of podiatry;

but does not include :

1. Instrument grade disinfectants; or
2. sterilant; or
3. an antibacterial clothes preparation; or
4. a sanitary fluid; or
5. a sanitary powder; or
6. a sanitiser.

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}}

1. an antibacterial clothes preparation; or
2. a sanitary fluid; or
3. a sanitary powder; or
4. a sanitiser

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 > 1. Those that are less effective have a coefficient < 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.{{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}}

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."{{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 |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 }}

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.{{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 }} 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.{{cite journal | vauthors = García MR, Cabo ML | title = Optimization of E. coli 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 }}

A perfect disinfectant would also offer complete and full microbiological 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 reactions can occur.{{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 }} 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).{{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 }}

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 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 boards and worktops in the home with bactericidal chemicals.{{Citation needed|date=December 2012}}

{{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.{{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 }} An air disinfectant must be dispersed either as an aerosol or vapour 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 using various glycols, principally propylene glycol and triethylene glycol.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 }} In principle, these chemical substances are ideal air disinfectants because they have both high lethality to microorganisms and low mammalian toxicity.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}}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 = }}

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.{{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 }}{{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 }}

{{see also|Hand sanitizer}}

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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.{{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 }} Alcohols are most effective when combined with distilled water to facilitate diffusion through the cell membrane; 100% alcohol typically denatures only external membrane proteins.{{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 }} 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.{{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 }} 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).{{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 }}{{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 }}

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 (C.Diff) spores with higher concentrations of ethanol and dodecanoic acid, which proved effective with a contact time of ten minutes.{{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}}

Aldehydes, 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 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 hospitals 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.
• Hydrogen peroxide vapor is used as a 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 OSHA permissible exposure limit is 1 ppm (29 CFR 1910.1000 Table Z-1) calculated as an eight-hour time weighted average and the NIOSH immediately dangerous to life and health limit is 75 ppm.{{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 }} 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 surfactants 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 endoscopes.{{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 }} 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.{{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 }}
• 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 organochlorides 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 (KMnO₄) 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 aquariums and is used in some community swimming pools as a foot disinfectant before entering the pool. Typically, a large shallow basin of KMnO₄ / 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.

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
• Chloroperbenzoic acid
• Monoperoxyphthalic acid
• Peroxymonosulfuric acid

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{{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}} and newborn humans{{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}}

• Phenol is probably the oldest known disinfectant as it was first used by 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 hydrocarbons including benzene, which is an IARC Group 1 carcinogen.
• 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.{{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}}
• 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 ("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. 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}}

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{{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}}

• Sodium hypochlorite
• Calcium hypochlorite
• Monochloramine
• Chloramine-T
• Trichloroisocyanuric acid
• Chlorine dioxide
• Hypochlorous acid

• Iodine
• Iodophors

• Sodium hydroxide
• Potassium hydroxide
• Calcium hydroxide
• Magnesium hydroxide
• Sulfurous acid
• Sulfur dioxide
• phosphoric acid{{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}}
• dodecylbenzenesulfonic acid

{{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}}

• Thymol
• Pine oil

The biguanide polymer polyaminopropyl biguanide is specifically bactericidal at very low concentrations (10 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.{{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 }} It has very low toxicity to higher organisms such as human cells, which have more complex and protective membranes.

Common sodium bicarbonate (NaHCO₃) has antifungal properties,{{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 }} and some antiviral and antibacterial properties,{{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 }} though those are too weak to be effective at a home environment.{{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 }}

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.{{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 }}

{{anchor|Sunlight}}The phrase "sunlight is the best disinfectant" was popularized in 1913 by United States Supreme Court Justice Louis Brandeis{{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 }} 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.{{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 }}

Since the mid-1990s cold plasma has been shown to be an efficient sterilization/disinfection agent.{{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 }}{{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 }} 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.

There has been a rise in the use of electrostatic disinfectants in recent years.{{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}} 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.{{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}} 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}}

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. This is due to the use of manual labor and automated machinery.{{Cite web |last=Showalter |first=Donna |title=Lysol |url=https://storymaps.arcgis.com/stories/90fa1c184d6840f29ae524d90d8c9af5}} However, the use of automated machinery does not dismiss any direct contact with the chemicals within the production of disinfectants. Chemicals used in disinfectants vary in forms, such as gel, liquid, and powder.{{Cite web |last=CDC |title=Chemical Disinfectants |url=https://www.cdc.gov/infection-control/hcp/disinfection-sterilization/chemical-disinfectants.html}}{{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}} 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. 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. Studies have shown reports of workers with short-term neurological impairments,{{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 }} dermal hypersensitivity, skin irritation, chemical burns, dermatitis, occupational asthma and work-related asthma,{{Cite web |last=CDC |title=Asthma |url=https://www.cdc.gov/niosh/asthma/about/index.html}}{{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}} mucus membrane (nasal){{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.}} and lung irritation, and some types of cancer after direct and consistent contact with disinfectants.{{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 }}

The chemicals, quaternary ammonium compounds (QACs), phenolic compounds, iodophors, glutaraldehyde, alcohols, and chlorine, were most associated with the previous health effects. This evidence of dermal exposure was associated with the misuse or lack of Personal Protective Equipment (PPE).{{Cite web |last=OSHA |title=Person Protective Equipment |url=https://www.osha.gov/personal-protective-equipment}} Cancer has been shown to only develop in consistent exposure, along with the lack of use of Personal Protective Equipment (PPE). Among these numerous health effects, evidence showed that dermal exposure was more hazardous than inhalation.{{Cite web |last=OSHA |title=Dermal Exposure |url=https://www.osha.gov/dermal-exposure}} These health effects can be minimized with the implementation of guidelines from the CDC, NPIC, OSHA, and NIOSH.{{Cite web |last=CDC |title=About Advanced Manufacturing |url=https://www.cdc.gov/niosh/manufacturing/about/index.html}}{{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 }}{{Cite web |last=National Pesticide Information Center |title=Disinfectant Safety for Workers |url=https://npic.orst.edu/health/workerdisinfect.html}}

There is evidence that exposure to cleaning and disinfectant products can cause acute health effects on healthcare workers.{{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 }} Observed effects include eye irritation and watery eyes,{{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 }}{{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}} headaches, dizziness, throat irritation and wheezing, skin irritation, and work-related asthma.{{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 }} Most of these have a low severity. Some chemicals in cleaning and disinfectants that have been associated with health impacts include chlorine, ammonia,[2] ethanolamine, 2-butoxyethanol, quaternary ammonium compounds (QACs), and bleach.

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. There is also little information about how effective and safe alternative cleaning technology, so-called “green cleaning,” is. New guidelines would need to maintain high hygiene standards and prevent healthcare-associated infections.

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,{{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 }} chloramine-T, and Quaternary Ammonium Compounds (QACs){{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 }} was found to cause Occupational Asthma (OA) in cleaners. 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.{{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}} 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.

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. 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.

• Drug resistance
• Diethylene glycol - a raw material for air sanitation
• Hand sanitizer
• Hygiene
• List of cleaning products
• Sanitation Standard Operating Procedures
• Virucide

{{Reflist|30em}}

{{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}}

• [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}}

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Category:Hygiene

Category:Bactericides

Category:Occupational safety and health