Scientists recommend eliminating the unnecessary use of quaternary ammonium compounds

The COVID-19 pandemic has boosted the unnecessary use of antimicrobial chemicals linked to health problems, antimicrobial resistance and environmental harm, more than two dozen scientists warn in a peer-reviewed journal Environmental Sciences and Technologies. Their critical review details how quaternary ammonium compounds (QACs) are increasingly sold and used in the home, healthcare, education and workplace despite the availability of safer alternatives and, in some cases, limited evidence of reduced disease transmission.

Disinfectant wipes containing QAC are often used on children’s school desks, hospital examination tables, and in homes where they remain on these surfaces and in the air. Our review of the science suggests that disinfection with these chemicals is in many cases useless or even harmful. We recommend regular cleaning with soap and water and disinfection only when necessary with safer products.”

Courtney Carignan, co-author and assistant professor at Michigan State University

Human studies have found links between QACs and asthma, dermatitis and inflammation. Laboratory animal studies also raise concerns about potential links to infertility, birth defects, and more. Additionally, there is evidence dating back to the 1950s that QACs contribute to antimicrobial resistance, making certain types of bacteria resistant to both the QACs themselves and critical antibiotics.

“It’s ironic that the chemicals we’re using in vain for one health crisis are actually fueling another,” said Erica Hartman, co-author and professor at Northwestern University. “Antimicrobial resistance was already contributing to millions of deaths annually before the pandemic. Excessive disinfection, especially with products containing QAC, threatens to worsen the situation.’

QACs are increasingly used in disinfectant solutions, wipes, hand sanitizers, sprays, and mists, and are also incorporated into personal care products, textiles, paints, medical instruments, and more. Since the pandemic, the levels of these chemicals in the environment and our bodies have increased in parallel.

One of the most common QACs is benzalkonium chloride, but others can be identified on ingredient labels with names that end in “ammonium chloride” or similar. However, QAC disclosure and regulation varies widely. For example, pesticide labels are required to list the QAC, but paint labels are not. Most QACs are not regulated at all, nor are they thoroughly screened for health hazards.

The scientists recommend eliminating the use of QACs that are either unnecessary or where their effectiveness has not been proven. For example, disinfection with QAC often does not benefit from cleaning with ordinary soap and water. Other recommendations include requiring full disclosure of QACs in all products and careful monitoring of their levels in humans and the environment.

“A drastic reduction in many uses of QAC will not spread COVID-19,” said Karol Kwiatkowski, co-author and scientist at the Green Science Policy Institute. “In fact, it will make our homes, classrooms, offices and other shared spaces healthier.”