Brie M. Hawley, PhD, an industrial hygienist in the NIOSH Respiratory Health Division, recommends the following measures to protect healthcare workers exposed to cleaning products with acetic acid, peroxyacetic acid, and hydrogen peroxide:

  • Hospitals should be alert for respiratory, skin, and eye symptoms in environmental services staff.
  • Hospital management can implement a reporting system that would permit employees to report work-related symptoms, with the option for employees who do not wish to be identified to remain anonymous.
  • If environmental services staff do report respiratory, skin, and/or eye symptoms, a combination of engineering and administrative controls might be needed to reduce employee exposures.
  • Additionally, although a one-step disinfectant, virucide, and deodorizer might be considered for widespread use in a hospital, the decision to use disinfectants in specific areas of a healthcare facility should reflect the level of risk of a healthcare-acquired infection.
  • Physicians should be aware of the potential adverse health effects of occupational exposure to cleaning products and disinfectants when evaluating patients with respiratory and skin complaints.1


  1. Hawley, BM. Are Hospital Cleaning Staff at Risk When Using a One-step Cleaner? NIOSH Science Blog. April 29th, 2016: