A comprehensive health effects assessment of the use of sanitizers and disinfectants during COVID-19 pandemic: a global survey

Environ Sci Pollut Res Int. 2023 Jun;30(28):72368-72388. doi: 10.1007/s11356-023-27197-6. Epub 2023 May 11.


COVID-19 has affected all aspects of human life so far. From the outset of the pandemic, preventing the spread of COVID-19 through the observance of health protocols, especially the use of sanitizers and disinfectants was given more attention. Despite the effectiveness of disinfection chemicals in controlling and preventing COVID-19, there are critical concerns about their adverse effects on human health. This study aims to assess the health effects of sanitizers and disinfectants on a global scale. A total of 91,056 participants from 154 countries participated in this cross-sectional study. Information on the use of sanitizers and disinfectants and health was collected using an electronic questionnaire, which was translated into 26 languages via web-based platforms. The findings of this study suggest that detergents, alcohol-based substances, and chlorinated compounds emerged as the most prevalent chemical agents compared to other sanitizers and disinfectants examined. Most frequently reported health issues include skin effects and respiratory effects. The Chi-square test showed a significant association between chlorinated compounds (sodium hypochlorite and per-chlorine) with all possible health effects under investigation (p-value <0.001). Examination of risk factors based on multivariate logistic regression analysis showed that alcohols and alcohols-based materials were associated with skin effects (OR, 1.98; 95%CI, 1.87-2.09), per-chlorine was associated with eye effects (OR, 1.83; 95%CI, 1.74-1.93), and highly likely with itching and throat irritation (OR, 2.00; 95%CI, 1.90-2.11). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92-2.44). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92-2.44). The use of sodium hypochlorite and per-chlorine also had a high chance of having respiratory effects. The findings of the current study suggest that health authorities need to implement more awareness programs about the side effects of using sanitizers and disinfectants during viral epidemics especially when they are used or overused.

Keywords: COVID-19; Health protocols; Sanitizers and disinfectants; Side effects.

MeSH terms

  • Alcohols
  • COVID-19*
  • Chlorides / chemistry
  • Chlorine
  • Cross-Sectional Studies
  • Disinfectants* / chemistry
  • Formaldehyde
  • Humans
  • Pandemics / prevention & control
  • Sodium Hypochlorite / chemistry
  • Surveys and Questionnaires


  • Disinfectants
  • Sodium Hypochlorite
  • Chlorine
  • Chlorides
  • Formaldehyde
  • Alcohols