In 2023, ISSA conducted 54 in-person Cleaning for Health workshops and trained 893 Essential Cleaning Professionals. Dr. Michael A. Berry wrote and published the book “Protecting the Built Environment: Cleaning for Health” in 1993, from which ISSA adopted the curriculum. The program was led by Doug Hoffman, Dave Maurer, Jim Mannes, and Dr. Gavin Macgregor-Skinner and translated into seven languages: Spanish, Portuguese, Korean, Chinese, Arabic, Italian, and Haitian Creole.

Of the 893 workers that attended a workshop:

• Only 13% or 116 workers had received any training in the past five years (2018-2022).
• Many workers reported not having access to personal protective equipment (PPE) such as gloves, eye protection, or designated work clothes.
• The term “handle in accordance with good industrial hygiene and safety practice,” as stated on Product Safety Data Sheets, could not be defined as to what an individual should do.
• 90% or 804 workers could not recall one cleaning ingredient that was in a cleaning product they used at work.

What the professional cleaner should know

Cleaning is the process of removing pollutants from the environment and putting them in their proper place. Its purpose of cleaning is to protect human and animal health and restore and maintain the appearance of property and indoor spaces. If cleaning services are to be professional, we must master a body of knowledge, skills, and behaviors to maintain a healthy and safe built environment and succeed in business. We need to understand cleaning methods and procedures, tools and equipment and products, business and management skills, and the science to justify why we clean the way we do. Professional cleaners must understand how the cleaning products and their ingredients work. The first goal of cleaning should always be to clean for health.

Cleaning products

The use of cleaning products is ubiquitous, with a wide variety of types and formulations available in the market. Based on application type, you can divide cleaning products into general-purpose cleaners and specialty cleaners, such as kitchen cleaners, bathroom cleaners, glass cleaners, carpet cleaners, floor care products, and furniture cleaners.

Always check the product specifications and application instructions before using different cleaning products, as they may contain different chemicals. Also, you should never mix cleaning products unless you can confirm that the mixture is safe and effective, as some mixtures of safe products can become very hazardous.

Ingredients in cleaning products

The ingredients and their concentrations vary greatly from product to product and change rapidly as the available ingredients and consumers’ needs change. The details of product formulation are proprietary information generally not disclosed by the manufacturers. However, if a cleaning product contains hazardous chemicals, it must be accompanied by Material Safety Data that discloses the identity of any hazardous chemicals, health and physical hazards, exposure limits, and precautions.

Most cleaning products rely on basic ingredient elements that include:

• Surfactants allow a product to wet surfaces, emulsify greasy soils, and lift away dirt. The word “surfactant” is a compound word comprised of the words surface, active, and agent.
• Solvents dissolve soils.
• Builders adjust pH to optimize cleaning performance and suspend soils.
• Bleaches oxidize and remove soils and lighten the color of stains.
• Enzymes accelerate the rate of a chemical reaction to break down soils, and specific enzymes can target different soils.
• Chelants bind to positively charged metal ions like calcium and magnesium found in cleaning water. Without the chelant in a cleaning product, more surfactant would be necessary, or the user would have to use more cleaning product.
• Biological additives break down organic soils into smaller particles so that soils are more readily separated and emulsified by surfactants for subsequent removal.
• Preservatives allow the cleaning product to remain usable for several months after production.

Understanding the risks

Cleaning products consist of chemical ingredients. Due to their properties, some chemicals may be, but are not limited to being toxic, explosive, flammable, self-reactive, oxidizing, or corrosive. Exposure to chemicals can occur by different routes, including inhalation, dermal (skin) absorption, or ingestion, and can lead to adverse health effects. There is no comprehensive list of hazardous chemicals. However, exposure to chemicals can damage the lungs, skin, eyes, and mucous membranes, causing allergic reactions, asthma, and cancer.

Employers and workers need to consult and plan appropriately for risks of exposure to chemicals in cleaning products that can potentially be harmful. Risk assessments are not just paper exercises. They are about taking steps to prevent harm and adverse health. You need to know how workers might be exposed and how much. As we learned from the Cleaning for Health workshop attendees, they did not know, BUT they need to know what chemicals are in the cleaning products they use.

Cleaning products, indoor air quality, and health

Cleaning products sometimes contain chemical ingredients listed as asthmagens, carcinogens, reproductive toxins, or toxic air contaminants. They frequently contain identified ingredients of concern like quaternary ammonium chlorides or “quats;” glycols and glycol ethers such as 2-butoxyethanol and ethanolamine; and some alcohols such as benzyl alcohol; ammonia; and chlorinated hydrocarbons.

When applied on surfaces, these chemicals emit volatile components into indoor air during and after cleaning, potentially harming indoor air quality and occupant health. Other factors, such as the physical characteristics of the cleaning product (e.g., aerosols vs. liquids), the type of cleaning tasks (e.g., application rate and procedure), and the ventilation rate of the building, also influence the concentration of VOCs (volatile organic compounds) released from cleaning products in indoor air.

The way the cleaning product is delivered can have a substantial effect on exposure to the chemicals in the product. For instance, aerosol sprays emit larger numbers of much smaller droplets of cleaning product at high velocities, resulting in much greater inhalation exposure to whatever is in the cleaning product. Pump dispensers, in contrast, will emit smaller numbers of larger droplets at a lower velocity.

Besides the primary chemical emissions, constituents in cleaning products can also react with oxidants (such as ozone) in indoor air and produce many other chemicals with adverse effects. For example, terpenes associated with fragrances (such as pinene and limonene) can quickly react with ozone and generate secondary pollutants, including formaldehyde and ultrafine particles.

The most significant health effect potentially caused by inhalation exposure due to the use of cleaning products is the development or exacerbation of respiratory symptoms or asthma.

The Work-Related Asthma Prevention Program (WRAPP) in the California Department of Public Health (CDPH) found that the rate of work-related asthma among janitors and cleaners is nearly double the rate in the overall workforce.

Nationally, in states that keep track of work-related asthma, 12% of all confirmed cases are associated with cleaning products.

Cleaning products may also pose hazards from ingestion and dermal (skin) contact, in addition to inhalation.

The importance of labels

As many other instructors do, we mention during our Cleaning for Health workshops that you should read the label for every product you use. But how helpful is that reminder? The cleaning industry needs better education and training on safely and effectively using cleaning products.

We need to pause and consider why this is such a challenge. Labels should:

1. Help with decision-making.
2. Ensure safe use of the product.
3. Ensure effective use of the product according to the manufacturers’ intended purpose.
4. Lend authenticity to products by listing the manufacturer’s address, product identification codes, and barcodes for tracking. Many brands also use QR codes.

What actions do you take?

Activities that attendees undertook in a Cleaning for Health workshop illustrated the enormous gap in users’ knowledge and understanding of cleaning ingredients. For example, very few attendees could correctly answer the question: “What actions do you take if you read the product label or safety data sheet and see these statements that came from one safety data sheet for one cleaning product?”

1. This chemical is considered hazardous.
2. This product causes burns to the eyes, skin, and mucous membranes.
3. Although not expected, heart conditions or chronic respiratory problems such as asthma, chronic bronchitis, or obstructive lung disease may be aggravated by exposure to high concentrations of vapor or mist.
4. Avoid contact with eyes, skin, and clothing.
5. Ensure adequate ventilation.
6. Use personal protective equipment as required.
7. Reacts with other household chemicals, such as toilet bowl cleaners, rust removers, acids, or products containing ammonia, to produce hazardous irritating gases, such as chlorine and other chlorine compounds.
8. Very toxic to aquatic life with long-lasting effects.

How to identify chemicals on a label

For every Cleaning for Health workshop, we stressed that if you have questions or want more information on the chemical ingredients in a cleaning product, we highly recommend that you contact the company that makes the product. Manufacturers’ websites have “Contact Us” tabs, list phone numbers, and often offer the ability to send a message if you have product questions.

We also illustrated, using examples, how challenging it can be to know what chemical ingredients are in your cleaning product as listed on the label.

• 2-Butoxyethanol is used as a solvent. The label may list it as Butyl CELLOSOLVE™, butyl glycol, EGBE (ethylene glycol monobutyl ether), or 2-BE.
• Coal Tar Dye is used to give cleaning products a specific color. The label may list it as p-phenylenediamine, coal tar solutions, naphtha, estar, or benzin B70.
• MEA (monoethanolamine), DEA (diethanolamine), and TEA (triethanolamine) are emulsifying ingredients that combine two immiscible liquids to combine in a suspension, such as oil and water. Labels may list them as written.
• Nonylphenol ethoxylates (NPEs) are surfactants used to enhance the effectiveness of cleaning products. Labels may list them as Nonylphenol (NP) and nonylphenol ethoxylates (NPEs).
• Phosphates are used as chelating agents to prevent minerals in water from interfering with cleaning. They help prevent magnesium and calcium ions in water from binding with surfactants. Labels may list them as sodium tripolyphosphate (STPP).
• Sodium lauryl sulfate (SLS) and sodium laureth sulfate (SLES) are surfactants that help remove dirt and oil from surfaces and create a foamy lather. Labels may list them as sodium lauryl sulfate, sodium laureth sulfate, sodium salt, ammonium laureth sulfate, sodium n-dodecyl sulfate, dodecyl sulfate, and sodium dodecyl sulfate.

Making informed choices

ISSA has partnered with Penn State College of Medicine (Dr. Rebecca Bascom) and the City University of New York School of Medicine (Dr. Omrana Pasha-Razzak) on a two-year project on “Making Safer Choices: Research and Practical Toolkit Development for Businesses and Disadvantaged Communities to Use Safer and More Sustainable Cleaning Products.” Our project will increase knowledge, demand, and use of cleaning products with safer ingredients by creating partnerships with manufacturers and business stakeholders.

Our project will provide education and technical assistance to businesses and professional cleaning staff, regardless of the language they speak or other socio-economic factors. It will encourage people to make safer choices and advocate for safer cleaning products to help protect the health of businesses, building occupants, and the environment. Please contact Dr. Gavin Macgregor-Skinner if you would like more information at [email protected].