Centers for Disease Control and Prevention (CDC) has stated the importance of cleaning and disinfecting visibly dirty surfaces in household and community areas to protect against respiratory diseases caused by COVID-19 and other viral infections¹. Especially frequently contacted surfaces such as door handles, tables, chairs, handrails, bathroom and kitchen surfaces, toilets, light switches, telephones, computers, keyboards, remote controls and toys should be regularly cleaned and disinfected.². However, dangers that may arise from mixing different cleaning products can be ignored with the concern of virus protection³.

Bleaches are disinfectant, stain remover and mold remover cleaning products that contain sodium hypochlorite, calcium hypochlorite, hydrogen peroxide, or sodium carbonate peroxide⁴. Mixing bleach with acidic cleaning products such as vinegar, dishwasher detergent, tub and tile cleaning products, toilet bowl cleaners, drain openers and rust removers would result in chlorine gas release^3,4,5. Exposure to chlorine gas causes blurry vision, burning pain, redness and swelling on the skin, burning sensation on the nose, throat and eyes, coughing, chest tightness, difficulty in breathing, nausea, vomiting, watery eyes, wheezing, and fluid buildup in lungs in later periods⁶. Mixing bleach with ammonia containing cleaning products such as glass and window cleaners, interior and exterior paints causes chloramine gas release. Urine also contains ammonia; therefore cleaning litter boxes and toilet bowls with bleach must be done carefully. Exposure to this released gas causes nausea, cough, chest tightness, watery eyes, chest pain, irritation on throat, nose and eyes, wheezing, lung inflammations, and fluid buildup in lungs⁵. Mixing bleach with alcohol-containing products (ethanol or isopropyl alcohol) causes chloroform release³. Inhalation of chloroform causes chest tightness, irritation on nose and throat, excitation, nausea and vomiting, ataxia, dizziness, and drowsiness. Exposure to high concentrations of chloroform causes convulsion, coma and death due to respiratory arrest and irregular heartbeat. Liver dysfunction and kidney damage can be seen after a few days subsequently to healing after exposure⁷. Mixing hydrogen peroxide-containing products with acidic products causes the release of corrosive gases. Mixing hydrogen peroxide with vinegar releases peroxyacetic acid gas and inhalation of it causes irritation on the nose, throat and lungs and chest tightness. Exposure to high doses causes a liquid buildup in the lungs and serious chest tightness that requires immediate medical care⁸.

References

1. Centers for Disease Control and Prevention. 2020. Cleaning and disinfection for Households. 28.08.2020 tarihinde https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cleaning-disinfection.html adresinden erişilmiştir.
2. UNICEF. Cleaning And Hygiene Tips To Help Keep The COVID-19 Virus Out Of Your Home. 28.08.2020 tarihinde https://www.unicef.org/coronavirus/cleaning-and-hygiene-tips-help-keep-coronavirus-covid-19-out-your-home adresinden erişilmiştir.
3. U.S. Fire Administration. 2020. The Dangers of Mixing Household Cleaners. 19.08.2020 tarihinde https://www.usfa.fema.gov/operations/infograms/031920.html adresinden erişilmiştir.
4. National Capital Poison Center. Spring Cleaning. 28.08.2020 tarihinde https://www.poison.org/articles/2015-mar/spring-cleaning adresinden erişilmiştir.
5. Washington State Department of Health. Dangers of Mixing Bleach with Cleaners. 19.08.2020 tarihinde https://www.doh.wa.gov/YouandYourFamily/HealthyHome/Contaminants/BleachMixingDangers adresinden erişilmiştir.
6. Centers for Disease Control and Prevention. 2018. Facts About Chlorine. 19.08.2020 tarihinde https://emergency.cdc.gov/agent/chlorine/basics/facts.asp adresinden erişilmiştir.
7. Health Protection Agency. 2007. Chloroform Toxicological Overview. 19.08.2020 tarihinde https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/338535/Chloroform_Toxicological_Overview.pdf adresinden erişilmiştir.
8. New Jersey Department of Health and Senior Services. 2014. Peroxyacetic Acid Hazardous Substance Fact Sheet. 19.08.2020 tarihinde https://nj.gov/health/eoh/rtkweb/documents/fs/1482.pdf adresinden erişilmiştir.

(You can reach all of the articles published by Yeditepe University Pharmaceutical and Poison Advisory Unit by clicking the PEPIRC / YIZDA section under the "Research" title found on the navigation bar.)