A threat to teen workers: disinfectants and occupational illness.

Three out of four U.S. adolescents work at some time during their junior and senior years of high school. Youth workplace injury and illness may be underreported because the majority of teen employees work part-time, even during the summer; children may not enter the workers' compensation system and therefore may be missed by ongoing surveillance. Are important trends being missed? This month, Theresa A. Brevard of The Ohio State University and colleagues report on the first study to measure the magnitude, incidence, and nature of disinfectant-related occupational illness in young workers, and they find room for improvement [EHP 111:1654-1659].

In 1996-1998, according to the Bureau of Labor Statistics, 24.8% of youth aged 15-17 worked during the school year, with that figure swelling to 34.2% during the summer. In the food and beverage industry, the most common workplace for minors, disinfectants are used to keep preparation surfaces and equipment clean and germ-free. Disinfectant exposure can happen in other industries, as well, including recreation-related jobs such as lifeguarding (where workers may be responsible for chlorinating the pool) and cleaning, manufacturing, and service jobs.

Brevard and colleagues looked at data on disinfectant-related illnesses for 1993-1998 from two sources: the Toxic Exposure Surveillance System, maintained by a nationwide network of poison control centers, and the California Department of Pesticide Regulation, which keeps detailed data on known and suspected acute poisoning cases, including those involving disinfectants. The team examined data for teen workers under age 17 and, as a comparison group, adult workers aged 25-44.

The researchers tracked episodes of worker illness and injury related to five classes of disinfectants: halogens including hypochlorites (bleach and its relatives), quaternary ammonium compounds (hard-surface cleaners that impede bacterial growth at high dilution), phenolic agents (including coal tar disinfectants such as Lysol), products containing pine oils (added more for their "clean" scent than their cleansing properties), and "unspecified" agents (where the identity of the specific disinfectant was not determined).

The researchers found that adolescents, with 307 episodes of illness, were more than four times as likely as adults to be injured or made ill by workplace exposure to disinfectants. The most commonly reported illnesses and injuries (59%) came from exposure to halogens, and the skin and eyes were the most commonly affected organs. Although overall risk was higher for adolescents than for adults, adults working in the industries that employ the most young workers also had more disinfectant-related illness than all other working adults.

Most of the reported effects, such as scratchy throat and watery eyes, were characterized as mild, causing minimally bothersome, rapidly resolved health issues. Less frequent but more serious effects included corneal abrasions and second- and third-degree skin burns. None of the cases examined involved severe injuries or fatalities. In cases where data on personal protective equipment use were available, 65% of illness and injury fell to teens who were not using safeguards.

The authors raise the need for better enforcement of existing health and safety regulations, especially those related to the appropriate use of personal protective equipment, and suggest revision of the Fair Labor Standards Act to include disinfectants as a hazard against which young workers must be protected. They call for states to do a better job of collecting information on disinfectant-related illness and to establish uniform reporting requirements, which would make it easier to establish how these injuries are impacting the work force.