# Chemical Substance Exposure of Some Cleaning Workers in Korea: Focusing on Inhalation Exposure
## 4 Observations
Examination of the ingredients and their hazards in the products used in the exposure survey revealed that the most frequently present substances were those causing severe eye damage/eye irritation, skin corrosion/skin irritation, and specific target organ toxicity (single exposure): Category 3 (respiratory tract irritation). A risk assessment was conducted for the most common substances found in cleaning agents and disinfectants (i.e., sodium hydroxide) and the representative substances generated by their combined use (i.e., chlorine). This assessment revealed that chlorine posed an unacceptable level of risk. Chlorine gas can be generated when hypochlorite-based disinfectants such as bleach are mixed with acidic cleaners containing substances such as nitric, hydrochloric, or citric acid. Based on the 95 th percentile exposure values, the risk index for chlorine gas in the building cleaning industry was 5.65, exceeding the threshold of 1 and indicating an unacceptable level of risk. Domestic and international literature reviews have been conducted on the use of cleaning agents and disinfectants to understand the health impacts. Additionally, a work environment measurement survey and focus group interviews were conducted with facility management cleaning workers and kitchen staff to assess the health impacts. The findings indicate that cleaning workers typically earned relatively low wages and were older, and there was a higher proportion of women than men. The most commonly used product was bleach, which causes eye irritation, skin irritation from contact, respiratory symptoms (e.g., throat irritation and pain), and potentially asthma. Musculoskeletal disorders including wrist tendinitis, carpal tunnel syndrome, herniated discs, and knee arthritis were also prevalent. Wrist disorders were particularly common during washing tasks involving the handling of trays and containers. Recent studies have been conducted on aircraft cleaning workers. The primary insecticide components identified during aircraft cleaning were permethrin and decamethrin. Worker exposure to permethrin was assessed using the ECETOC TRA (targeted risk assessment) tool, which utilizes toxicity values and various parameters. The derived no-effect level for human exposure to permethrin was 0.04 mg/m\({}^{3}\) for inhalation (8 h) and 0.05 mg/kg per day for oral intake. The risk assessment for this substance revealed that the dermal and inhalation risks as well as the overall risk were approximately 33-41 times higher than safe exposure levels across all exposure routes. This indicates a significant risk of permethrin exposure among aircraft cleaning workers [37]. According to the study by [PERSON] et al. [38] on exposure assessment and work environment management for aircraft cleaning workers, the evaluation of five disinfect and insecticide components (i.e., ethylenediaminetetraacetic acid, 1-methyl-2-pyrrolidone, pyrethrum, deltamethrin, and permethrin) showed that all were non-detectable (99 cases for ethylenediaminetetraacetic acid and 1-methyl-2-pyrrolidone, 41 cases for pyrethrum, 13 cases for deltamethrin, and 30 cases for permethrin). The cleaning agents included: ethylbenzene, xylene, benzene, toluene, ethanol (106 cases), and propylene glycol (11 cases). Benzene (exposure limit of 0.5 ppm) and propylene glycol were consistently undetectable. Ethanol (exposure limit of 1000 ppm) had a maximum concentration of 0.53 ppm, ethylbenzene (exposure limit of 100 ppm) had a maximum concentration of 0.085 ppm, toluene (exposure limit of 50 ppm) had a maximum concentration of 0.69 ppm, and xylene (exposure limit of 100 ppm) had a maximum concentration of 0.49 ppm. All measured values were <5% of the respective exposure limits. [PERSON] et al. [15] investigated the health impacts of cleaning workers by reviewing epidemiological studies from 1981 to 2005. Among the 35 studies examined (excluding case studies), the most frequent focus was respiratory diseases (17 studies).