# Exposure to Oxycide(tm) Disinfect in Dental Practices: Occupational Symptoms and Risk Factors
## 1 Introduction  
Mygiene and infection control are essential in dental practices. Because of the increased risk of cross-contamination and infection transmission, rigorous disinfection protocols are essential to protect patients' and dental staff's health. Studies have highlighted the potential spread of infections if protocols are not rigorously enforced, emphasizing that effectivedisinfection of equipment and surfaces is important in minimizing the risk of healthcare-associated infections [1; 2; 3]. Dental professionals increasingly rely on chemical disinfectants for air and surface sterilization [4; 5]. Although rigorous hygiene in dental offices is essential for preventing nosocomial infections, the frequent use of chemical disinfectants may pose risks to staff and patients, and caution and standardization of their use are needed [6]. The widespread implementation of surface disinfection protocols in medical and dental settings has been significantly intensified following the COVID-19 pandemic. While these measures aim to reduce microbial transmission, the increased use of potent chemical disinfectants--particularly those containing peracetic acid (PA), hydrogen peroxide (HA), and acetic acid (AA)--has raised important concerns about occupational exposure and its potential short- and long-term health effects on healthcare personnel [7; 8; 9]. Oxycide(tm) (Ecolab, Copenhagen, Denmark) is a powerful air and surface oxidative disinfectant for medical and dental facilities. Oxycide(tm) is composed of PAA (0.13%), HA (0.64%), and acetic acid (AA) (0.16%). This combination allows it to effectively target and kill a broad spectrum of pathogens, including bacteria, viruses, and spores, making it valuable and often used in healthcare environments with a high risk of infection transmission. Oxycide(tm)'s oxidative mechanism of action allows rapid destruction of microbial cell structures, thus providing enhanced antimicrobial activity against highly resistant pathogens, such as Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE) [10; 11; 12]. In healthcare environments, occupational exposure to PAA, HP, and AA can cause various health problems for workers in the short and long term. Acute exposure to PAA, HP, and AA can cause immediate respiratory symptoms such as nasal and throat irritation, cough, wheezing, and shortness of breath. Other studies have reported that although Oxycide(tm) is advertised as effective and biodegradable, repeated exposure has been associated with airway irritation, allergic reactions, and skin damage in people who come into contact with it [7; 10; 13; 14]. Regarding long-term health effects, prolonged exposure to PAA and HP can lead to chronic respiratory conditions, including occupational asthma [15; 16; 17]. This is due to the sensitization mechanism triggered by repeated exposure to these chemicals, which can cause persistent inflammation and hyperreactivity of the airways [18; 19]. While exposure levels in healthcare settings are often below established occupational exposure limits, continuous monitoring and assessment are crucial to ensuring safety [15; 20]. Despite some manufacturers' claims that no PPE is required when using diluted products, appropriate PPE, such as masks and gloves, is recommended to minimize exposure and protect workers' health [14; 21]. Exploring non-chemical disinfection technologies could reduce reliance on these hazardous chemicals and decrease the associated health risks for healthcare workers [7]. Additionally, the implementation of robust occupational health programs and regular health surveillance can help identify at-risk workers early and mitigate potential health issues [21]. In addition to disinfect agents, dental practice involves using various other materials--such as endodontic irrigants [22], impression compounds, and restorative materials [23]--that may carry health risks upon exposure. These materials can release irritant or sensitizing compounds.