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Knowledge and Practices Regarding Safe Household Cleaning and Disinfection for COVID-19 Prevention — United States, May 2020

Our take —

An online survey administered to 502 adults in the United States showed suboptimal knowledge of safe and appropriate household cleaning and disinfection practices. The survey also demonstrated concerning levels of unsafe cleaning and disinfection behaviors, resulting in adverse but minor health outcomes in some instances.

Study design

Cross-Sectional

Study population and setting

In May 2020, 502 adults (18 years and older) in the United States participated in an internet survey assessing practices and behaviors for household cleaning and disinfection, involving products like cleaners (e.g., bleach), disinfectants, and hand sanitizer. The survey measured participants’ household cleaning and disinfection behaviors in the previous month, knowledge of appropriate cleaning and disinfection procedures, and any adverse health effects associated with cleaning and disinfection practices.

Summary of Main Findings

Despite high reporting (50%) of increased home cleaning and disinfecting practices to prevent COVID-19 transmission, surveyed adults reported unsafe cleaning and disinfecting procedures with concerning frequency. The most commonly reported unsafe cleaning and disinfecting behaviors included washing food with bleach (19%) and using household cleaner to wash/disinfect hands or bare skin (18%). Knowledge of appropriate cleaning and disinfection practices was also mixed, with high a high proportion of participants acknowledging that cleaning supplies should be kept out of children’s reach (79%) and should be handled with appropriate protective equipment (71%). Yet, fewer than half knowing bleach should not be mixed with vinegar (35%) and that only room-temperature water should be used when diluting bleach (23%). One-fourth of surveyed adults reported at least one adverse health outcome associated with cleaning and disinfecting behaviors (most commonly nose/sinus irritation [11%]). Adverse health outcomes were predominantly reported by participants who reported unsafe cleaning and disinfection practices.

Study Strengths

The authors weighted survey responses by age, gender, race/ethnicity, education, and region of residence to make results representative of the U.S. census population. The investigators also included questions that addressed both knowledge and behaviors pertaining to safe household cleaning and disinfection.

Limitations

Given the study’s moderately sized sample and online recruitment strategy, its results are susceptible to selection bias. Specifically, the online survey may have excluded respondents with low literacy and/or internet accessibility, which restricts the generalizability of these findings to that population. Secondly, it is possible that participating adults responded to questions with what they believed was good or desired by researchers (i.e., social desirability bias) — rather than their reality. This may have led to underreporting of unsafe cleaning and disinfection practices. Lastly, results from this survey were presented descriptively and, therefore, do not identify the relationships between unsafe disinfection practices, knowledge, and demographic factors (e.g., age, race/ethnicity).

Value added

The study contributed new insights — knowledge about disinfection safety is limited and unsafe cleaning/disinfection practices to prevent COVID-19 spread are common among U.S. adults.

This review was posted on: 4 July 2020