Acute respiratory distress after exposure to chlorine dioxide-based disinfectant

Chlorine dioxide has become a widely used disinfectant during the COVID-19 pandemic. Even at very low concentrations, it is a fast-acting broad-spectrum surface disinfectant. Chlorine dioxide has irritant properties, but since the concentration used is so low, the product has been considered a safe alternative to many other disinfectants. However, this case report suggests that even though the concentration of disinfectant fluid is very low, there may still be serious health risks associated with its use. A hospital cleaner developed acute respiratory distress after working with a chlorine dioxide-based disinfectant. The content of chlorine dioxide in the product is below the limit that would require the product to be labelled as hazardous to health, but we show with a simple estimation that the relevant threshold limit values for chlorine dioxide in the working atmosphere may be exceeded under normal use of the product. This may have implications for risk assessment of the use of such chlorine dioxide-based disinfectants and may warrant stricter regulations for labelling these products.