My opinion

By Dr. Deepak Gupta
Corresponding Author Dr. Deepak Gupta
Wayne State University, - United States of America 48201
Submitting Author Dr. Deepak Gupta

Cleaning Products; Occupational Health; Hygiene Hypothesis

Gupta D. Let There Be Guideline For Being Too Clean. WebmedCentral INFECTIOUS DISEASES 2018;9(5):WMC005460

This is an open-access article distributed under the terms of the Creative Commons Attribution License(CC-BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Submitted on: 12 May 2018 01:06:17 PM GMT
Published on: 15 May 2018 07:41:04 AM GMT

My opinion

As interestingly brought to light by Svanes et al (2018) [1] and others [2-3], the time has been ripe for eliciting a discussion about the consequences of cleaning when with time, being too clean has been slowly replacing being too dirty [4-5]. To my limited understanding, the mechanical agents may elicit harm within moments and thus resolution against them may be successful within moments; the chemical agents may elicit harm within hours and thus their resolution may need more time; the biological agents may elicit harm within days and thus their recognition and thereafter their resolution may take longer times; and finally, the idiopathic (potentially psychological) agents may elicit harm within unknown time frames and consequently their recognition and resolution may spread over periods unknown. Hereafter, we can assume that workplaces like airports and hospitals [6-10], which may have been prone to be the most dangerous places in terms of transmitting diseases (biological agents) among the massive turnover of visitor populations' traffic harboring all types of contagions from all over the world, may have ended up achieving the tag of being the cleanest workplaces with the chemical agents (cleaning solutions) replacing the biological agents [11] at various points of contacts which are prone to be involved in humans-to-fomites-to-humans transmissions. Moreover, it may NOT be as much as the dusting off component of vacuum based often wet-cleaning but rather the spraying component of the cleaning solutions often "sitting on" (adhering to) the fomites waiting to be absorbed or adsorbed on to the next host body and in turn finding more often than not the bodies of cleaning solutions' dispersers (the cleaners) themselves. Even though the cleaning solutions' sprays may be replaced with cleaning solutions' sponges with the limitations and restrictions to be used only while donning the gloves along with the N95 respirators (masks) preventing the inhalation of 95% of small size inhalants [12] which are potentially evaporating while the recently cleansed surfaces are drying and turning/becoming to be odor-vapor-free, the human tendency to involuntarily touch mucosal surfaces of their faces with their hands [13] and contributing to transmissions of infectious agents (biological agents) may NOT differentiate much when translocating cleaning solutions (chemical agents) from their hands (even if they are gloved) to the mucosal surfaces of their faces and may thereafter raise the question whether it's time to re-explore if hot water or even cold water [14-15] cleansing may be sufficient enough for some surfaces to reduce humans' exposures to chemical agents as replacements for biological agents in the modern much more clean though much more chemicalized existence for humans [16-17]. Interestingly, the cleaning additives which used to need hot water for better dissolution are no longer needing water to be heated up thus raising the question whether the chemical agents in cleaning additives have become more powerful (and potentially more harmful) when they are no longer needing water's heat for dissolution/homogenization to make them work more effectively unless the cleaning additives irrespective of their affinity for cold or hot water may never be as harmless (and some may say pointless) as plain water itself. Summarily, the issues covertly inducted into readers' minds by Svanes et al (2018) [1] should bring modern society more into action like some [18] wherein as simple an action as cleaning houses or offices may be evolving as detrimental to cleaners' health warranting the need for guidelines about how to be safe without being too clean unless the society is sleeping while waiting to be shaken/awakened by overzealous/zealot litigating entities getting drawn on behalves of our insured healthcare costs and our protected occupational healthcare costs into these potentially lucrative avenues thus forcing our innocent hands into changing our cleaning practices and skills whether we are ourselves cleaning or are expecting others to clean our homes expectantly/domestically or our offices contractually/professionally.


  1. Svanes Ø, Bertelsen RJ, Lygre SH, Carsin AE, Antó JM, Forsberg B, García-García JM, Gullón JA, Heinrich J, Holm M, Kogevinas M, Urrutia I, Leynaert B, Moratalla JM, Le Moual N, Lytras T, Norbäck D, Nowak D, Olivieri M, Pin I, Probst-Hensch N, Schlünssen V, Sigsgaard T, Skorge TD, Villani S, Jarvis D, Zock JP, Svanes C. Cleaning at Home and at Work in Relation to Lung Function Decline and Airway Obstruction. Am J Respir Crit Care Med. 2018 Feb 16. Available at: Accessed 2018 Apr 6.  
  2. Vizcaya D, Mirabelli MC, Gimeno D, Antó JM, Delclos GL, Rivera M, Orriols R, Arjona L, Burgos F, Zock JP. Cleaning products and short-term respiratory effects among female cleaners with asthma. Occup Environ Med. 2015 Nov;72(11):757-63. Available at: Accessed 2018 Apr 6.
  3. Medina-Ramón M, Zock JP, Kogevinas M, Sunyer J, Torralba Y, Borrell A, Burgos F, Antó JM. Asthma, chronic bronchitis, and exposure to irritant agents in occupational domestic cleaning: a nested case-control study. Occup Environ Med. 2005 Sep;62(9):598-606. Available at: es/PMC1741089/ Accessed 2018 Apr 6.
  4. GCA Services Group. 6 Reasons Why a Clean Workplace Means a Safe Workplace. 2014 Nov 19. Available at: means-a-safe-workplace Accessed 2018 Apr 6.
  5. Workforce: Vesely R. Shaping Up: Workplace Wellness in the ’80s and Today. 2012 Jul 18. Available at: http: // Accessed 2018 Apr 6.
  6. Centers for Disease Control and Prevention. Guidelines for Environmental Infection Control in Health-Care Facilities (2003). 2017 Feb 15. Available at: infectioncontrol/guidelines/environmental/index.html Accessed 2018 Apr 6.
  7. WATCH: Japanese airport cleaning staff inspires netizens with her work ethic. 2017 May 31. Available at: es-netizens-with-her-work-ethic/ Accessed 2018 Apr 6.
  8. Commercial Flooring & Interior Concepts: Mikulski T. How does hospital flooring promote patient well-being? 2015 Apr 29. Available at:  ht tp:// Accessed 2018 Apr 6.
  9. Healthcare Facilities Today: Daukus S. How flooring supports the needs of today's medical and healthcare facilities. 2015 Aug 12. Available at: pports-the-needs-of-todays-medical-and-healthcare-facilities--9934 Accessed 2018 Apr 6.
  10. Interiors+Sources. Specifying Flooring for Healthcare Environments. 2018. Available at: le/specifying-flooring-for-healthcare-environments Accessed 2018 Apr 6.
  11. Gupta D. Pathogens being replaced with allergens or immunogens: a theoretical perspective. Indian Journal of Community Health, 2013 Dec;25(4):498-9, Available at: Accessed 2018 Apr 6.
  12. U.S. Food & Drug Administration. Masks and N95 Respirators: N95 Respirators for Use by the Public. 2017 Dec 14. Available at: calProcedures/GeneralHospitalDevicesandSupplies/PersonalProtectiveEquipment/ucm055977.htm#s3 Accessed 2018 Apr 6.
  13. Nicas M, Best D. A study quantifying the hand-to-face contact rate and its potential application to predicting respiratory tract infection. J Occup Environ Hyg. 2008 Jun;5(6):347-52. Available at: Accessed 2018 Apr 6.
  14. Stack Exchange: Chemistry. Why hot water is more effective than cold water in cleaning. 2016 Oct 26. Available at: ve-than-cold-water-in-cleaning Accessed 2018 Apr 6.
  15. Facilities Supplies Team. Cleaning With Hot Water Vs Cold Water. 2015 Sep 14. Available at: http://otfac Accessed 2018 Apr 6.
  16. Febreze FABRIC Refresher Extra Strength TV Commercial, ‘Still Stuffy’. 2018. Available at: Accessed 2018 May 12.
  17. YouTube. Floor cleaning, stripping, buffing and waxing Bartlett IL. 2011 May 6. Available at: Accessed 2018 May 12.
  18. Facility Management: Hughes T. Flooring: When Clean is Not Enough. 2016 Apr. Available at: Accessed 2018 Apr 6.

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