This was a "well-performed study," said Lidwien Smit, PhD, from the University of Utrecht in the Netherlands. "I just wonder about the pathology, and how it influences the microbiome."
"Disinfectants are meant to kill off bacteria, but if you're exposed to large concentrations, you're also inhaling them, which could affect your airway microbes," she explained.
In fact, disinfectants could play a role in killing off bacterial communities in the airways that are responsible for "immune homeostasis" and keep users healthy, she added.
If that immune balance gets disturbed, it might have an influence on a person's reaction to pathogens or inflammation. "This is all part of the COPD pathology — that could be another interesting hypothesis to study," Dr Smit told Medscape Medical News.
Dr Dumas is clear that this is preliminary observational research and more studies are needed. Determining which agents are most harmful "would help define guidelines to protect workers," she noted.
The current findings do not show that the disinfectants are a direct cause of COPD, but they do draw an association between some disinfectants and development of the disease. "I hope this study will help open the discussion for better guidelines," Dr Dumas said.