But What in the world are QUATS

Dr. Helene Paxton

MS, MT(ASCP), PhD, CIC, Professor of Biosciences

Quats are workhorses of modern disinfection. In the home and in healthcare the cleaning disinfectants are some formulation of Quats.

“QACs have been in use for approximately 50 years and are considered relatively safe. Despite the duration and prevalence of their use in commercial and consumer products, few studies have assessed the toxicity of single QACs.

In the last 10 years however scientists have linked quats to reproductive and developmental problems in animals and found they can disrupt key cellular processes. According to one author, “so far there is no data linking the compounds to toxicity in humans, but some scientists say there’s more to be done to fully assess Quats’ safety.”

The compounds pose their biggest risks when they get on the skin. While Quats are nonvolatile due to their high molecular weight, making them unlikely to be inhaled, the repeated spraying and wiping can lead to a lot of exposure. The greatest opportunity to exposures include health care facilities, day care centers, playgrounds, classrooms, and laboratories and the home.¹

The daily use of Quats comes with risks.

Unfortunately, many products we would least suspect, contain Quats and not all are associated with disinfectant action, such as dish soap, shampoo and softeners.

Healthcare workers and environmental staff are exposed continuously with wipes and sprays with little concern about the health effects. Many use different wipes with different chemicals and mix them together causing unknown reactions and fumes.

Quats are formaldehyde releasing toxic chemicals that have been associated with multiple health risks including:

Allergies & irritation (skin, eye, lung)

Contact dermatitis – Studies estimate that between 13% and 34% of contact dermatitis cases may be linked to quats.

Asthma- triggering it in those who already have asthma and new onset in people with no prior asthma

Reproductive and developmental toxicity

Injuries: eye and mucous membrane injuries from splashes or contact with mists and oral and gastrointestinal injuries from swallowing solutions containing quats

Promoting “super bugs“. Concerns about quaternary ammonium compounds leading to resistant bacteria stem from how these ingredients interact with bacterial cell membranes.

We cannot change ingrained practices overnight, but if we could reduce the exposure to Quats with proven chemical-free methods, the opportunity must be seriously considered.

I’m proposing the use of Rapid UVC Decontamination Systems for the decontamination of all noncritical Electronics, Wearable Devices, Personal Effects and Unopened Supplies.

In so doing Quats can be replaced with a simple Alcohol wipe to remove any potential bio-material then placed into the UVC cabinet for 30 seconds or less to achieve a high LOG 10 reduction of pathogens. There is also a cost and time savings benefit. Disinfectants wipes and sprays is a large part of the facilities budget. There is no supply cost or waste expense using UVC, but for healthcare workers our most precious commodity is time. Why take 3-5 minutes cleaning a single device, when you can disinfect multiple devices simultaneously in 30 seconds!

The rapid UVC solution that I have come to rely on is the RDS-32a system from TMG Health Technologies.

The system can be used as a standalone desktop or be mobile shared amongst departments.

It has been independently certified on hard and soft surfaces to high Log 10 reduction of the most virulent pathogens.

There proprietary M²D Technology guarantees the required germicidal dosage for pathogen reduction on every cycle, providing repeatable results every time.

The RDS will also conveniently accommodate electronics and devices that are hard-wired or plugged-in, like Keyboards, Pumps and Monitors.

And germane to our conversation today, the system is a totally green process. No exposure to fumes and skin irritants, it does not contribute to antibiotic resistance, there no consumables, no supply cost and no waste expense.

Hospitals today average 10-15 devices per bed, and the growth of wearables is exponential. The Joint Commission May 2021 Newsletter reported the non-compliance of electronics and device sanitization at 72% in hospitals, with similar numbers in post-acute facilities.

We need tools like the RDS to maintain a higher-level sanitized environment, prevent the crosscontamination of touched-items impacting HAI’s and to leverage opportunities for efficiency and cost-savings.

The RDS can be easily adopted by any size facility, requires little training, and allows everyone to participate in the disinfection process. For questions or information on this subject or another, please reach out to me via email at [email protected] and keep your eye on this space for other topics of interest on Infection Prevention.

Thank you.


1. https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&i d=25483128