COVID-19 is changing household behaviors related to how we are exposed to various household chemicals linked to poor health outcomes. People surveyed earlier in the pandemic were using fewer personal care products but more household cleaners, and eating less fast food and restaurant food but more ultra-processed food. These changes, which occurred since the pandemic onset, are also linked to pandemic-related traumatic stress, which itself may worsen health outcomes.
Researchers at Columbia University Mailman School of Public Health, along with partners from Dartmouth College, as part of the Environmental influences on Child Health Outcomes (ECHO) consortium, have analyzed responses to a survey from 1,535 adults in six states. Results are published in the journal PLOS ONE.
Personal care products
Overall, participants reported using fewer personal care products, including hair products (perms or relaxers, hair dye, hair sprays, hair gels) and makeup/body products (nail polish, makeup, perfume, lotion) since the start of the pandemic. Participants who experienced more pandemic-related traumatic stress were more likely to report using fewer hair products and cosmetics. Approximately half of all respondents reported using more liquid soaps (52%) and antibacterial soaps (48%), and 81% of respondents reported using more hand sanitizer gels. The use of all three products was associated with pandemic-related traumatic stress symptoms.
Two-thirds of respondents reported using more antibacterial cleaners and 54% reported using more bleach-containing cleaning products—changes made more likely among those experiencing more pandemic-related traumatic stress.
Nearly half (49%) of respondents said they ate more home-cooked meals because of the pandemic. One-third (34%) of respondents reported eating less fast food after the start of the pandemic. Both of these behavior changes were more common among those with more symptoms of pandemic-related traumatic stress. In all, 12% reported eating more ultra-processed foods, and 24% reported eating less processed foods, with the latter more likely among those with symptoms of pandemic-related traumatic stress.
While the study did not include measurements of environmental exposures, the researchers say that the scientific literature suggests that these behavior changes likely reflect changes in their exposures to environmental chemicals. They also likely reflect changes—both good and bad—to health outcomes linked to these chemicals.
“We can infer that some behaviors like less consumption of fast foods and less use of personal care products might lower exposures to some phthalates and phenols, while greater use of personal and household cleansers may be associated with higher exposure to quaternary ammonium compounds and glycol ethers; and more frequent consumption of ultra-processed food could increase exposure to phthalates and phenols,” says lead author Julie Herbstman, Ph.D., director of the Columbia Center for Children’s Environmental Health (CCCEH) and professor of environmental health sciences.
Phthalates are linked to asthma, attention-deficit hyperactivity disorder, breast cancer, obesity and type II diabetes and neurodevelopmental and behavioral issues. Phenols like BPA are linked to reproductive dysfunction, reduced birth size, cognitive and/or behavior outcomes, asthma, and obesity. Quaternary ammonium compounds are skin irritants and can also lead to asthma exacerbations. Exposure to glycol ethers may also irritate skin, eyes, nose, and throat and may also lead to anemia and/or adverse reproductive outcomes like birth defects.
A roadmap to interventions
The study identifies several factors that make some of these behavior changes more likely, including symptoms of pandemic-related traumatic stress and living in a household where someone tested positive for COVID-19, as well as race/ethnicity. Going forward, the researchers plan to repeat their analysis, adding a biological measure of chemical exposures to assess whether the trends in pandemic-related behavior change reported here do, in fact, result in shifts in exposures measured through biomarkers of internal dose. They also say it is important to continue to monitor pandemic-related behavior change as pandemic severity waxes and wanes.
The researchers say their study could lead to an intervention to reduce exposure to harmful environmental chemicals.
“Interventions and campaigns targeting the reduction of environmental exposures, pandemic-related traumatic stress, as well as those that facilitate behavior change can help improve health outcomes that are indirectly related to the pandemic,” says Herbstman.
The study’s senior authors are Frederica Perera, director of the translational research program at CCCEH and professor of environmental health sciences at Columbia Mailman School of Public Health; and Margaret R. Karagas, professor and chair of epidemiology at the Geisel School of Medicine at Dartmouth. A full list of co-authors is available in the journal article.
Julie B. Herbstman et al, Characterizing changes in behaviors associated with chemical exposures during the COVID-19 pandemic, PLOS ONE (2023). DOI: 10.1371/journal.pone.0277679
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