| Sumario: | This study assessed occupational exposure to airborne chlorine dioxide (ClO2) during routine hospital disinfection using a rinsing bottle and textile cloth. Sixty-three personal measurements (>108 h) were collected in operating rooms, patient rooms, and a bed-disinfection unit using direct-reading electrochemical sensors. Exposures were summarized as 8-h time-weighted averages (TWA-8h); fractions of time above 0.1 and 0.3 ppm; and 10 s, 60 s, and 15 min moving averages. TWA-8h exposures were generally below the Norwegian OEL-8h of 0.1 ppm. In contrast, short-term peak exposures were frequent and substantial: all tasks had at least one exceedance of 0.1 ppm on 10 s moving averages (Norwegian recommended reference period), and 78% of measured tasks exceeded 0.1 ppm on 60 s moving averages (German reference period). Peaks above 1.09 ppm (the instrument's upper reporting limit) occurred in 59% of tasks. Peaks above 0.3 ppm were typical across all task types, with the highest short-term exposures during disinfection of patient rooms and operating rooms, especially in periods of intensified activity during infectious outbreaks such as COVID-19. Individual work practices contributed to additional variability. The relatively long response time of the electrochemical sensor (t90 up to ∼160 s) likely led to underestimation of true peak magnitudes. Our findings add to emerging evidence that disinfectant use in healthcare is associated with acute respiratory symptoms, and that TWA-8h poorly capture short-term peak exposures. Together, these results underscore the need for revised safety protocols; re-evaluation of exposure limits and the definition of a ceiling value; improved sensor strategies; and clearer operational guidance on how ceiling/STEL metrics (including averaging time) should be applied, to ensure accurate monitoring and assessment for rapidly acting irritants (such as ClO2) in real-world hospital settings.
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