Health Consequences of Overexposure to Disinfectants and Self-Medication against SARS-CoV-2: A Cautionary Tale Review

Round 1

Reviewer 1 Report

The authors have reported poisoning rate of different sub- 379 stances such as disinfectants, alcohol sanitizers, household bleach, and drugs elevated 380 over these two years. hence they came to a conclusion that the increasing public awareness of the dangers of overusing 381 disinfectants, detergents, and self-medication of dietary supplements, drugs, and herbal 382 products, seems absolutely necessary. In the need for proper sanitizing measures, infor- 383 mation available on the dangers engulfed in their use is essential. Finally, the authors hope 384 that the summarized findings of this literature review may act as a warning, as a guide 385 for bad practices not to be repeated anew. The article can be accepted in its present form.

Author Response

We appreciate the time and effort that you have dedicated to providing your valuable feedback on our manuscript.

Reviewer 2 Report

This article is interesting and very relevant to current conditions. However, there are some that can be developed.

1. Abstract is not well structured. I have not seen a clear method, objective and result of the research. The introduction is too much and dominates the abstract.

2. There is no research gap in the introduction

3. There is no research method. Is this a systematic review?

4. Even though it is a literature review, there is still need for data from the literature to strengthen the argument

 

5. Why do people overusing disinfectants, detergents, and self-medication of dietary supplements, drugs, and herbal products? Is there for all elements of people?

 

Author Response

We appreciate the time and effort that you have dedicated to providing your valuable feedback on our manuscript. The answer to the comments is attached.

Author Response File: Author Response.pdf

Reviewer 3 Report

The paper presents an overview of the possible toxic effects of materials, alcohol consumption, and self-medication during the COVID-19 pandemic. Using a literature search, the narrative review provided implications of overuses and malpractices of these substances on human health. 

In general, the paper is interesting and significant to the post-pandemic situation as the 'new normal' set minimum health standards including the use of disinfectants. While the paper provided a good overview of the literature on this topic, I do not see any academic merit in terms of academic contribution,  sound methodology, novelty of the findings, relevance to the special issue of the journal, and some characteristics of a review article: gap and future research. Specifically,

1. The Introduction provided a good research background. However, the originality of the paper is not clear. L57-58 "Research on COVID-19 has understandably a short history, and limited studies have recently been published on the toxicity of substances used in the COVID-19 pandemic" should be supported by citing relevant studies. The term "limited" is highly questionable as there are already existing studies, particularly  reviews on this topic.

2. While Sustainability journal support free-format for articles, the paper has no sound Methodology. The literature search was too shallow resulting to more questions than answers. Why GoogleScholar was used as one of the database searches when this include both academic and gray literatures? Using the keywords, how many studies have been searched? After exclusion of duplicates and unrelated studies, how many papers were included for the qualitative ('narrative') review?

3. Section 2 only presented the results of the study. A Discussion in a broader perspective should be added.   What are the broader implications of the main findings? How can you relate these findings to the aims and scope of the Special Issue "Impact of COVID-19 on the Environment, Energy and Economics"? 

4. While the paper provided a good analysis of the state-of-the-art, I am missing some important characteristics of a Review Article: what are the literature gaps  and how future studies address these gaps. 

5. Some of the References seemed questionable. For instance, according to L69 "we used articles that best match the subject from 2000 to 2022". However, the reviewed documents include paper from 1990, 1996, 2000, 2003, 2004, 2005, 2006, 2010, 2011, 2012, 2014, 2015, 2017, 2018, 2019. These may just be references for the Discussion, but I am missing the results of the "review". A table of the reviewed articles should be presented in text or as an appendix.

6. In connection to #5, some cited articles do not reflect the contents of the papers. For instance, "...vitamin D deficiency has become a global health concern, especially during the COVID-19 pandemic [48], when isolation and quarantine led to imbalance in proper diet and exposure to sunlight" - article #48 was published in 2019 and mentioned nothing about the COVID-19 pandemic. Also, from Table 2 "Inhibition of alkaline phosphatase, papain and alcohol dehydrogenase in liver. Gastrointestinal discomfort, nausea. Allergic conjunctives, rhinitis, and bronchospasm (as a result of RBCs and WBCs aggregation and alveoli thickening at very high doses)" - these are not mentioned in article #80, except for the aggregation and alveoli thickening in rats.

 

 

Author Response

We appreciate the time and effort that you have dedicated to providing your valuable feedback on our manuscript. The answer to the comments is attached.

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

The manuscript has revised largely. However, why in the conclusion there is a table?

Author Response

Thank you very much for the careful reading of our manuscript. Table 1 was transferred to the previous section.

Reviewer 3 Report

The authors carefully addressed all comments and suggestions and made significant changes to improve the manuscript.

The paper seems ready for the production and I am looking forward to read the published version of the manuscript.

 

Author Response

We appreciate the time and effort that you have dedicated to providing your valuable feedback on our manuscript.