Occupational Asthma Reference

Tjalvin G, Svanes Ø, Igland J, Bertelsen RJ, Benediktsdóttir B, Dharmage S, Forsberg B, Holm M, Janson C, Jõgi NO, Johannessen A, Malinovschi A, Pape K, Real FG, Sigsgaard T, Torén K, Vindenes HK, Zock JP, Schlünssen V, Svanes C, Maternal preconception occupational exposure to cleaning products and disinfectants and offspring asthma., J Allergy Clin Immunol, 2022;149:422-431,https://doi.org/10.1016/j.jaci.2021.08.025
(Plain text: Tjalvin G, Svanes O, Igland J, Bertelsen RJ, Benediktsdottir B, Dharmage S, Forsberg B, Holm M, Janson C, Jogi NO, Johannessen A, Malinovschi A, Pape K, Real FG, Sigsgaard T, Toren K, Vindenes HK, Zock JP, Schlunssen V, Svanes C, Maternal preconception occupational exposure to cleaning products and disinfectants and offspring asthma., J Allergy Clin Immunol)

Keywords: cleaner, biocides, epigenetic, ep, childhood asthma, Norway, Australia, Spain

Known Authors

Torben Sigsgaard, University of Aarhus Torben Sigsgaard

Kjell Toren, Sahlgrenska University Hospital. Goteborg Kjell Toren

Jan-Paul Zock, Municipal Institute of Medical Research, Barcelona, Spain Jan-Paul Zock

Vivi Schlunssen, Aarhus Vivi Schlunssen

Cecile Svanes, University of Bergen, Norway Cecile Svanes

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Abstract



BACKGROUND:
Emerging research suggests health effects in offspring after parental chemical exposures before conception. Many future mothers are exposed to potent chemicals at work, but potential offspring health effects are hardly investigated.

OBJECTIVE:
We sought to investigate childhood asthma in relation to mother's occupational exposure to cleaning products and disinfectants before conception.

METHODS:
The multicenter Respiratory Health In Northern Europe/Respiratory Health In Northern Europe, Spain and Australia generation study investigated asthma and wheeze starting at age less than 10 years in 3318 mother-offspring pairs. From an asthma-specific Job-Exposure Matrix and mothers' occupational history, we defined maternal occupational exposure to indoor cleaning agents (cleaning products/detergents and disinfectants) starting before conception, in the 2-year period around conception and pregnancy, or after birth. Never-employed mothers were excluded. Exposed groups include cleaners, health care workers, cooks, and so forth. Associations were analyzed using mixed-effects logistic regression and ordinary logistic regression with clustered robust SEs and adjustment for maternal education.

RESULTS:
Maternal occupational exposure to indoor cleaning starting preconception and continuing (n = 610) was associated with offspring's childhood asthma: odds ratio 1.56 (95% CI, 1.05-2.31), childhood asthma with nasal allergies: 1.77 (1.13-2.77), and childhood wheeze and/or asthma: 1.71 (95% CI, 1.19-2.44). Exposure starting around conception and pregnancy (n = 77) was associated with increased childhood wheeze and/or asthma: 2.25 (95% CI, 1.03-4.91). Exposure starting after birth was not associated with asthma outcomes (1.13 [95% CI, 0.71-1.80], 1.15 [95% CI, 0.67-1.97], 1.08 [95% CI, 0.69-1.67]).

CONCLUSIONS:
Mother's occupational exposure to indoor cleaning agents starting before conception, or around conception and pregnancy, was associated with more childhood asthma and wheeze in offspring. Considering potential implications for vast numbers of women in childbearing age using cleaning agents, and their children, further research is imperative.

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Comments

This is an interesting study which finds that maternal jobs with exposure to indoor cleaning agents including cleaning products/detergents and disinfectants starting before conception was associated with an increased risk of asthma in their offspring. They suggest that this is more likely to be an epigenetic effect of exposure rather than an in-utero effect, although both were possible. Maternal exposures were estimated from a JEM, we are given no clues as to which jobs were included, but jobs with passive biocide exposures (such as those working in cleaned environments where occupational asthma to cleaning agents have been documented) are likely to have been excluded, as were any domestic exposures (in cases or controls). Many cleaning agents are lipophilic and may accumulate in the future mother’s fat tissue leading to continued effects after direct exposure ceases. Any effect may also be related to altering the maternal microbiome.
1/6/2022

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