Occupational Asthma Reference
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Vizcaya D, Mirabelli MC, Gimeno D, Antó J, Delclos GL, Rivera M, Orriols R, Arjona L, Burgos F,
Cleaning products and short-term respiratory effects among female cleaners with asthma,
Occup Environ Med,
2015;72:757-763,10.1136/oemed-2013-102046
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(Plain text:
Vizcaya D, Mirabelli MC, Gimeno D, Anto J, Delclos GL, Rivera M, Orriols R, Arjona L, Burgos F,
Cleaning products and short-term respiratory effects among female cleaners with asthma,
Occup Environ Med)
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Keywords: Cleaner,pef, Spain, chlorine, ammonia, hydrochloric acid
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Abstract
Objective
We evaluated the short-term effects of exposure to cleaning products on lung function and respiratory symptoms among professional cleaning women.
Methods
Twenty-one women with current asthma and employed as professional cleaners participated in a 15-day panel study. During 312 person-days of data collection, participants self-reported their use of cleaning products and respiratory symptoms in daily diaries and recorded their forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF) three times per day using a handheld spirometer. We evaluated associations of cleaning product use with upper and lower respiratory tract symptoms using Poisson mixed regression models and with changes in FEV1 and PEF using linear mixed regression analyses.
Results
Participants reported using an average of 2.4 cleaning products per day, with exposure to at least one strong irritant (eg, ammonia, bleach, hydrochloric acid) on 56% of person-days. Among participants without atopy, lower respiratory tract symptoms were associated with the use of hydrochloric acid and detergents. Measurements of FEV1 and PEF taken in the evening were 174 mL (95% CI 34 to 314) and 37 L/min (CI 4 to 70), respectively, lower on days when three or more sprays were used. Evening and next morning FEV1 were both lower following the use of hydrochloric acid (-616 and -526 mL, respectively) and solvents (-751 and -1059 mL, respectively). Diurnal variation in FEV1 and PEF increased on days when ammonia and lime-scale removers were used.
Conclusions
The use of specific cleaning products at work, mainly irritants and sprays, may exacerbate asthma.
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Comments
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This study provides evidence of lung function decline in symptomatic cleaners, the decline was still present the following morning making short-term irritant effects an unlikely explanation. There is a lack of information on the content of the cleaning agants used, particularly whether any contained enzymes. There was a dose-respons relationship between the number of sprays used and decline in FEV1.
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