Short-term respiratory effects of cleaning exposures in domestic cleaning women

¹ Respiratory and Environmental Health Research Unit, Institut Municipal d'Investigació Mèdica, (IMIM), Barcelona, Spain; and Dept of Environmental Health, Harvard School of Public Health, Boston, MA, USA
² Respiratory and Environmental Health Research Unit, Institut Municipal d'Investigació Mèdica, (IMIM), Barcelona, Spain
³ Respiratory and Environmental Health Research Unit, Institut Municipal d'Investigació Mèdica, (IMIM), Barcelona, Spain; and Dept of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
⁴ Dept of Biostatistics, Harvard School of Public Health, Boston MA, USA
⁵ Dept of Environmental Health, Harvard School of Public Health, Boston, MA, USA; and Channing Laboratory, Brigham and Women's Hospital, Dept of Medicine, Harvard Medical School, Boston, MA, USA
⁶ Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Birmingham, UK

^* To whom correspondence should be addressed. E-mail: jpzock{at}imim.es.

	Abstract

Symptoms of obstructive lung disease in domestic cleaners have been related to the use of bleach and other irritant cleaning products. We investigated short-term effects of cleaning exposures on respiratory symptoms and peak expiratory flow (PEF) in domestic cleaners with respiratory disorders.

In a panel study, 43 domestic cleaning women with a recent history of asthma and/or chronic bronchitis completed a two-week diary collecting information on respiratory symptoms, PEF and cleaning exposures. Mixed regression models were used to assess daily changes in symptoms and PEF associated with specific cleaning exposures. The probability of having work-related asthma was individually assessed by a computerized diagnostic system (Oasys) and by an occupational asthma expert.

Lower respiratory symptoms were more common on working days (odds ratio (OR) 4.3; 95% confidence interval 1.7 to 11) and were predominantly associated with exposure to diluted bleach (OR 2.5; 1.1 to 5.8), degreasing sprays/atomizers (OR 2.6; 1.1 to 6.6) and air fresheners (OR 6.5; 2.1 to 20). Associations with upper respiratory symptoms and PEF were less apparent. Eleven subjects (30%) were positively scored for work-related asthma.

We conclude that exposure to certain irritant cleaning products aggravates lower respiratory symptoms in domestic cleaning women with asthma or chronic bronchitis.

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