Long term effect of cleaning on lung function decline among women in the ECRHS study

Abstract

Introduction: Occupational and regular cleaning at home is associated with excess risk of asthma and respiratory symptoms, but little is known about long term effects on lung function decline.

Aim: To study whether occupational cleaning and/or cleaning at home causes accelerated lung function decline.

Methods: Lung function (FVC and FEV₁) was measured in the ECRHS multicentre population-based study in 1992-94 and at two follow-ups in 1998-02 and 2010-12. In ECRHS II 3462 women responded to the questions “since the last survey, have you been the person doing the cleaning and/or washing in your home?” and “since the last survey, have you worked as a cleaner?” respectively. Decline in FVC and FEV₁ between ECRHS I and III was analysed by mixed effect models adjusted for FEV₁, age and height at baseline, number of years between each follow-up, BMI at each survey, pack years at last survey, age at completed education, social class and centre.

Results: Between the first and last survey, women not working as cleaners or doing the cleaning at home had an adjusted mean decline in FVC and FEV₁ of 19.5 (95% CI [15.4-23.6]) and 29.6 [26.8-32.3] ml/yr, respectively. Women cleaning at home had an adjusted mean decline in FVC and FEV₁ of 24.6 [23.4-25.5] and 33.6 [32.9-34.3] ml/yr, whereas the decline in occupational cleaners was 27.6 [24.2-31.0] and 34.6 [32.2-36.7] ml/yr, respectively. Lung function decline was significantly more rapid in both groups of cleaners as compared to the reference group (p<0.001).

Conclusion: Women who work as cleaners and/or regularly clean their home had accelerated lung function decline and are thus at increased risk for the development of obstructive and/or restrictive lung disease.