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What this paper adds Women employed as professional cleaners commonly use bleach, liquid detergents and other respiratory irritant cleaning products on the job.
Bleach, glass cleaner, detergents, limescale remover and air fresheners are associated with upper respiratory tract symptoms, and these associations are stronger among women with atopy than among women without atopy.
Specific cleaning products are associated with decreases in forced expiratory volume in 1 s and peak expiratory flow on the evening of and morning after exposure that are largely not statistically significant.
These results support the importance of developing workplace health and safety practices designed to limit exposures to irritant chemicals in cleaning products.
Introduction
In the past decade, numerous studies have reported on associations between cleaning-related exposures and asthma and have suggested an important role for the exposure to airway irritants. 1-3 Results from recent epidemiological and clinical studies have shown potential links between occupational cleaning-related exposures and exacerbation of existing asthma. 4-7 Findings from studies of short-term respiratory health effects following cleaning-related exposures have improved our understanding of how exposures to cleaning products may affect respiratory symptoms and lung function. In a workforce-based study of the short-term effects of cleaning products on asthma symptoms among domestic cleaning workers with pre-existing chronic bronchitis or asthma, Medina-Ramon et al 8 concluded that exposure to irritant products may exacerbate respiratory conditions. Similarly, a 12-week prospective study conducted among female homemakers with asthma showed an increased risk of lower respiratory tract symptoms (LRTS) associated with cleaning activities, though no link was found with specific cleaning exposures. 9 A case series study of 13 cleaners with and without bronchial hyper-responsiveness showed that inhalation challenge with hypochlorite bleach, even at concentrations below the 8 h occupational exposure standard, can induce a significant decrease in forced expiratory volume in 1 s (FEV1 ). 10 Likewise, exposure to chlorine, which is released when using certain cleaning products, 11 has been associated with short-term decrements in lung function among individuals with and without airways hyper-responsiveness. 12 13
The Epidemiological Study of Asthma Risk in Cleaning Workers (EPIASLI-2) cohort provided a unique opportunity to assess the relationship between occupational exposure to cleaning products and short-term changes in FEV1 and peak expiratory flow (PEF), objective measures of obstructive...