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A workforce-based study of occupational exposures and asthma symptoms in cleaning workers
  1. David Vizcaya1,2,3,4,
  2. Maria C Mirabelli5,
  3. Josep-Maria Antó1,2,3,4,
  4. Ramon Orriols6,7,
  5. Felip Burgos7,8,
  6. Lourdes Arjona1,2,4,
  7. Jan-Paul Zock1,2,4
  1. 1Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
  2. 2Hospital del Mar Research Institute (IMIM), Barcelona, Spain
  3. 3Universitat Pompeu Fabra (UPF), Barcelona, Spain
  4. 4CIBER Epidemiologia y Salud Pública (CIBERESP). Barcelona, Spain
  5. 5Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
  6. 6Servei de Pneumologia, Hospital Universitari Vall d' Hebron, Barcelona, Spain
  7. 7CIBER Enfermedades Respiratorias (CIBERES), Barcelona, Spain
  8. 8Servei de Pneumologia, Hospital Clínic, IDIBAPS, Barcelona, Spain
  1. Correspondence to David Vizcaya Fernández, CREAL-Centre for Research in Environmental Epidemiology, Barcelona Biomedical Research Park, Dr Aiguader, 88 08003 Barcelona, Spain; dvizcaya{at}


Objectives To study associations between use of cleaning products and asthma symptoms in cleaning workers.

Methods Information on respiratory symptoms, history of asthma, workplaces, use of cleaning products and acute inhalation incidents were obtained through a self-administered questionnaire. 917 employees of 37 cleaning companies in Barcelona were studied. 761 (83%) were current cleaners, 86 (9%) former cleaners and 70 (8%) had never worked as cleaners. Multivariable logistic regression analyses were used to evaluate the associations between specific exposures among current cleaners and wheeze without having a cold, chronic cough and current asthma. Associations with an asthma symptom score were also studied using negative binomial regression analyses to report mean ratios.

Results After adjusting for sex, age, nationality and smoking status, the prevalence of current asthma was non-significantly higher among current (OR 1.9; 95% CI 0.5 to 7.8) and former cleaners (OR 1.9; CI 0.6 to 5.5) than in never cleaners. Cleaners working in hospitals during the last year had a significantly increased prevalence of wheeze, current asthma and a 1.8 (95% CI 1.2 to 2.8) times higher mean asthma score. Use of hydrochloric acid was strongly associated with asthma score (mean ratio 1.7; 95% CI 1.1 to 2.6). Use of ammonia, degreasers, multiple purpose products and waxes was also associated with asthma score.

Conclusions Cleaning work in places with high demand for disinfection, high cleaning standards and use of cleaning products containing respiratory irritants is associated with higher risk of asthma symptoms. This suggests irritants have an important role in cleaning-related asthma.

  • Asthma
  • cleaners
  • irritants
  • occupational asthma
  • Cross sectional studies

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  • Funding Financial support was provided by the Instituto de Salud Carlos III/European Regional Development Fund (grant number PI 06/1378). The authors also acknowledge partial funding from CIBER Epidemiología y Salud Pública (CIBERESP), Spain.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Ethics Committee of the Municipal Institute of Medical Research (IMIM), Barcelona.

  • Provenance and peer review Not commissioned; externally peer reviewed.