Original Articles: Asthma, Lower Airway Diseases
Evaluation of cleaning activities on respiratory symptoms in asthmatic female homemakers

https://doi.org/10.1016/S1081-1206(10)60106-8Get rights and content

Background

Asthma among professional cleaners is recognized as a common cause of new-onset and aggravated occupational asthma. Women are usually the primary persons responsible for cleaning their homes, but little information is available regarding the health impact of cleaning in the nonoccupational setting.

Objectives

To compare health effects of cleaning among asthmatic and nonasthmatic women who are the primary cleaners in their homes.

Methods

A 12-week, prospective, parallel-group study assessing the effects of cleaning on peak expiratory flow rates and upper and lower respiratory tract symptoms in women with and without asthma.

Results

Twenty-five women with asthma and 19 without asthma, ages 18 to 65 years, completed the study. No effect was observed on peak expiratory flow rates after cleaning between groups. Upper respiratory tract symptoms increased after cleaning for both groups, adjusted for chemical severity exposure index and duration of cleaning. However, the change in the number of lower respiratory tract symptoms (after cleaning minus before cleaning) was statistically significant for asthmatic patients compared with nonasthmatic patients (P = .01).

Conclusions

The study suggests that cleaning activities are associated with increased lower respiratory tract symptoms in asthmatic patients independent of chemical severity exposure index and cleaning duration. Women with asthma should be routinely interviewed as to whether they clean their home and cautioned about the potential respiratory health effects of these activities.

Section snippets

INTRODUCTION

Asthma is a chronic inflammatory lung disease that affects approximately 20 million individuals in the United States, but asthma mortality rates are higher among women compared with men.1, 2 This alarming statistic makes asthma an important women's health issue.3 Data from surveillance registries in many countries have identified cleaning as being strongly associated with a cause for workplace-related asthma.4 The third National Health and Nutrition Examination Survey reported that hospital

Study Design and Participant Recruitment

This parallel-group, longitudinal pilot study was designed to generate data to determine the health effects of household cleaning in asthmatic vs nonasthmatic women. Twenty-five women with asthma (forced expiratory volume in 1 second [FEV1] ≥60%) and 25 without asthma, between the ages of 18 and 65 years, were recruited from a clinical allergy practice. A prescreening questionnaire was used to identify women with mild to moderate persistent asthma who were the primary household cleaner for the

RESULTS

Table 1 summarizes demographic characteristics and baseline information of patients in the asthma and nonasthma groups. The mean ages of patients in the asthma and nonasthma groups were 49.6 and 45.7 years, respectively. Patients were predominantly white (92%) in the asthma group compared with the nonasthma group (63%) (P = .02). The presence of having a clinical diagnosis of allergic and/or nonallergic rhinitis and atopic status, defined as producing specific IgE antibodies to environmental

DISCUSSION

This prospective pilot study investigating the health effects experienced by women who clean their homes demonstrated increased lower respiratory tract symptoms during cleaning in asthmatic women compared with nonasthmatic women in the absence of significant changes in PEFR. The increased occurrence of lower respiratory tract symptoms in the asthma group without significant changes in PEFR emphasizes the known discrepancy between symptoms and objective changes in lung function. Several studies15

REFERENCES (16)

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Cited by (21)

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    Citation Excerpt :

    For example, a recent review of 24 epidemiological studies found that household cleaning products may trigger asthma, bronchitis, and rhinitis, while bleach (hypochlorite) may trigger wheezing, shortness of breath, and coughing (Folletti et al., 2014). Indeed, household cleaning sprays have been linked to adult asthma (Zock et al., 2007; Le Moual et al., 2012), as well as to increased lower respiratory symptoms in asthma patients, especially women (Bernstein et al., 2009). Despite active research, many consumer cleaning products have unknown health effects.

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Disclosures: Authors have nothing to disclose.

Funding Sources: This study was funded by the CHEST Foundation Women's Health Initiative Award.

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