Rhinitis, sinusitis, and upper airway diseaseDomestic use of hypochlorite bleach, atopic sensitization, and respiratory symptoms in adults
Section snippets
Study design and participants
The ECRHS is a multicenter study designed to identify risk factors for asthma and allergy. Participants age between 20 and 44 years were recruited from 1992 to 1994 by random sampling from a community-based sampling frame in each center. A random sample of responders to a short postal questionnaire was invited for clinical testing. In 2001 and 2002, participants who had taken part in these clinical investigations were invited for further study (ECRHS II).18 Twenty-two centers from 10 European
Results
About two thirds of the study population were women (Table I). Twenty-eight percent had any atopic sensitization, predominantly against grass and house dust mite. Allergic conditions (rhinitis, eczema, and to a lesser extent, asthma) and associated symptoms were common.
Sixty-three percent of the study population reported ever using bleach in their homes; approximately 1 in 4 (28%) used bleach on a weekly basis, and 1 in 10 did so at least every second day, if not daily (Table II). The use of
Discussion
In this large observational study among adults from 10 European countries, we found that the use of hypochlorite bleach in the home was associated with lower rates of sensitization to common environmental allergens. This inverse association was present for specific IgE to both indoor and outdoor allergens, and was consistent in various subgroups including those without clinically apparent respiratory disease, and the effect was stronger when bleach was used more frequently. Allergic symptoms
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2018, Annals of EpidemiologyCitation Excerpt :Other blocks also appeared to be relevant (e.g., “chemical products”, “humid cleaning”). Furthermore, it is interesting to note that bleach, the use of which may vary across social groups [39] regardless of other general cleaning habits, resulted in a single-variable block, indicating that this variable was not correlated with the other ones, conditionally on class. The seven resulting classes also appeared relevant as they could be distinguished by the intensity of general cleaning tasks and the intensity of use of specific products, and for some classes distinction according to the type of products used (e.g., specific chemicals vs. sprays).
The coordination of the European Community Respiratory Health Survey II was supported by the European Commission as part of their Quality of Life program. This work was also funded by the US National Institutes of Health (grant 1R01HL062633) and the Carlos III Health Institute of the Spanish Ministry of Health and Consumption (Fondo de Investigaciones Santarias [FIS] grant 01/3058). The following bodies funded the local studies in the European Community Respiratory Health Survey II included in this article: Albacete, FIS (grants 97/0035-01, 99/0034-01, and 99/0034-02), Hospital Universitario de Albacete, Consejeria de Sanidad; Antwerp, Fund for Scientific Research, Flanders, Belgium (grant G.0402.00), University of Antwerp, Flemish Health Ministry; Barcelona, SEPAR, Public Health Service (grant R01 HL62633-01), FIS (grants 97/0035-01, 99/0034-01, and 99/0034-02), CIRIT (grant 1999SGR 00241), Red Respira ISCII; Basel, Swiss National Science Foundation, Swiss Federal Office for Education and Science, Swiss National Accident Insurance Fund, USC NIEHS Center (grant 5P30 ES07048); Bergen, Norwegian Research Council, Norwegian Asthma and Allergy Association, Glaxo Wellcome AS, Norway Research Fund; Erfurt, GSF-National Research Centre for Environment and Health, Deutsche Forschungsgemeinschaft (grant FR 1526/1-1); Galdakao, Basque Health Department; Göteborg, Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Grenoble, Programme Hospitalier de Recherche Clinique-DRC de Grenoble 2000 no. 2610, Ministry of Health, Direction de la Recherche Clinique, Ministere de l'Emploi et de la Solidarite, Direction Generale de la Sante, CHU de Grenoble, Comite des Maladies Respiratoires de l'Isere; Hamburg, GSF-National Research Centre for Environment and Health, Deutsche Forschungsgemeinschaft (grant MA 711/4-1); Ipswich and Norwich, Asthma UK (formerly known as the National Asthma Campaign); Huelva, FIS (grants 97/0035-01, 99/0034-01, and 99/0034-02); Oviedo, FIS (grants 97/0035-01, 99/0034-01, and 99/0034-02);Paris, Ministere de l'Emploi et de la Solidarite, Direction Generale de la Sante, UCB-Pharma (France), Aventis (France), Glaxo France, Programme Hospitalier de Recherche Clinique-DRC de Grenoble 2000 no. 2610, Ministry of Health, Direction de la Recherche Clinique, CHU de Grenoble; Pavia, GlaxoSmithKline Italy, Italian Ministry of University and Scientific and Technological Research, Local University Funding for research 1998 and 1999; Tartu, Estonian Science Foundation; Turin, ASL 4 Regione Piemonte, AO CTO/ICORMA Regione Piemonte, Italian Ministry of University and Scientific and Technological Research; GlaxoSmithKline Italy; Umeå, Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Uppsala, Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Verona, University of Verona; Italian Ministry of University and Scientific and Technological Research; GlaxoSmithKline Italy.
Disclosure of potential conflict of interest: G. Benke has received research support from the National Health and Medical Research Council of Australia. P. D. Blanc has received research support from the National Institutes of Health, UC Tobacco Related Diseases, and FAMRI and has served as an expert witness on hepatotoxicity and inhalation injury. J. Sunyer has received research support from the European Union, Ministry of Health, Spain, and the Ministry of Health, Catalonia. The rest of the authors have declared that they have no conflict of interest.