Asthma and exposure to cleaning products

作者：Dumas O^*; Kauffmann F; Le Moual N

来源：Archives des Maladies Professionnelles et de l'Environnement, 2013, 74(2): 117-129.

• Asthma
• Cleaning
• Disinfecting
• Occupational exposure
• Domestic exposure
• Healthcare workers

Aim of the study. Exposure to cleaning products is common, both at the workplace and at home. The objective of this article is to summarize the literature on the relationship between asthma and exposure to cleaning products.
Methods. A literature review has been conducted. After a brief presentation of the cleaning products potentially affecting respiratory health, results from case studies, surveillance studies and epidemiological studies are synthesized.
Results. Cleaning and disinfecting products contain numerous chemicals, which may be irritants or sensitizers. Surveillance studies have underlined the role of exposure to cleaning products in occupational asthma and in work-exacerbated asthma, in particular in the healthcare industry. In epidemiological studies, associations with asthma were observed for healthcare and cleaning workers, or for exposure to cleaning products, in several cross-sectional studies and in one prospective longitudinal study. In studies with information regarding specific cleaning products, associations with asthma have been observed mostly for ammonia, bleach and cleaning sprays. Few studies have investigated the specific asthma phenotypes associated with exposure to cleaning products. Non IgE-dependent and IgE-dependent mechanisms have been suggested. Assessment methods for exposure to cleaning products need improvement. Assessment of exposure to specific cleaning products is often based on self-report, which may generate differential misclassification bias.
Discussion and conclusion. It is now established that exposure to cleaning products is related to both asthma onset and exacerbations of preexisting asthma. However, several questions remain regarding the specific cleaning products involved and their mechanisms. More objective exposure assessment methods, applicable to large populations such as task-exposure matrix, need to be developed. Quantitative measurements would be useful to improve exposure assessment.

• 出版日期2013-4