Update on effects of cleaning agents on allergy and asthma
Abstract
Background: Cleaning and disinfecting agents are widely used in modern life, in homes, schools, public places, and workplaces as well as in recreational facilities such as swimming pools. Use has been for sanitizing purposes and to assist in reduction of infection as well as for deodorizing purposes. However, adverse respiratory effects have been associated with use of cleaning products ranging from effects in infancy and early childhood up to adults at home and work.
Methods: This review summarizes recent published literature on the effects of cleaning agents used pre-natally, in childhood and adult life, at home, work, and in swimming pools.
Results: Several studies have indicated that there is an increased risk of developing asthma among adults with frequent exposure to cleaning products at work and in the home. Potential mechanisms include sensitization and respiratory irritant effects. Exposure to irritant chlorine by-products from swimming pools have also been associated with respiratory effects and increased risk of asthma. Potential effects from maternal exposures to cleaning products on infants, and effects on early childhood atopy are less clear.
Conclusions: Exposure to cleaning agents increases relative risks of asthma among workers, and adults using these agents in the home. Risks are also increased with exposure to chlorinated by-products from swimming pools, both in adults and children. Further studies are needed to understand the mechanisms of these associations.
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REFERENCES
Arif A.A. and Delclos G.L. 2012. Association between cleaning-related chemicals and work-related asthma and asthma symptoms among healthcare professionals. Occup. Environ. Med. 69:35–40.
Arif A.A., Delclos G.L., and Serra C. 2009. Occupational exposures and asthma among nursing professionals. Occup. Environ. Med. 66:274–278.
Barnes C.S., Kennedy K., Gard L., Forrest E., Johnson L., Pacheco F., Hu F., Amado M., and Portnoy J.M. 2008. The impact of home cleaning on quality of life for homes with asthmatic children. Allergy Asthma Proc. 29:197–204.
Bedard A., Varraso R., Sanchez M., Clavel-Chapelon F., Zock J.P., Kauffmann F., and Le Moual N. 2014. Cleaning sprays, household help and asthma among elderly women. Respir. Med. 108:171–180.
Bello A., Quinn M.M., Perry M.J., and Milton D.K. 2010. Quantitative assessment of airborne exposures generated during common cleaning tasks: A pilot study. Environ. Health. 9:76.
Bernard A. 2007. Chlorination products: Emerging links with allergic diseases. Curr. Med. Chem. 14:1771–1782.
Bernard A., Carbonnelle S., de Burbure C., Michel O., and Nickmilder M. 2006. Chlorinated pool attendance, atopy, and the risk of asthma during childhood. Environ. Health Perspect. 114:1567–1573.
Bernard A., Nickmilder M., and Dumont X. 2015. Chlorinated pool attendance, airway epithelium defects and the risks of allergic diseases in adolescents: Interrelationships revealed by circulating biomarkers. Environ. Res. 140:119–126.
Bernstein J.A., Brandt D., Rezvani M., Abbott C., and Levin L. 2009. Evaluation of cleaning activities on respiratory symptoms in asthmatic female homemakers. Ann. Allergy Asthma Immunol. 102:41–46.
Bougault V. and Boulet L.P. 2012. Is there a potential link between indoor chlorinated pool environment and airway remodeling/inflammation in swimmers? Expert Rev. Respir. Med. 6:469–471.
Casas L., Zock J.P., Carsin A.E., Fernandez-Somoano A., Esplugues A., Santa-Marina L., Tardon A., Ballester F., Basterrechea M., and Sunyer J. 2013. The use of household cleaning products during pregnancy and lower respiratory tract infections and wheezing during early life. Int. J. Public Health. 58:757–764.
Casey M.L., Hawley B., Edwards N., Cox-Ganser J.M., and Cummings K.J. 2017. Health problems and disinfectant product exposure among staff at a large multispecialty hospital. Am. J. Infect. Control. 45:1133–1138.
Dimich-Ward H., Wymer M.L., and Chan-Yeung M. 2004. Respiratory health survey of respiratory therapists. Chest. 126:1048–1053.
Dumas O., Donnay C., Heederik D.J., Hery M., Choudat D., Kauffmann F., and Le Moual N. 2012. Occupational exposure to cleaning products and asthma in hospital workers. Occup. Environ. Med. 69:883–889.
Ege M.J. 2017. The hygiene hypothesis in the age of the microbiome. Ann. Am. Thorac. Soc. 14:S348–S353.
El-Helaly M., Balkhy H.H., Waseem K., and Khawaja S. 2016. Respiratory symptoms and ventilatory function among health-care workers exposed to cleaning and disinfectant chemicals, a 2-year follow-up study. Toxicol. Ind. Health. 32:2002–2008.
Folletti I., Siracusa A., and Paolocci G. 2017. Update on asthma and cleaning agents. Curr. Opin. Allergy Clin. Immunol. 17:90–95.
Font-Ribera L., Kogevinas M., Zock J.P., Gómez F.P., Barreiro E., Nieuwenhuijsen M.J., Fernandez P., Lourencetti C., Pérez-Olabarría M., Bustamante M., Marcos R., Grimalt J.O., and Villanueva C.M. 2010. Short-term changes in respiratory biomarkers after swimming in a chlorinated pool. Environ. Health Perspect. 118:1538–1544.
Gonzalez M., Jegu J., Kopferschmitt M.C., Donnay C., Hedelin G., Matzinger F., Velten M., Guilloux L., Cantineau A., and de Blay F. 2014. Asthma among workers in healthcare settings: Role of disinfection with quaternary ammonium compounds. Clin. Exp. Allergy. 44:393–406.
Gotzev S., Lipszyc J.C., Connor D., and Tarlo S.M. 2016. Trends in occupations and work sectors among patients with work-related asthma at a Canadian tertiary care clinic. Chest. 150:811–818.
Helenius I. and Haahtela T. 2000. Allergy and asthma in elite summer sport athletes. J. Allergy Clin. Immunol. 106:444–452.
Henderson J., Sherriff A., Farrow A., and Ayres J.G. 2008. Household chemicals, persistent wheezing and lung function: Effect modification by atopy? Eur. Respir. J. 31:547–554.
Knoeller G.E., Mazurek J.M., and Moorman J.E. 2013. Health-related quality of life among adults with work-related asthma in the United States. Qual. Life Res. 22:771–780.
Kurtz S.L. 2016. Are we sending the wrong message when we ask health care workers to wash their hands? Am. J. Infect. Control. 44:1184–1186.
Le Moual N., Varraso R., Siroux V., Dumas O., Nadif R., Pin I., Zock J.-P., and Kauffmann F. 2012. Domestic use of cleaning sprays and asthma activity in females. Eur. Respir. J. 40:1381–1389.
Le Moual N., Rava M., Siroux V., Matran R., and Nadif R. 2014. Use of household cleaning products, exhaled nitric oxide and lung function in females. Eur. Respir. J. 44:816–818.
Lipinska-Ojrzanowska A., Wiszniewska M., Swierczynska-Machura D., Wittczak T., Nowakowska-Swirta E., Palczynski C., and Walusiak-Skorupa J. 2014. Work-related respiratory symptoms among health centres cleaners: A cross-sectional study. Int. J. Occup. Med. Environ. Health. 27:460–466.
Liu A.H. 2015. Revisiting the hygiene hypothesis for allergy and asthma. J. Allergy Clin. Immunol. 136:860–865.
Matulonga B., Rava M., Siroux V., Bernard A., Dumas O., Pin I., Zock J.P., Nadif R., Leynaert B., and Le Moual N. 2016. Women using bleach for home cleaning are at increased risk of non-allergic asthma. Respir. Med. 117:264–271.
Moore V.C., Burge P.S., Robertson A.S., and Walters G.I. 2017. What causes occupational asthma in cleaners? Thorax. 72:581–583.
Nickmilder M. and Bernard A. 2007. Ecological association between childhood asthma and availability of indoor chlorinated swimming pools in Europe. Occup. Environ. Med. 64:37–46.
Nickmilder M., Carbonnelle S., and Bernard A. 2007. House cleaning with chlorine bleach and the risks of allergic and respiratory diseases in children. Pediatr. Allergy Immunol. 18:27–35.
Pechter E., Davis L.K., Tumpowsky C., Flattery J., Harrison R., Reinisch F., Reilly M.J., Rosenman K.D., Schill D.P., Valiante D., and Filios M. 2005. Work-related asthma among health care workers: Surveillance data from California, Massachusetts, Michigan, and New Jersey, 1993–1997. Am. J. Ind. Med. 47:265–275.
Petrova M., Diamond J., Schuster B., and Dalton P. 2008. Evaluation of trigeminal sensitivity to ammonia in asthmatics and healthy human volunteers. Inhal. Toxicol. 20:1085–1092.
Siracusa A., de Blay F., Folletti I., Moscato G., Olivieri M., Quirce S., Raulf-Heimsoth M., Sastre J., Tarlo S.M., Walusiak-Skorupa J., and Zock J.P. 2013. Asthma and exposure to cleaning products—A European Academy of Allergy and Clinical Immunology task force consensus statement. Allergy. 68:1532–1545.
Stelmach I., Bobrowska-Korzeniowska M., Smejda K., Majak P., Jerzynska J., Stelmach W., Polanska K., Sobala W., Krysicka J., and Hanke W. 2014. Risk factors for the development of atopic dermatitis and early wheeze. Allergy Asthma Proc. 35:382–389.
Strachan D.P. 2000. Family size, infection and atopy: The first decade of the ‘hygiene hypothesis’. Thorax. 55(Suppl. 1):S2–S10.
Svanes O., Bertelsen R.J., Lygre S.H.L., Carsin A.E., Anto J.M., Forsberg B., Garcia-Garcia J.M., Gullon J.A., Heinrich J., Holm M., Kogevinas M., Urrutia I., Leynaert B., Moratalla J.M., Le Moual N., Lytras T., Norback D., Nowak D., Olivieri M., Pin I., Probst-Hensch N., Schlunssen V., Sigsgaard T., Skorge T.D., Villani S., Jarvis D., Zock J.P., and Svanes C. 2018. Cleaning at home and at work in relation to lung function decline and airway obstruction. Am. J. Respir. Crit. Care Med. 197:1157–1163.
Tarlo S.M., Arif A.A., Delclos G.L., Henneberger P., and Patel J. 2018. Opportunities and obstacles in translating evidence to policy in occupational asthma. Ann. Epidemiol. 28:392–400.
Uyan Z.S., Carraro S., Piacentini G., and Baraldi E. 2009. Swimming pool, respiratory health, and childhood asthma: Should we change our beliefs? Pediatr. Pulmonol. 44:31–37.
Valeriani F., Protano C., Vitali M., and Romano Spica V. 2017a. Swimming attendance during childhood and development of asthma: Meta-analysis. Pediatr. Int. 59:614–621.
Valeriani F., Protano C., Vitali M., and Romano Spica V. 2017b. Swimming pool attendance during childhood and development of asthma: Reply. Pediatr. Int. 59:847–848.
Vandenplas O., D’Alpaos V., Evrard G., Jamart J., Thimpont J., Huaux F., and Renauld J.-C. 2013. Asthma related to cleaning agents: A clinical insight. BMJ Open. 3:e003568.
Voisin C., Sardella A., Marcucci F., and Bernard A. 2010. Infant swimming in chlorinated pools and the risks of bronchiolitis, asthma and allergy. Eur. Respir. J. 36:41–47.
Walters G.I., Moore V.C., McGrath E.E., Burge P.S., and Henneberger P.K. 2013. Agents and trends in health care workers’ occupational asthma. Occup. Med. 63:513–516.
Walters G.I., Robertson A.S., Moore V.C., and Burge P.S. 2017. Occupational asthma caused by sensitization to a cleaning product containing triclosan. Ann. Allergy Asthma Immunol. 118:370–371.
Weber J., Illi S., Nowak D., Schierl R., Holst O., von Mutius E., and Ege M.J. 2015. Asthma and the hygiene hypothesis. Does cleanliness matter? Am. J. Respir. Crit. Care Med. 191:522–529.
Weinmann T., Gerlich J., Heinrich S., Nowak D., Mutius E.V., Vogelberg C., Genuneit J., Lanzinger S., Al-Khadra S., Lohse T., Motoc I., Walter V., and Radon K. 2017. Association of household cleaning agents and disinfectants with asthma in young German adults. Occup. Environ. Med. 74:684–690.
Weisel C.P., Richardson S.D., Nemery B., Aggazzotti G., Baraldi E., Blatchley E.R. 3rd, Blount B.C., Carlsen K.H., Eggleston P.A., Frimmel F.H., Goodman M., Gordon G., Grinshpun S.A., Heederik D., Kogevinas M., Lakind J.S., Nieuwenhuijsen M.J., Piper F.C., and Sattar S.A. 2009. Childhood asthma and environmental exposures at swimming pools: State of the science and research recommendations. Environ. Health Perspect. 117:500–507.
Weng S.C., Weaver W.A., Afifi M.Z., Blatchley T.N., Cramer J.S., Chen J., and Blatchley E.R. 2011. Dynamics of gas-phase trichloramine (NCl3) in chlorinated, indoor swimming pool facilities. Indoor Air. 21:391–399.
Zock J.-P., Plana E., Jarvis D., Antó J.M., Kromhout H., Kennedy S.M., Künzli N., Villani S., Olivieri M., Torén K., Radon K., Sunyer J., Dahlman-Hoglund A., Norbäck D., and Kogevinas M. 2007. The use of household cleaning sprays and adult asthma: An international longitudinal study. Am. J. Respir. Crit. Care Med. 176:735–741.
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Published In
LymphoSign Journal
Volume 5 • Number 4 • December 2018
Pages: 121 - 129
History
Received: 1 September 2018
Accepted: 27 September 2018
Accepted manuscript online: 11 October 2018
Version of record online: 11 October 2018
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© 2018.
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ShivonnePrasad, Joshua C.Lipszyc, and Susan M.Tarlo. 2018. Update on effects of cleaning agents on allergy and asthma. LymphoSign Journal.
5(4): 121-129. https://doi.org/10.14785/lymphosign-2018-0013
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