Longitudinal associations of household use of cleaning agents and asthma symptoms in women: the EGEA study

Abstract

ObjectiveTo evaluate the associations between the evolution of household use of cleaning products with the asthma symptom score and its evolution over 8 years.MethodsOur study is based on 509 women participating in the last two surveys of the Epidemiological study on the Genetics and Environment of Asthma (EGEA) study (EGEA2: 2003–2007 (44 years, 19% current smokers) and EGEA3: 2011–2013). We assessed an asthma symptom score and the use of household cleaning products through standardised questionnaires. We studied longitudinal associations of the evolution of weekly use of irritant or spayed cleaning products with (1) the asthma symptom score at EGEA3 and a stable symptom score between EGEA2-EGEA3 (negative binomial models) and (2) the incidence/evolution of asthma symptoms between EGEA2-EGEA3 (logistic/polytomous logistic regressions). Models accounted for familial dependence and were adjusted for age, smoking status, body mass index and occupational exposure to asthmagens.ResultsPersistent and increased (40% and 16%, respectively) weekly use of irritants or sprays were associated with a higher risk of asthma symptoms at EGEA3 (Mean Score Ratio (MSR)=1.51 (95% CI 1.06 to 2.14) and 1.33 (95% CI 0.85 to 2.08), respectively). A decreased use (19%) was associated with a lower risk of symptoms at EGEA3, compared with a persistent use (MSR=0.59 (95% CI 0.39 to 0.88)). We also observed an association between an increased use of sprays and the incidence of asthma symptoms (OR=2.30 (95% CI 1.08 to 4.91)), compared with no weekly use of irritants/sprays.ConclusionsThis longitudinal study, with repeated assessment of exposure and respiratory health, supports the hypothesis that a persistent or increased weekly use of sprayed cleaning products over time may have an adverse effect on the evolution of asthma symptoms.

Household Use of Irritant and Sprayed Cleaning Products and Asthma Endotypes. A Brief Report

“…1,2 In the last two decades, evidence is growing on the harmful role of the weekly use of household cleaning products for respiratory health, especially irritants and those used in spray form. [3][4][5] Their use could influence the incidence, clinical expression, and control of asthma. Among the variety of ingredients contained in cleaning products, some are considered as irritants (eg, bleach, acids) and/or sensitizers (eg, perfumes) and may be associated with asthma through different mechanisms that remain poorly understood.…”

“…We assessed the household use of irritants (bleach, ammonia, acids, and solvents) and sprays at EGEA2 by self-administered standardized questionnaire. The reference group was the same for all exposure variables and defined as a no weekly use of irritants and sprays 4 . We studied the weekly use of irritants/sprays (reference, ≥1 day per week irritants/sprays), the frequency of use of irritants/sprays (reference, 1 to 3 days per week, 4 to 7 days per week), and the number of irritants/sprays used (reference, one product, two or more products).…”

“…Crude and adjusted associations for potential confounders (age, gender, smoking status, 14 and occupational exposure to asthmagens, 4 as previously performed) between weekly use of irritants and sprays and respiratory endotypes were estimated by polytomous logistic regressions. We conducted a sensitivity analysis by assessing associations in women only, as a previous study showed that men do not frequently use household cleaning products at EGEA2 15 .…”

“…Disinfectants and cleaning products are commonly used by workers, especially women, and are already known as an occupational risk factor of asthma 1,2 . In the last two decades, evidence is growing on the harmful role of the weekly use of household cleaning products for respiratory health, especially irritants and those used in spray form 3–5 . Their use could influence the incidence, clinical expression, and control of asthma.…”