Traditional and environmentally preferable cleaning product exposure and health symptoms in custodians

Garza, Jacob C.; Cavallari, Jennifer M.; Wakai, Sara; Schenck, Paula; Simcox, Nancy J.; Morse, Tim; Meyer, John D.

doi:10.1002/ajim.22484

Cited by 24 publications

(20 citation statements)

References 20 publications

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“…aldehydes) [39]. Our result thus support the investigation of emerging non-chemical technologies for disinfection (e.g., steam, ultraviolet light) as a potential alternative to chemical disinfection [15], and further research on green cleaning, integrating health risk reduction among the products’ standards [40]. …”

Section: Discussionsupporting

confidence: 70%

Occupational exposure to disinfectants and asthma control in US nurses

et al. 2017

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Disinfectant use has been associated with adverse respiratory effects among healthcare workers. However, the specific harmful agents have not been elucidated. We examined the association between occupational exposure to disinfectants and asthma control in the Nurses’ Health Study II, a large cohort of female nurses. Nurses with asthma were invited in 2014 to complete two questionnaires on their current occupation and asthma (response rate: 80%). Asthma control was defined by the Asthma Control Test (ACT). Exposure to major disinfectants was evaluated by a Job-Task-Exposure Matrix (JTEM). Analyses included 4,102 nurses with asthma (mean age: 58 years). Asthma control was poor (ACT=16–19) in 12% of nurses and very poor (≤15) in 6%. Use of disinfectants to clean medical instruments (19% exposed) was associated with poorly (odds ratio 1.37; 95%CI: [1.05–1.79]) and very poorly (1.88 [1.38–2.56]) controlled asthma (P-trend 0.004, after adjustment for potential confounders). Using JTEM estimates, exposure to formaldehyde, glutaraldehyde, hypochlorite bleach, hydrogen peroxide and enzymatic cleaners was associated with poor asthma control (all P-trend<0.05); exposure to quaternary ammonium compounds and alcohol was not. Use of several disinfectants was associated with poor asthma control. Our findings suggest targets for future efforts to prevent worsening of asthma control in healthcare workers.

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Section: Discussionsupporting

confidence: 70%

Occupational exposure to disinfectants and asthma control in US nurses

et al. 2017

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“…Several cross‐sectional studies have established an association between exposure to cleaning products and disinfectants and current asthma or asthma symptoms/exacerbations . However, in such studies, it is difficult to determine whether the observed associations are driven by occupational asthma (new‐onset asthma caused by occupational exposure) or work‐exacerbated asthma (pre‐existing asthma worsened by occupational exposure).…”

Section: Discussionmentioning

confidence: 99%

Occupational exposure to disinfectants and asthma incidence in U.S. nurses: A prospective cohort study

Dumas

Boggs

Quinot

et al. 2019

American J Industrial Med

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Background: Exposure to disinfectants among healthcare workers has been associated with respiratory health effects, in particular, asthma. However, most studies are cross-sectional and the role of disinfectant exposures in asthma development requires longitudinal studies. We investigated the association between occupational exposure to disinfectants and incident asthma in a large cohort of U.S. female nurses. Methods: The Nurses' Health Study II is a prospective cohort of 116 429 female nurses enrolled in 1989. Analyses included 61 539 participants who were still in a nursing job and with no history of asthma in 2009 (baseline; mean age: 55 years). During 277 744 person-years of follow-up (2009-2015), 370 nurses reported incident physician-diagnosed asthma. Occupational exposure was evaluated by questionnaire and a Job-Task-Exposure Matrix (JTEM). We examined the association between disinfectant exposure and subsequent asthma development, adjusted for age, race, ethnicity, smoking status, and body mass index.Results: Weekly use of disinfectants to clean surfaces only (23% exposed) or to clean medical instruments (19% exposed) was not associated with incident asthma (adjusted hazard ratio [95% confidence interval] for surfaces, 1.12 [0.87-1.43]; for instruments, 1.13 [0.87-1.48]). No association was observed between high-level exposure to specific disinfectants/cleaning products evaluated by the JTEM (formaldehyde, glutaraldehyde, bleach, hydrogen peroxide, alcohol quats, or enzymatic cleaners) and asthma incidence. Conclusions:In a population of late career nurses, we observed no significant association between exposure to disinfectants and asthma incidence. A potential role of disinfectant exposures in asthma development warrants further study among healthcare workers at earlier career stage to limit the healthy worker effect. K E Y W O R D Sasthma, cleaning products, disinfection, healthcare workers, occupational asthma

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“…There is no single standard definition for “green” cleaning products in the U.S. The absence of asthmagens or allergens is among the required criteria for only some of the green or environmentally preferable labels [Garza et al, ; Quinn et al, ]. Regional differences in the use of green products may, thus, be driven by differential environmental considerations or health concerns other than asthma.…”

Section: Discussionmentioning

confidence: 99%

“…Reducing the use of sprays may be relevant as part of a strategy for asthma prevention. Experts have also encouraged the investigation of green cleaning [Garza et al, ], and of emerging non‐chemical technologies for disinfection (e.g., steam, ultraviolet light) as a potential alternative to chemical disinfection [Quinn et al, ].…”

Section: Discussionmentioning

confidence: 99%

Determinants of disinfectant use among nurses in U.S. healthcare facilities

Dumas

Wiley

Henneberger

et al. 2016

American J Industrial Med

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Background Disinfectant use among healthcare workers has been associated with respiratory disorders, especially asthma. We aimed to describe disinfectants used by U.S. nurses, and to investigate qualitative and quantitative differences according to workplace characteristics and region. Methods Disinfectant use was assessed by questionnaire in 8,851 nurses. Hospital characteristics were obtained from the American Hospital Association database. Results Working in a hospital was associated with higher disinfectant use (OR: 2.06 [95%CI: 1.89-2.24]), but lower spray use (0.74 [0.66-0.82]). Nurses working in smaller hospitals (<50 beds vs. ≥200 beds) were more likely to use disinfectants (1.69 [1.23-2.32]) and sprays (1.69 [1.20-2.38]). Spray use was lower in the West than in the Northeast (0.75 [0.58-0.97]). Conclusion Disinfectant use was more common among nurses working in smaller hospitals, possibly because they perform more diverse tasks. Variations in spray use by hospital size and region suggest additional targets for future efforts to prevent occupational asthma.

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Traditional and environmentally preferable cleaning product exposure and health symptoms in custodians

Cited by 24 publications

References 20 publications

Occupational exposure to disinfectants and asthma control in US nurses

Occupational exposure to disinfectants and asthma control in US nurses

Occupational exposure to disinfectants and asthma incidence in U.S. nurses: A prospective cohort study

Determinants of disinfectant use among nurses in U.S. healthcare facilities

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