BACKGROUND AND PURPOSE:

• Excess risk of asthma and respiratory symptoms have been identified in professional cleaners as well as those cleaning their own home
• Long-term consequences have not been well studied
• Svanes et al. (American Journal of Respiratory and Critical Care Medicine, 2018) investigated long-term effects of occupational cleaning and cleaning at home on lung function decline and chronic airway obstruction

METHODS:

• International multi-center population-based cohort
  • European Community Respiratory Health Survey (ECRHS)
  • 3 time points over 20 years
• Participants: ≥1 lung function measurement and responded to questionnaire modules concerning cleaning activities
  • Categorized as “not cleaning”, “cleaning at home” and “occupational cleaning
• Exposure categorized as “not cleaning”, “≥1 cleaning spray ≥1/week”, and “≥1 other cleaning product
• Lung function measurements included
  • Forced expiratory volume in one second (FEV1)
  • Forced Vital Capacity (FVC)
• Risks adjusted for potential cofounders to assess associations

RESULTS:

• 6,230 participants were involved in the study
  • 53% were women
• Compared to women not engaged in cleaning
  • FEV1 declined more rapidly in women responsible for cleaning at home (-22.1, p=0.01) and occupational cleaners (-22.4, p=0.03)
• FCV followed a similar trend with faster decline in women who cleaned at home (-13.1, p=0.02) and occupational cleaners(-15.9, p=0.002)
• Both cleaning sprays (-22.0, p=0.04) and other cleaning agents (-22.9, p=0.004) were associated with accelerated FEV1 decline
• Cleaning was not significantly associated with lung function decline in men or with chronic airway obstruction
• Women cleaning at home and female occupational cleaners had more doctor diagnosed asthma than women not cleaning

CONCLUSION:

• Women who were exposed to cleaning supplies either at home or at work have a faster decline in lung function, suggesting a long-term impact on respiratory health
• Possible mechanisms
  • Repetitive exposure to low-grade irritative cleaning agents over time
  • Some cleaning agents may have sensitizing properties through specific immunological mechanism (e.g., quaternary ammonium compounds)
• Exposures in men who work as cleaners may be different than in women
• There may be sex differences, similar to other exposures such as tobacco smoke
• The authors state that these “findings advocate a need for further focus on preventing harmful exposure to the airways from exposure in cleaning activities.”

Learn More – Primary Sources:

Cleaning at Home and at Work in Relation to Lung Function Decline and Airway Obstruction

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