Update on asthma and cleaners

Abstract

Purpose of review: The present study summarizes the recent literature on the relation between cleaning exposures and respiratory health, in particular asthma, including reviews, epidemiological surveys, surveillance programmes and exposure studies. The authors also aimed to identify gaps in the current knowledge and to recommend future research on the topic.

Recent findings: A large international general population study showed an increased risk of new-onset asthma associated with cleaning work, with professional use of cleaning products and with domestic use of cleaning sprays. Three surveillance studies confirm the recognition of occupational asthma cases among cleaners and among others who use cleaning products at work. Six workforce-based studies show that respiratory symptoms are partly work-related, and are associated with certain specific exposures including sprays, chlorine bleach and other disinfectants.

Summary: Recent studies have strengthened the evidence of asthma and other adverse respiratory effects in cleaning workers. Similar effects are seen in other settings in which cleaning products are used such as healthcare professionals and homemakers. Both new-onset asthma and work-exacerbated asthma due to cleaning exposures may play a role. Exposure to cleaning sprays, chlorine bleach and other disinfectants may be particularly relevant. The predominant effect mechanisms remain largely unclear and may include both specific sensitization and irritant-related features.

Figure 1

Process flow diagram of the tasks performed for patient room cleaning. The shaded boxes indicate cleaning tasks/steps with higher potential for inhalation exposure. Reproduced from [21*].