1
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Agache I, Canelo-Aybar C, Annesi-Maesano I, Cecchi L, Biagioni B, Chung F, D'Amato G, Damialis A, Del Giacco S, De Las Vecillas L, Dominguez-Ortega J, Galàn C, Gilles S, Giovannini M, Holgate S, Jeebhay M, Nadeau K, Papadopoulos N, Quirce S, Sastre J, Traidl-Hoffmann C, Walusiak-Skorupa J, Sousa-Pinto B, Salazar J, Rodríguez-Tanta LY, Cantero Y, Montesinos-Guevara C, Song Y, Alvarado-Gamarra G, Sola I, Alonso-Coello P, Nieto-Gutierrez W, Jutel M, Akdis CA. The impact of indoor pollution on asthma-related outcomes: A systematic review for the EAACI guidelines on environmental science for allergic diseases and asthma. Allergy 2024. [PMID: 38366695 DOI: 10.1111/all.16051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 02/18/2024]
Abstract
Systematic review using GRADE of the impact of exposure to volatile organic compounds (VOCs), cleaning agents, mould/damp, pesticides on the risk of (i) new-onset asthma (incidence) and (ii) adverse asthma-related outcomes (impact). MEDLINE, EMBASE and Web of Science were searched for indoor pollutant exposure studies reporting on new-onset asthma and critical and important asthma-related outcomes. Ninety four studies were included: 11 for VOCs (7 for incidenceand 4 for impact), 25 for cleaning agents (7 for incidenceand 8 for impact), 48 for damp/mould (26 for incidence and 22 for impact) and 10 for pesticides (8 for incidence and 2 for impact). Exposure to damp/mould increases the risk of new-onset wheeze (moderate certainty evidence). Exposure to cleaning agents may be associated with a higher risk of new-onset asthma and with asthma severity (low level of certainty). Exposure to pesticides and VOCs may increase the risk of new-onset asthma (very low certainty evidence). The impact on asthma-related outcomes of all major indoor pollutants is uncertain. As the level of certainty is low or very low for most of the available evidence on the impact of indoor pollutants on asthma-related outcomes more rigorous research in the field is warranted.
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Affiliation(s)
- Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Carlos Canelo-Aybar
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - Isabella Annesi-Maesano
- Institute Desbrest of Epidemiology and Public Health, University of Montpellier and INSERM, Montpellier, France
| | - Lorenzo Cecchi
- Centre of Bioclimatology, University of Florence, Florence, Italy
| | - Benedetta Biagioni
- Allergy and Clinical Immunology Unit, San Giovanni di Dio Hospital, Florence, Italy
| | | | - Gennaro D'Amato
- Respiratory Disease Department, Hospital Cardarelli, Naples, Italy
- Medical School of Respiratory Allergy, University of Naples Federico II, Naples, Italy
| | - Athanasios Damialis
- Department of Ecology, School of Biology, Faculty of Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy
| | - Leticia De Las Vecillas
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Javier Dominguez-Ortega
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Carmen Galàn
- Department of Botany, Ecology and Plant Physiology, International Campus of Excellence on Agrifood (ceiA3), University of Córdoba, Córdoba, Spain
| | - Stefanie Gilles
- Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Stephen Holgate
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Mohamed Jeebhay
- Occupational Medicine Division and Centre for Environmental & Occupational Health Research, University of Cape Town, Cape Town, South Africa
| | - Kari Nadeau
- Department of Environmental Health, Center for Climate, Health, and the Global Environment, Climate and Population Studies, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Nikos Papadopoulos
- Allergy and Clinical Immunology Unit, Second Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
- University of Manchester, Manchester, UK
| | - Santiago Quirce
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Joaquin Sastre
- Allergy Service, Fundación Jiménez Díaz, Faculty of Medicine Universidad Autónoma de Madrid and CIBERES, Instituto Carlos III, Ministry of Science and Innovation, Madrid, Spain
| | - Claudia Traidl-Hoffmann
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- Institute of Environmental Medicine, Helmholtz Center Munich -German Research Center for Environmental Health, Augsburg, Germany
- Christine Kühne Center for Allergy Research and Education, Davos, Switzerland
| | - Jolanta Walusiak-Skorupa
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Josefina Salazar
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - L Yesenia Rodríguez-Tanta
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - Yahveth Cantero
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - Camila Montesinos-Guevara
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Yang Song
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - Giancarlo Alvarado-Gamarra
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - Ivan Sola
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - Pablo Alonso-Coello
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Wendy Nieto-Gutierrez
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
- Centro Cochrane Iberoamericano, Sant Antoni Maria Claret, Barcelona, Spain
| | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University, and ALL-MED Medical Research Institute, Wroclaw, Poland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
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2
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Mwanga HH, Baatjies R, Jeebhay MF. Occupational risk factors and exposure-response relationships for airway disease among health workers exposed to cleaning agents in tertiary hospitals. Occup Environ Med 2023; 80:361-371. [PMID: 37137692 DOI: 10.1136/oemed-2022-108763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 04/20/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES This study investigated occupational risk factors and exposure-response relationships for airway disease among health workers (HWs) exposed to cleaning agents in two tertiary hospitals in South Africa and Tanzania. METHODS In this cross-sectional study, 697 participants completed questionnaire interviews while 654 underwent fractional exhaled nitric oxide (FeNO) testing. Asthma Symptom Score (ASS) was computed based on the sum of answers to five questions on asthma-related symptoms in the past 12 months. For exposure-response analyses, cleaning agent-related self-reported exposure variables were categorised into three levels (cleaning product not used; use of a cleaning product for up to 99 min per week and use of a cleaning product for ≥100 min per week). RESULTS Asthma-related outcomes (ASS and FeNO) demonstrated positive associations with medical instrument cleaning agents (orthophthalaldehyde and enzymatic cleaners) and tasks (instruments precleaning and changing sterilisation solutions) as well as patient care activities (disinfection prior to procedures and disinfecting wounds). A particularly pronounced dose-response relationship was observed between work-related ocular-nasal symptoms and medical instrument cleaning agents (orthophthalaldehyde, glutaraldehyde, enzymatic cleaners, alcohols and bleach) (OR range: 2.37-4.56) and tasks (OR range: 2.92-4.44). A strong association was also observed between ASS and use of sprays for fixed surface cleaning (mean ratio 2.81; 95% CI 1.41 to 5.59). CONCLUSIONS Specific agents for medical instrument disinfection for example, orthophthalaldehyde and enzymatic cleaners, patient care activities and use of sprays are important occupational risk factors for airway disease among HWs.
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Affiliation(s)
- Hussein H Mwanga
- Division of Occupational Medicine and Centre for Environmental & Occupational Health Research, School of Public Health, University of Cape Town, Cape Town, South Africa
- Department of Environmental and Occupational Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Roslynn Baatjies
- Division of Occupational Medicine and Centre for Environmental & Occupational Health Research, School of Public Health, University of Cape Town, Cape Town, South Africa
- Department of Environmental and Occupational Studies, Faculty of Applied Sciences, Cape Peninsula University of Technology, Cape Town, Western Cape, South Africa
| | - Mohamed Fareed Jeebhay
- Division of Occupational Medicine and Centre for Environmental & Occupational Health Research, School of Public Health, University of Cape Town, Cape Town, South Africa
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3
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Ndlela NH, Naidoo RN. Job and exposure intensity among hospital cleaning staff adversely affects respiratory health. Am J Ind Med 2023; 66:252-264. [PMID: 36611285 DOI: 10.1002/ajim.23456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Occupational exposure to various types of cleaning agents may increase the risk of adverse respiratory health among cleaners. This study investigated the relationship between exposure to cleaning and disinfecting agents, using a job-task and exposure intensity metric, and respiratory outcomes among cleaners. METHODS A sample of 174 cleaners was selected from three public hospitals in Durban. A questionnaire was used to collect demographic and occupational information, and spirometry, including post-bronchodilator measures, was conducted according to the American Thoracic Society guidelines and skin prick testing were performed. Exposure metrics for job tasks and chemical exposures were created using frequency and employment-lifetime duration of exposure. Multivariate analysis regression models used job task and exposure intensity metrics. RESULTS Doctor-diagnosed asthma prevalence was 9.8%. Breathlessness with wheeze (22.4%) was the prevalent respiratory symptom. Positive responses to skin prick testing were seen in 74 (43.2%). There was a statistically significant increased risk for shortness of breath with exposure to quaternary ammonium compounds (odds ratio [OR]: 3.44; 95% confidence interval [CI]: 1.13-10.5) and breathlessness with exposure to multipurpose cleaner (OR: 0.34; CI: 0.12-0.92). The losses in percent-predicted forced expiratory volume in 1 s (FEV1) ranged from 0.3%-6.7%. Results among the bronchodilator-positive (8.6%) showed lung function losses twofold greater when compared to the total study population with percentage predicted FEV1 (-22.6 %; p < 0.000). CONCLUSION Exposure to certain cleaning and disinfectant agents adversely affects respiratory health, particularly lung function. This effect, while seen generally among cleaning workers, is more pronounced among those with pre-existing reversible obstructive lung disease.
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Affiliation(s)
- Nana Happiness Ndlela
- Occupational Health and Safety, RK Khan Hospital, Chatsworth, Chatsworth, South Africa.,Discipline of Occupational and Environmental Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Rajen N Naidoo
- Discipline of Occupational and Environmental Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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4
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Kurt OK, Ergun D, Anlar HG, Hazar M, Aydin Dilsiz S, Karatas M, Basaran N. Evaluation of Oxidative Stress Parameters and Genotoxic Effects in Patients With Work-Related Asthma and Silicosis. J Occup Environ Med 2023; 65:146-151. [PMID: 36075368 DOI: 10.1097/jom.0000000000002701] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the mechanistic roles of oxidative stress, inflammation, and genotoxicity parameters in patients with work-related asthma (WRA) and silicosis. METHODS Thirty-eight healthy office workers, 27 employees with a history of exposure and no disease, 24 employees with WRA, and 23 employees with silicosis were included in this study. Superoxide dismutase, catalase, glutathione peroxidase, malondialdehyde, and interleukins (IL) 17, 23, and 27 levels were measured in the serum. Genotoxic damage was evaluated by calculating the frequency of micronuclei in swab samples and 8-hydroxy-2'-deoxyguanosine in serum. RESULTS Serum superoxide dismutase, catalase, glutathione peroxidase, malondialdehyde, 8-hydroxy-2'-deoxyguanosine, and IL-17, IL-23, and IL-27 levels were found to be statistically significantly higher in the exposure, WRA, and silicosis groups compared with the control group. The frequency of micronuclei in buccal epithelial cells of the patient group was found to be significantly higher than that of the control group. CONCLUSION These results may provide information for molecular mechanisms and early diagnosis of WRA and silicosis and will be a guide for taking precautions in the early period.
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Affiliation(s)
- Ozlem Kar Kurt
- From the Department of Pulmonary Medicine and Occupational Medicine, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey (Dr Ozlem Kar); Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey (Drs Ozlem Kar, Dilsiz, and Basaran); Department of Pulmonary Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey (Dr Ergun); Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Bulent Ecevit University, Zonguldak, Turkey (Anlar); Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Ibrahim Cecen University, Agri, Turkey (Ms Hazar); Department of Pulmonary Medicine, Occupational and Environmental Diseases Hospital, Ankara, Turkey (Dr Karatas); and Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Baskent University, Ankara, Turkey (Dr Basaran)
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5
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Oțelea MR, Fell AKM, Handra CM, Holm M, Filon FL, Mijakovski D, Minov J, Mutu A, Stephanou E, Stokholm ZA, Stoleski S, Schlünssen V. The value of fractional exhaled nitric oxide in occupational diseases - a systematic review. J Occup Med Toxicol 2022; 17:14. [PMID: 35879723 PMCID: PMC9317127 DOI: 10.1186/s12995-022-00355-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/04/2022] [Indexed: 12/04/2022] Open
Abstract
Fractional exhaled nitric oxide (FeNO) is a non-invasive biomarker of respiratory tract inflammation, originally designated to identify eosinophilic airway inflammation and to predict steroid response. The main field of application of this biomarker is asthma, but FeNO has also been used for other allergic and non-allergic pulmonary disorders such as chronic obstructive pulmonary disease, hypersensitivity pneumonitis and interstitial lung disease. A substantial part of respiratory diseases are related to work, and FeNO, a safe and easy measure to conduct, is a potential valid examination in an occupational setting. This systematic review assesses the value of measuring FeNO related to three types of airborne exposures: allergens, irritants, and respiratory particles inhaled during occupational activities. The review covers results from longitudinal and observational clinical studies, and highlights the added value of this biomarker in monitoring effects of exposure and in the diagnostic criteria of occupational diseases. This review also covers the possible significance of FeNO as an indicator of the efficacy of interventions to prevent work-related respiratory diseases. Initially, 246 articles were identified in PUBMED and SCOPUS. Duplicates and articles which covered results from the general population, symptoms (not disease) related to work, non-occupational diseases, and case reports were excluded. Finally, 39 articles contributed to this review, which led to the following conclusions: a) For occupational asthma there is no consensus on the significant value of FeNO for diagnosis, or on the magnitude of change needed after specific inhalation test or occupational exposure at the workplace. There is some consensus for the optimal time to measure FeNO after exposure, mainly after 24 h, and FeNO proved to be more sensitive than spirometry in measuring the result of an intervention. b) For other occupational obstructive respiratory diseases, current data suggests performing the measurement after the work shift. c) For interstitial lung disease, the evaluation of the alveolar component of NO is probably the most suitable.
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Affiliation(s)
| | - Anne Kristin M Fell
- Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway.,Department of Global Health and Community Medicine, Institute of Health and Community, University of Oslo, Oslo, Norway
| | - Claudia Mariana Handra
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Colentina Clinical Hospital, Clinic for Occupational Medicine, Bucharest, Romania
| | - Mathias Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Francesca Larese Filon
- Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Dragan Mijakovski
- Institute of Occupational Health of RN Macedonia, Skopje, North Macedonia.,Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, Skopje, North Macedonia
| | - Jordan Minov
- Institute of Occupational Health of RN Macedonia, Skopje, North Macedonia.,Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, Skopje, North Macedonia
| | - Andreea Mutu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Central Military University Emergency Hospital "Carol Davila", Bucharest, Romania
| | | | - Zara Ann Stokholm
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Sasho Stoleski
- Institute of Occupational Health of RN Macedonia, Skopje, North Macedonia.,Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, Skopje, North Macedonia
| | - Vivi Schlünssen
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
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6
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Mwanga HH, Baatjies R, Singh T, Jeebhay MF. Work-related allergy and asthma associated with cleaning agents in health workers in Southern African tertiary hospitals. Am J Ind Med 2022; 65:382-395. [PMID: 35267214 DOI: 10.1002/ajim.23344] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/10/2022] [Accepted: 02/25/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Health workers (HWs) are exposed to diverse cleaning agents in large hospitals. This study determined the prevalence of work-related symptoms, allergic sensitization, and lung function abnormalities in HWs of two tertiary hospitals in Southern Africa. METHODS A cross-sectional study of 699 HWs (South Africa: SAH, n = 346; Tanzania: TAH, n = 353) was conducted. Health outcomes were assessed using a standardized ECRHS questionnaire, immunological tests (specific IgE antibody to common aero-allergens and to occupational allergens: natural rubber latex [NRL] Hev b5 and Hev b6.02, chlorhexidine, and ortho-phthalaldehyde [OPA]), spirometry [pre-and post- bronchodilator], methacholine challenge, and fractional exhaled nitric oxide (FeNO). RESULTS A large proportion of participants (78%) were women. Median age was 42 years, with 76% nurses, 12% cleaners, and 5% administrative workers. Current smoking was more common in SAHWs (12%) than TAHWs (1%). The overall prevalence of doctor-diagnosed asthma was 7%. Atopy was present in 43% of HWs, while 4% were sensitized to OPA, 2% to NRL, and 1% to chlorhexidine. Prevalence of work-related ocular-nasal symptoms (16%) was higher than skin (12%) and chest (7%) symptoms. TAHWs had significantly lower mean lung volumes, higher degrees of significant airflow obstruction and impaired lung function. The prevalence of bronchial hyperresponsiveness in SAHWs (14%) was high. Overall, 23% of HWs had abnormal FeNO; 6% having high (>50 ppb) levels. FeNO was positively associated with sensitization to occupational allergens, primarily OPA and NRL. CONCLUSIONS HWs from both hospitals had similar prevalence of work-related respiratory symptoms. Sensitization to OPA and NRL appears to be contributing to allergic airway inflammation in these HWs.
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Affiliation(s)
- Hussein H. Mwanga
- Division of Occupational Medicine, Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine University of Cape Town Cape Town South Africa
- Department of Environmental and Occupational Health, School of Public Health and Social Sciences Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania
| | - Roslynn Baatjies
- Division of Occupational Medicine, Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine University of Cape Town Cape Town South Africa
- Department of Environmental and Occupational Studies, Faculty of Applied Sciences Cape Peninsula University of Technology Cape Town South Africa
| | - Tanusha Singh
- National Institute for Occupational Health National Health Laboratory Services Johannesburg South Africa
- Department of Environmental Health, School of Health Sciences University of Johannesburg Johannesburg South Africa
- Department of Clinical Microbiology and Infectious Diseases, School of Pathology University of the Witwatersrand Johannesburg South Africa
| | - Mohamed F. Jeebhay
- Division of Occupational Medicine, Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine University of Cape Town Cape Town South Africa
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7
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Andrianjafimasy MV, Febrissy M, Zerimech F, Dananché B, Kromhout H, Matran R, Nadif M, Oberson-Geneste D, Quinot C, Schlünssen V, Siroux V, Zock JP, Le Moual N, Nadif R, Dumas O. Association between occupational exposure to irritant agents and a distinct asthma endotype in adults. Occup Environ Med 2021; 79:155-161. [PMID: 34413158 DOI: 10.1136/oemed-2020-107065] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 07/22/2021] [Indexed: 11/04/2022]
Abstract
AIM The biological mechanisms of work-related asthma induced by irritants remain unclear. We investigated the associations between occupational exposure to irritants and respiratory endotypes previously identified among never asthmatics (NA) and current asthmatics (CA) integrating clinical characteristics and biomarkers related to oxidative stress and inflammation. METHODS We used cross-sectional data from 999 adults (mean 45 years old, 46% men) from the case-control and familial Epidemiological study on the Genetics and Environments of Asthma (EGEA) study. Five respiratory endotypes have been identified using a cluster-based approach: NA1 (n=463) asymptomatic, NA2 (n=169) with respiratory symptoms, CA1 (n=50) with active treated adult-onset asthma, poor lung function, high blood neutrophil counts and high fluorescent oxidation products level, CA2 (n=203) with mild middle-age asthma, rhinitis and low immunoglobulin E level, and CA3 (n=114) with inactive/mild untreated allergic childhood-onset asthma. Occupational exposure to irritants during the current or last held job was assessed by the updated occupational asthma-specific job-exposure matrix (levels of exposure: no/medium/high). Associations between irritants and each respiratory endotype (NA1 asymptomatic as reference) were studied using logistic regressions adjusted for age, sex and smoking status. RESULTS Prevalence of high occupational exposure to irritants was 7% in NA1, 6% in NA2, 16% in CA1, 7% in CA2 and 10% in CA3. High exposure to irritants was associated with CA1 (adjusted OR aOR, (95% CI) 2.7 (1.0 to 7.3)). Exposure to irritants was not significantly associated with other endotypes (aOR range: 0.8 to 1.5). CONCLUSION Occupational exposure to irritants was associated with a distinct respiratory endotype suggesting oxidative stress and neutrophilic inflammation as potential associated biological mechanisms.
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Affiliation(s)
- Miora Valérie Andrianjafimasy
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, France
| | - Mickaël Febrissy
- LIPADE, Université Paris 5 Descartes, Paris, Île-de-France, France
| | - Farid Zerimech
- Univ. Lille, ULR 4483 - IMPECS, CHU Lille, F-59000 Lille, Lille, France.,Institut Pasteur de Lille, F-59000, Lille, France
| | | | - Hans Kromhout
- Utrecht University, Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht, Netherlands
| | - Régis Matran
- Univ. Lille, ULR 4483 - IMPECS, CHU Lille, F-59000 Lille, Lille, France.,Institut Pasteur de Lille, F-59000, Lille, France
| | - Mohamed Nadif
- LIPADE, Université Paris 5 Descartes, Paris, Île-de-France, France
| | | | - Catherine Quinot
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, France
| | - Vivi Schlünssen
- Aarhus University, Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus, Denmark.,National Research Centre for the Working Environment, Kobenhavn, Denmark
| | - Valérie Siroux
- Universite Grenoble Alpes, Inserm, CNRS, Team of environmental epidemiology applied to Reproduction and Respiratory health, IAB, Grenoble, France
| | - Jan-Paul Zock
- Institute for Global Health (ISGlobal) and Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Nicole Le Moual
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, France
| | - Rachel Nadif
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, France
| | - Orianne Dumas
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, France
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8
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De Matteis S, Ronsmans S, Nemery B. Respiratory Health Effects of Exposure to Cleaning Products. Clin Chest Med 2021; 41:641-650. [PMID: 33153684 DOI: 10.1016/j.ccm.2020.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
There is consistent and growing evidence of an epidemic of "asthma-like" symptoms among professional cleaners. Questions include how big is this problem worldwide, which cleaning agents are dangerous, how do they affect the lungs, and is it really asthma? This issue is important to public health because of the increasing number of professional cleaners, many from vulnerable categories. There are implications for anybody exposed to cleaning products during housekeeping, including children. This article uses available evidence to give a broad but concise overview on what we know so far and how we can prevent the cleaning-associated respiratory public health burden.
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Affiliation(s)
- Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; NHLI, Imperial College London, London, United Kingdom.
| | - Steven Ronsmans
- Clinic for Occupational and Environmental Medicine, Department of Pulmonary Medicine, University Hospitals Leuven, Leuven, Belgium; Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Benoit Nemery
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
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Archangelidi O, Sathiyajit S, Consonni D, Jarvis D, De Matteis S. Cleaning products and respiratory health outcomes in occupational cleaners: a systematic review and meta-analysis. Occup Environ Med 2020; 78:oemed-2020-106776. [PMID: 33234692 DOI: 10.1136/oemed-2020-106776] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/25/2020] [Accepted: 10/30/2020] [Indexed: 01/07/2023]
Abstract
There is consistent evidence of increased respiratory symptoms in occupational cleaners; however, uncertainty remains on type of respiratory health effects, underlying causal agents, mechanisms and respiratory phenotypes. We aimed to conduct a systematic review and if possible, a meta-analysis of the available literature to characterise and quantify the cleaning-related respiratory health effects. We searched MEDLINE and EMBASE databases and included studies that evaluated the association of any respiratory health outcome with exposure to cleaning occupation or products in occupational cleaners. A modified GRADE was used to appraise the quality of included studies. We retrieved 1124 articles, and after applying our inclusion criteria, 39 were selected for the systematic review. We performed a meta-analysis of the 21 studies evaluating asthma which showed a 50% increased pooled relative risk in cleaners (meta-relative risk (RR)=1.50; 95% CI 1.44 to 1.56). Population-based cross-sectional studies showed more stable associations with asthma risk. No evidence of atopic asthma as dominant phenotype emerged. Also, we estimated a 43% increased risk (meta-RR=1.43; 95% CI 1.31 to 1.56) of chronic obstructive pulmonary disease. Evidence for associations with bronchial-hyper-responsiveness, lung function decline, rhinitis, upper and lower respiratory tract symptoms was weaker. In our systematic review and meta-analysis, we found that working as a cleaner is associated with an increased risk of reversible and even irreversible obstructive airway diseases. All studies lacked quantitative exposure assessment to cleaning products; this would help elucidate underlying causal agents and mechanisms. Exposure control and respiratory surveillance among cleaners is warranted to prevent the associated respiratory health burden. Trial registration number: CRD4201705915.
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Affiliation(s)
| | | | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Sara De Matteis
- NHLI, Imperial College London, London, UK
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Sardegna, Italy
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10
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Chemicals inhaled from spray cleaning and disinfection products and their respiratory effects. A comprehensive review. Int J Hyg Environ Health 2020; 229:113592. [PMID: 32810683 DOI: 10.1016/j.ijheh.2020.113592] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/20/2020] [Accepted: 07/03/2020] [Indexed: 12/13/2022]
Abstract
Spray cleaning and disinfection products have been associated with adverse respiratory effects in professional cleaners and among residents doing domestic cleaning. This review combines information about use of spray products from epidemiological and clinical studies, in vivo and in vitro toxicological studies of cleaning chemicals, as well as human and field exposure studies. The most frequent chemicals in spray cleaning and disinfection products were compiled, based on registrations in the Danish Product Registry. The chemicals were divided into acids, bases, disinfectants, fragrances, organic solvents, propellants, and tensides. In addition, an assessment of selected cleaning and disinfectant chemicals in spray products was carried out. Chemicals of concern regarding respiratory effects (e.g. asthma) are corrosive chemicals such as strong acids and bases (including ammonia and hypochlorite) and quaternary ammonium compounds (QACs). However, the evidence for respiratory effects after inhalation of QACs is ambiguous. Common fragrances are generally not considered to be of concern following inhalation. Solvents including glycols and glycol ethers as well as propellants are generally weak airway irritants and not expected to induce sensitization in the airways. Mixing of certain cleaning products can produce corrosive airborne chemicals. We discuss different hypotheses for the mechanisms behind the development of respiratory effects of inhalation of chemicals in cleaning agents. An integrative assessment is needed to understand how these chemicals can cause the various respiratory effects.
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11
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Reference Ranges of 8-Isoprostane Concentrations in Exhaled Breath Condensate (EBC): A Systematic Review and Meta-Analysis. Int J Mol Sci 2020; 21:ijms21113822. [PMID: 32481492 PMCID: PMC7311981 DOI: 10.3390/ijms21113822] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022] Open
Abstract
Isoprostanes are physiopathologic mediators of oxidative stress, resulting in lipid peroxidation. 8-isoprostane seems particularly useful for measuring oxidative stress damage. However, no reference range values are available for 8-isoprosante in exhaled breath condensate (EBC) of healthy adults, enabling its meaningful interpretation as a biomarker. We conducted this systematic review and meta-analysis according to the protocol following PROSPERO (CRD42020146623). After searching and analyzing the literature, we included 86 studies. After their qualitative synthesis and risk of bias assessment, 52 studies were included in meta-analysis. The latter focused on studies using immunological analytical methods and investigated how the concentrations of 8-isoprostane differ based on gender. We found that gender had no significant effect in 8-isoprostane concentration. Among other studied factors, such as individual characteristics and factors related to EBC collection, only the device used for EBC collection significantly affected measured 8-isoprostane concentrations. However, adjustment for the factors related to EBC collection, yielded uncertainty whether this effect is due to the device itself or to the other factors. Given this uncertainty, we estimated the reference range values of 8-isoprostane stratified by gender and EBC collection device. A better standardization of EBC collection seems necessary; as well more studies using chemical analytical methods to extend this investigation.
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Brooks C, Slater T, Corbin M, McLean D, Firestone RT, Zock JP, Pearce N, Douwes J. Respiratory health in professional cleaners: Symptoms, lung function, and risk factors. Clin Exp Allergy 2020; 50:567-576. [PMID: 32159892 DOI: 10.1111/cea.13597] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 02/13/2020] [Accepted: 03/08/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cleaning is associated with an increased risk of asthma symptoms, but few studies have measured functional characteristics of airway disease in cleaners. AIMS To assess and characterize respiratory symptoms and lung function in professional cleaners, and determine potential risk factors for adverse respiratory outcomes. METHODS Symptoms, pre-/post-bronchodilator lung function, atopy, and cleaning exposures were assessed in 425 cleaners and 281 reference workers in Wellington, New Zealand between 2008 and 2010. RESULTS Cleaners had an increased risk of current asthma (past 12 months), defined as: woken by shortness of breath, asthma attack, or asthma medication (OR = 1.83, 95% CI = 1.18-2.85). Despite this, they had similar rates of current wheezing (OR = 0.93, 95% CI = 0.65-1.32) and were less likely to have a doctor diagnosis of asthma ever (OR = 0.62, 95% CI = 0.42-0.92). Cleaners overall had lower lung function (FEV1 , FVC; P < .05). Asthma in cleaners was associated with less atopy (OR = 0.35, 95% CI = 0.13-0.90), fewer wheezing attacks (OR = 0.40, 95% CI = 0.17-0.97; >3 vs ≤3 times/year), and reduced bronchodilator response (6% vs 9% mean FEV1 -%-predicted change, P < .05) compared to asthma in reference workers. Cleaning of cafes/restaurants/kitchens and using upholstery sprays or liquid multi-use cleaner was associated with symptoms, whilst several exposures were also associated with lung function deficits (P < .05). CONCLUSIONS AND CLINICAL RELEVANCE Cleaners are at risk of some asthma-associated symptoms and reduced lung function. However, as it was not strongly associated with wheeze and atopy, and airway obstruction was less reversible, asthma in some cleaners may represent a distinct phenotype.
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Affiliation(s)
- Collin Brooks
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Tania Slater
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Marine Corbin
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Dave McLean
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | | | - Jan-Paul Zock
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Neil Pearce
- Centre for Public Health Research, Massey University, Wellington, New Zealand.,Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Jeroen Douwes
- Centre for Public Health Research, Massey University, Wellington, New Zealand
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Getahun B, Haile DW. Assessment of pulmonary function among cleaners in governmental hospitals in Addis Ababa, Ethiopia; comparative cross-sectional study. BMC Res Notes 2019; 12:384. [PMID: 31287017 PMCID: PMC6613241 DOI: 10.1186/s13104-019-4401-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 06/24/2019] [Indexed: 11/22/2022] Open
Abstract
Objective Work-related disorders are the major causes of different diseases in working populations. Respiratory disorders are among the most common occupational diseases. The alterations of the pulmonary function of professional cleaners in hospitals have not been addressed previously in Ethiopia. The aim of this study was to assess the pulmonary functions of cleaners working in the hospital setting in Addis Ababa, Ethiopia. A comparative cross-sectional study design was employed. The study was composed of 70 cleaners and 70 control subjects. Spirometer was used to measure pulmonary function. The data were coded, entered and analyzed using SPSS version 20. Results The mean and standard deviation of both actual value and percent predicted for forced vital capacity, forced expiratory volume in 1 s, percent ratio of forced vital capacity and forced expiratory volume in 1 s, peak expiratory flow rate and forced expiratory flow between 25 and 75% of cleaners were found to be significantly lower than the control group. Among cleaners 24.3% (n = 17) and controls 8.6% (n = 6) had shown obstructive lung disease, and among cleaners 22.9% (n = 16) and controls 4.3% (n = 3) had shown restrictive pattern.
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Affiliation(s)
- Biruk Getahun
- Department of Medical Physiology, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, P.O.Box 79, Bahir Dar, Ethiopia.
| | - Diresibachew W Haile
- Department of Medical Physiology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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14
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Ammonium lauryl sulfate-induced apoptotic cell death may be due to mitochondrial dysfunction triggered by caveolin-1. Toxicol In Vitro 2019; 57:132-142. [DOI: 10.1016/j.tiv.2019.02.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 01/23/2019] [Accepted: 02/25/2019] [Indexed: 11/22/2022]
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15
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Ederle C, Donnay C, Khayath N, Mielcarek M, de Blay F. Asthma and Cleaning: What’s New? CURRENT TREATMENT OPTIONS IN ALLERGY 2018. [DOI: 10.1007/s40521-018-0153-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Heederik D. Occupational exposure and asthma control. Eur Respir J 2017; 50:50/4/1701951. [PMID: 29074549 DOI: 10.1183/13993003.01951-2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 09/26/2017] [Indexed: 11/05/2022]
Affiliation(s)
- Dick Heederik
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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Abstract
PURPOSE OF REVIEW Asthma due to cleaning products has been known for 20 years, and the interest in this topic is still large because of the number of cleaning workers with respiratory problems. In this review, we sought to highlight the most recent findings on the relationship between exposure to cleaning products and asthma and to summarize the specific literature published between 2013 and 2016. RECENT FINDINGS Women are confirmed as most of workers exposed to cleaning products and have a higher frequency than men of work-related respiratory symptoms and diseases. Many cases of asthma due to cleaning products occur in healthcare occupations. The increased risk of asthma has been shown to be related to the number of years in the job and to early life disadvantage. Recent evidence suggests that predisposition to adult-onset asthma may be related to interaction between genes and occupational exposure to low-molecular weight agents/irritants. There is some evidence that an irritant mechanism is more common, although several case reports showed animmunologic mechanism (e.g. disinfectants, amine compounds, aldehydes and fragrances). SUMMARY The review updated recent findings on epidemiology, cleaning agents and their mechanism, and prevention of asthma due to cleaning agents. This article provides new information on the level of exposure, which is still high in professional cleaners and even more in domestic cleaners, and on the frequency of asthma in professional and domestic cleaners. An irritant mechanism is more common, although an immunological mechanism is possible, especially in healthcare workers exposed to disinfectants.
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Abstract
PURPOSE OF REVIEW Work-related asthma is a common disorder among adult asthma patients, and in the case of occupational asthma, it is induced by workplace exposures. RECENT FINDINGS Occupational asthma provides an excellent model and benchmark for identifying and testing different allergy or inflammatory biomarkers associated with its inception or progression. Moreover, specific inhalation challenge with the incriminated agent represents an experimental setting to identify and validate potential systemic or local biomarkers. Some biomarkers are mainly blood-borne, while local airway biomarkers are derived from inflammatory or resident cells. Genetic and gene-environment interaction studies also provide an excellent framework to identify relevant profiles associated with the risk of developing these work-related conditions. Despite significant efforts to identify clinically relevant inflammatory and genomic markers for occupational asthma, apart from the documented utility of airway inflammatory biomarkers, it remains elusive to define specific markers or signatures clearly associated with different endpoints or outcomes in occupational asthma.
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Weinmann T, Gerlich J, Heinrich S, Nowak D, Mutius EV, Vogelberg C, Genuneit J, Lanzinger S, Al-Khadra S, Lohse T, Motoc I, Walter V, Radon K. Association of household cleaning agents and disinfectants with asthma in young German adults. Occup Environ Med 2017; 74:684-690. [PMID: 28483971 DOI: 10.1136/oemed-2016-104086] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 03/28/2017] [Accepted: 04/13/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We scrutinised the association of private use of household sprays and disinfectants with asthma incidence in young adults in the transition from school to working life. METHODS Between 2007 and 2009,2051 young adults aged 19-24 years living in two major German cities took part in the Study on Occupational Allergy Risks II. Self-reported exposure to household sprays and disinfectants was characterised according to a composite score for frequency of use as no use (score=0), low use (score between 1 and the median), medium use (score between the median and the 90th percentile) and high use (score above the 90th percentile). Two outcome variables (current asthma and current wheezing) with four mutually exclusive categories (never, incident, persistent and remittent) were used for the risk analyses. Multinomial logistic regression models examined the association between the frequency of using household sprays and disinfectants with asthma and wheezing adjusting for potential confounders. RESULTS Compared with no use, high use of disinfectants was associated with a more than twofold increased odds of incident asthma (OR 2.79, 95% CI 1.14 to 6.83). In addition, low/medium use of disinfectants was associated with remittent asthma (OR 2.39, 95% CI 1.29 to 4.47). The evidence for an association between high usage of household sprays and asthma incidence was weak (OR 2.79, 95% CI 0.84 to 9.20). CONCLUSION Our results support the hypothesis of an association between the use of cleaning products and elevated risks for asthma and wheezing in young adults at the start of working life.
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Affiliation(s)
- Tobias Weinmann
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
| | - Jessica Gerlich
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
| | - Sabine Heinrich
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
| | - Erika von Mutius
- Dr. v. Haunersches Kinderspital, University Hospital of Munich (LMU), Munich, Germany
| | - Christian Vogelberg
- Paediatric Department, University Hospital Carl Gustav Carus Dresden, TU Dresden, Dresden, Germany
| | - Jon Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Stefanie Lanzinger
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | | | - Tina Lohse
- Epidemiology, Biostatistics and Prevention Institute, Chronic Disease Epidemiology, University of Zurich, Zurich, Switzerland
| | - Irina Motoc
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Viola Walter
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Katja Radon
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
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Coman I, Lemière C. Fractional Exhaled Nitric Oxide (FeNO) in the Screening and Diagnosis Work-Up of Occupational Asthma. CURRENT TREATMENT OPTIONS IN ALLERGY 2017. [DOI: 10.1007/s40521-017-0122-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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21
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Hallit S, Salameh P. Exposure to toxics during pregnancy and childhood and asthma in children: A pilot study. J Epidemiol Glob Health 2017; 7:147-154. [PMID: 28756822 PMCID: PMC7320455 DOI: 10.1016/j.jegh.2017.04.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 04/21/2017] [Indexed: 11/24/2022] Open
Abstract
Environmental factors, pesticides, alcohol and smoking are linked to asthma in children. The association of toxic substances exposure with asthma has not been evaluated. Our objective is to assess such associations among children aged less than 16 years old. This is a cross-sectional study, conducted between January and May 2015, using a sample of Lebanese students from private schools in Beirut and Mount Lebanon. Out of 700 distributed questionnaires, 527 (75.2%) were returned to us. Verbal informed consent was also obtained from all parents prior to participating in the study. A significant association was found between waterpipe smoking and diagnosed asthma (p = 0.003; ORa = 13.25; 95% CI 2.472–71.026). Alcohol during pregnancy, waterpipe smoking during pregnancy and parents respiratory problems significantly increased the risk of respiratory problems by approximately 5 times, 6 times and 2 times respectively (p = 0.016; ORa = 4.889; 95% CI 1.339–17.844, p = 0.021; ORa = 6.083; 95% CI 1.314–28.172, p = 0.004; ORa = 1.748; 95% CI 1.197–2.554 respectively). Waterpipe smoking, alcohol during pregnancy, recurrent otitis and humidity at home seem to be significantly correlated with asthma in children. Spreading awareness by health care professionals is needed to permit a reduction of the prevalence of these allergic diseases, especially asthma, in children.
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Affiliation(s)
- Souheil Hallit
- Lebanese University, School of Pharmacy, Hadath, Lebanon; Universite Saint Joseph, Faculty of Pharmacy, Beirut, Lebanon; Universite Saint-Esprit Kaslik, Faculty of Medicine, Kaslik, Lebanon; Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon; Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center Inserm - Université de Bordeaux, France.
| | - Pascale Salameh
- Lebanese University, School of Pharmacy, Hadath, Lebanon; Lebanese University, Faculty of Medicine, Hadath, Lebanon
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Zhu LY, Ni ZH, Luo XM, Wang XB. Advance of antioxidants in asthma treatment. World J Respirol 2017; 7:17-28. [DOI: 10.5320/wjr.v7.i1.17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 11/23/2016] [Accepted: 01/14/2017] [Indexed: 02/07/2023] Open
Abstract
Asthma is an allergic disease, characterized as a recurrent airflow limitation, airway hyperreactivity, and chronic inflammation, involving a variety of cells and cytokines. Reactive oxygen species have been proven to play an important role in asthma. The pathogenesis of oxidative stress in asthma involves an imbalance between oxidant and antioxidant systems that is caused by environment pollutants or endogenous reactive oxygen species from inflammation cells. There is growing evidence that antioxidant treatments that include vitamins and food supplements have been shown to ameliorate this oxidative stress while improving the symptoms and decreasing the severity of asthma. In this review, we summarize recent studies that are related to the mechanisms and biomarkers of oxidative stress, antioxidant treatments in asthma.
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Abstract
PURPOSE OF REVIEW The present review summarizes the recent literature on the relation between chronic workplace irritant exposures and asthma, focusing on exposures of low to moderate levels. We discuss results from epidemiological surveys, potential biological mechanisms, and needs for further research. These aspects are largely illustrated by studies on exposure to cleaning products. RECENT FINDINGS Recent results from nine population-based and workplace-based epidemiological studies, mostly cross-sectional, found an increased risk of both new-onset and work-exacerbated asthma among participants exposed to moderate level of irritants and/or cleaning products. SUMMARY Evidence of a causal effect of chronic workplace irritant exposure in new-onset asthma remains limited, mainly because of a lack of longitudinal studies and the difficulty to evaluate irritant exposures. However, recent epidemiological studies strengthen the evidence of an effect of chronic exposure to irritants in work-related asthma. The underlying mechanism remains unknown but may be related to oxidative stress, neurogenic inflammation and dual irritant and adjuvant effects. However, disentangling chronic irritant effects from either acute irritant-induced asthma or immunological low molecular weight agent-induced asthma is difficult for some agents. Further research is needed to improve assessment of irritant exposures and identify biomarkers.
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Radauceanu A, Grzebyk M, Edmé JL, Chérot-Kornobis N, Rousset D, Dziurla M, De Broucker V, Hédelin G, Sobaszek A, Hulo S. Effects of occupational exposure to poorly soluble forms of beryllium on biomarkers of pulmonary response in exhaled breath of workers in machining industries. Toxicol Lett 2016; 263:26-33. [DOI: 10.1016/j.toxlet.2016.10.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/19/2016] [Accepted: 10/20/2016] [Indexed: 01/20/2023]
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Quirce S, Campo P, Domínguez-Ortega J, Fernández-Nieto M, Gómez-Torrijos E, Martínez-Arcediano A, Mur P, Delgado J. New developments in work-related asthma. Expert Rev Clin Immunol 2016; 13:271-281. [PMID: 27653257 DOI: 10.1080/1744666x.2017.1239529] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Work-related asthma includes two subtypes: occupational asthma or asthma caused by specific agents (sensitizers or irritants) in the workplace, and work-exacerbated asthma or pre-existing asthma worsened by workplace exposures. Areas covered: This review provides an update on the definitions and the clinical features of the different work-related asthma subtypes as well as new insights into their etiology and the pathophysiological mechanisms involved. The diagnosis of work-related asthma should be made on objective basis using a constellation of clinical, physiologic and allergologic tests. Specific inhalation challenge with the suspected occupational agent(s) remains as the reference standard for diagnosis. A literature search was performed using the following terms: work-related asthma, occupational asthma, work-exacerbated asthma, irritant-induced asthma and etiological agents. Expert commentary: Studies focusing on the biological effects and mechanisms of environmental exposures in the development of sensitizer-induced or irritant-induced asthma in various workplace settings are of greatest interest. An integrative approach that combines clinical parameters with component-resolved diagnosis as well as inflammatory biomarkers appears to be very promising. Occupational allergy provides a good opportunity to understand the complex relationships between exposure to allergens in the workplace, interaction with genes and the co-exposures to other factors in the working environment.
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Affiliation(s)
- Santiago Quirce
- a Department of Allergy , Hospital La Paz Institute for Health Research and CIBER of Respiratory Diseases, CIBERES , Madrid , Spain
| | - Paloma Campo
- b Unidad de Gestión Clínica Allergy-IBIMA , Hospital Regional Universitario , Malaga , Spain
| | - Javier Domínguez-Ortega
- a Department of Allergy , Hospital La Paz Institute for Health Research and CIBER of Respiratory Diseases, CIBERES , Madrid , Spain
| | | | | | | | - Pilar Mur
- f Allergy Unit , Hospital Santa Barbara , Puertollano , Spain
| | - Julio Delgado
- g Unidad de Gestión Clínica Alergología , Hospital Virgen Macarena , Sevilla , Spain
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Mwanga HH, Dalvie MA, Singh TS, Channa K, Jeebhay MF. Relationship between Pesticide Metabolites, Cytokine Patterns, and Asthma-Related Outcomes in Rural Women Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13100957. [PMID: 27690066 PMCID: PMC5086696 DOI: 10.3390/ijerph13100957] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 09/05/2016] [Accepted: 09/20/2016] [Indexed: 11/16/2022]
Abstract
The objective of this study was to investigate the relationship between exposure to organophosphate (OP) and pyrethroid (PYR) pesticides with serum cytokine patterns and asthma-related outcomes among rural women workers. A cross-sectional study was conducted among rural women (n = 211), including those working and living on farms and nearby town dwellers. Pesticide exposure was assessed using urinary metabolite concentrations of OP and PYR pesticides. Health outcome assessment was ascertained through the European Community Respiratory Health Survey (ECRHS) questionnaire, fractional exhaled nitric oxide (FeNO), and serum cytokines associated with asthma. The prevalence of doctor-diagnosed asthma was 11%, adult-onset asthma 9%, and current asthma 6%. In this population, the proportion of T helper type 2 (Th2) cytokines (interleukin (IL)-4, IL-5, and IL-13) detectable in subjects was between 18% and 40%, while the proportion of non-Th2 cytokines (IL-6, IL-8, IL-10, IL-17, and interferon gamma) was between 35% and 71%. Most Th2 and non-Th2 cytokines were positively associated with either OP or PYR metabolites. Non-Th2 cytokines showed much stronger associations with OP metabolites (Dimethyl phosphate OR = 4.23; 95% CI: 1.54-11.65) than Th2 cytokines (Dimethyl phosphate OR = 1.69; 95% CI: 0.83-3.46). This study suggests that exposure to most OP and some PYR pesticides may be associated with asthma-related cytokines, with non-Th2 cytokines demonstrating consistently stronger relationships.
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Affiliation(s)
- Hussein H Mwanga
- Division of Occupational Medicine and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Room 4.47, Fourth Level, Falmouth Building, Anzio Road, Observatory, Cape Town 7925, South Africa.
- Department of Environmental and Occupational Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
| | - Mohamed Aqiel Dalvie
- Division of Occupational Medicine and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Room 4.47, Fourth Level, Falmouth Building, Anzio Road, Observatory, Cape Town 7925, South Africa.
| | - Tanusha S Singh
- National Institute for Occupational Health, National Health Laboratory Services, Johannesburg 2000, South Africa.
- Department of Clinical Microbiology & Infectious Diseases, School of Pathology, University of Witwatersrand, Johannesburg 2000, South Africa.
| | - Kalavati Channa
- National Institute for Occupational Health, National Health Laboratory Services, Johannesburg 2000, South Africa.
| | - Mohamed F Jeebhay
- Division of Occupational Medicine and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Room 4.47, Fourth Level, Falmouth Building, Anzio Road, Observatory, Cape Town 7925, South Africa.
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An official American Thoracic Society Workshop Report: presentations and discussion of the fifth Jack Pepys Workshop on Asthma in the Workplace. Comparisons between asthma in the workplace and non-work-related asthma. Ann Am Thorac Soc 2016. [PMID: 26203621 DOI: 10.1513/annalsats.201505-281st] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The fifth Jack Pepys Workshop on Asthma in the Workplace focused on the similarities and differences of work-related asthma (WRA) and non-work-related asthma (non-WRA). WRA includes occupational asthma (OA) and work-exacerbated asthma (WEA). There are few biological differences in the mechanisms of sensitization to environmental and occupational allergens. Non-WRA and OA, when due to high-molecular-weight agents, are both IgE mediated; it is uncertain whether OA due to low-molecular-weight agents is also IgE mediated. Risk factors for OA include female sex, a history of upper airway symptoms, and a history of bronchial hyperresponsiveness. Atopy is a risk factor for OA due to high-molecular-weight agents, and exposure to cleaning agents is a risk factor for both OA and non-WRA. WEA is important among workers with preexisting asthma and may overlap with irritant-induced asthma, a type of OA. Induced sputum cytology can confirm airway inflammation, but specific inhalation challenge is the reference standard diagnostic test. Inhalation challenges are relatively safe, with the most severe reactions occurring with low-molecular-weight agents. Indirect health care costs account for about 50% of total asthma costs. Workers with poor asthma control (WRA or non-WRA) are less likely to be employed. Income loss is a major contributor to the indirect costs of WRA. Overall, asthma outcomes probably are worse for adult-onset than for childhood-onset asthma but better for OA than adult-onset non-WRA. Important aspects of management of OA are rapid and proper confirmation of the diagnosis and reduction of exposure to sensitizers or irritants at work and home.
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De Matteis S, Cullinan P. Occupational asthma in cleaners: a challenging black box. Occup Environ Med 2015; 72:755-6. [PMID: 26163547 DOI: 10.1136/oemed-2015-102985] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 06/22/2015] [Indexed: 11/03/2022]
Affiliation(s)
- Sara De Matteis
- Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK
| | - Paul Cullinan
- Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK
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Pérez-Losada M, Castro-Nallar E, Bendall ML, Freishtat RJ, Crandall KA. Dual Transcriptomic Profiling of Host and Microbiota during Health and Disease in Pediatric Asthma. PLoS One 2015; 10:e0131819. [PMID: 26125632 PMCID: PMC4488395 DOI: 10.1371/journal.pone.0131819] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 06/07/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND High-throughput sequencing (HTS) analysis of microbial communities from the respiratory airways has heavily relied on the 16S rRNA gene. Given the intrinsic limitations of this approach, airway microbiome research has focused on assessing bacterial composition during health and disease, and its variation in relation to clinical and environmental factors, or other microbiomes. Consequently, very little effort has been dedicated to describing the functional characteristics of the airway microbiota and even less to explore the microbe-host interactions. Here we present a simultaneous assessment of microbiome and host functional diversity and host-microbe interactions from the same RNA-seq experiment, while accounting for variation in clinical metadata. METHODS Transcriptomic (host) and metatranscriptomic (microbiota) sequences from the nasal epithelium of 8 asthmatics and 6 healthy controls were separated in silico and mapped to available human and NCBI-NR protein reference databases. Human genes differentially expressed in asthmatics and controls were then used to infer upstream regulators involved in immune and inflammatory responses. Concomitantly, microbial genes were mapped to metabolic databases (COG, SEED, and KEGG) to infer microbial functions differentially expressed in asthmatics and controls. Finally, multivariate analysis was applied to find associations between microbiome characteristics and host upstream regulators while accounting for clinical variation. RESULTS AND DISCUSSION Our study showed significant differences in the metabolism of microbiomes from asthmatic and non-asthmatic children for up to 25% of the functional properties tested. Enrichment analysis of 499 differentially expressed host genes for inflammatory and immune responses revealed 43 upstream regulators differentially activated in asthma. Microbial adhesion (virulence) and Proteobacteria abundance were significantly associated with variation in the expression of the upstream regulator IL1A; suggesting that microbiome characteristics modulate host inflammatory and immune systems during asthma.
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Affiliation(s)
- Marcos Pérez-Losada
- Computational Biology Institute, George Washington University, Ashburn, Virginia, United States of America
- Division of Emergency Medicine, Children’s National Medical Center, Washington, DC, United States of America
- CIBIO-InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus Agrário de Vairão, Vairão, Portugal
| | - Eduardo Castro-Nallar
- Computational Biology Institute, George Washington University, Ashburn, Virginia, United States of America
- Universidad Andrés Bello, Center for Bioinformatics and Integrative Biology, Facultad de Ciencias Biológicas, Santiago, Chile
| | - Matthew L. Bendall
- Computational Biology Institute, George Washington University, Ashburn, Virginia, United States of America
| | - Robert J. Freishtat
- Division of Emergency Medicine, Children’s National Medical Center, Washington, DC, United States of America
| | - Keith A. Crandall
- Computational Biology Institute, George Washington University, Ashburn, Virginia, United States of America
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Vizcaya D, Mirabelli MC, Gimeno D, Antó JM, Delclos GL, Rivera M, Orriols R, Arjona L, Burgos F, Zock JP. Cleaning products and short-term respiratory effects among female cleaners with asthma. Occup Environ Med 2015; 72:757-63. [PMID: 25907212 DOI: 10.1136/oemed-2013-102046] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 03/27/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVE We evaluated the short-term effects of exposure to cleaning products on lung function and respiratory symptoms among professional cleaning women. METHODS Twenty-one women with current asthma and employed as professional cleaners participated in a 15-day panel study. During 312 person-days of data collection, participants self-reported their use of cleaning products and respiratory symptoms in daily diaries and recorded their forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF) three times per day using a handheld spirometer. We evaluated associations of cleaning product use with upper and lower respiratory tract symptoms using Poisson mixed regression models and with changes in FEV1 and PEF using linear mixed regression analyses. RESULTS Participants reported using an average of 2.4 cleaning products per day, with exposure to at least one strong irritant (eg, ammonia, bleach, hydrochloric acid) on 56% of person-days. Among participants without atopy, lower respiratory tract symptoms were associated with the use of hydrochloric acid and detergents. Measurements of FEV1 and PEF taken in the evening were 174 mL (95% CI 34 to 314) and 37 L/min (CI 4 to 70), respectively, lower on days when three or more sprays were used. Evening and next morning FEV1 were both lower following the use of hydrochloric acid (-616 and -526 mL, respectively) and solvents (-751 and -1059 mL, respectively). Diurnal variation in FEV1 and PEF increased on days when ammonia and lime-scale removers were used. CONCLUSIONS The use of specific cleaning products at work, mainly irritants and sprays, may exacerbate asthma.
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Affiliation(s)
- David Vizcaya
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain University of Montreal Hospital Research Centre (CRCHUM), Montreal, Canada Departament de Ciències Experimental i de la Salut, Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain
| | - Maria C Mirabelli
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain
| | - David Gimeno
- The University of Texas Health Science Center at Houston, School of Public Health, San Antonio Regional Campus, San Antonio, Texas, USA Center for Research in Occupational Health (CiSAL), University Pompeu Fabra (UPF), Barcelona, Catalonia, Spain
| | - Josep-Maria Antó
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Departament de Ciències Experimental i de la Salut, Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain IMIM (Hospital del Mar Medical Research Institute), Barcelona, Catalonia, Spain
| | - George L Delclos
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Center for Research in Occupational Health (CiSAL), University Pompeu Fabra (UPF), Barcelona, Catalonia, Spain IMIM (Hospital del Mar Medical Research Institute), Barcelona, Catalonia, Spain The University of Texas School of Public Health, Houston, Texas, USA
| | - Marcela Rivera
- Departament de Ciències Experimental i de la Salut, Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain
| | - Ramon Orriols
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Bunyola, Majorca, Balearic Islands, Spain Servei de Pneumologia, Hospitals de Girona i Salt. Institut d'Investigació Biomòdica de Girona (IDIBGI), Girona, Catalonia, Spain
| | - Lourdes Arjona
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain IMIM (Hospital del Mar Medical Research Institute), Barcelona, Catalonia, Spain
| | - Felip Burgos
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Bunyola, Majorca, Balearic Islands, Spain Servei de Pneumologia, Hospital Clínic, IDIBAPS, Barcelona, Catalonia, Spain
| | - Jan-Paul Zock
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Departament de Ciències Experimental i de la Salut, Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
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Dumas O, Matran R, Zerimech F, Decoster B, Huyvaert H, Ahmed I, Le Moual N, Nadif R. Occupational exposures and fluorescent oxidation products in 723 adults of the EGEA study. Eur Respir J 2015; 46:258-61. [PMID: 25837036 DOI: 10.1183/09031936.00177614] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 02/04/2015] [Indexed: 01/03/2023]
Affiliation(s)
- Orianne Dumas
- INSERM U1168, VIMA: Aging and chronic diseases, Epidemiological and public health approaches, Villejuif, France Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France Channing Division of Network Medicine, Dept of Medicine, Brigham and Women's Hospital, Boston, MA, USA Dept of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | | | - Farid Zerimech
- Laboratoire de Biochimie, Centre de Biologie Pathologie, CHRU de Lille, Lille, France
| | | | - Helene Huyvaert
- Univ Lille Nord de France, Lille, France Laboratoire de Biochimie, Centre de Biologie Pathologie, CHRU de Lille, Lille, France
| | - Ismail Ahmed
- INSERM UMR 1181 «Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases» (B2PHI), Villejuif, France Univ Versailles St-Quentin-en-Yvelines, UMR 1181, B2PHI, Montigny le Bretonneux, France
| | - Nicole Le Moual
- INSERM U1168, VIMA: Aging and chronic diseases, Epidemiological and public health approaches, Villejuif, France Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France
| | - Rachel Nadif
- INSERM U1168, VIMA: Aging and chronic diseases, Epidemiological and public health approaches, Villejuif, France Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France
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Heederik D. Cleaning agents and disinfectants: moving from recognition to action and prevention. Clin Exp Allergy 2014; 44:472-4. [PMID: 24666520 DOI: 10.1111/cea.12286] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- D Heederik
- Division of Environmental Epidemiology, Institute for Risk Assesment Sciences, Utrecht University, Utrecht, The Netherlands
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Yan R, Yang W, Liu J, Gao B, Guo K, Sun D. Cardiopulmonary exercise capacity and ventilation effectiveness in patients after clinical cure of acute irritant gas poisoning. Cell Biochem Biophys 2014; 71:789-94. [PMID: 25480428 DOI: 10.1007/s12013-014-0264-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The aim of this study is to assess the medium to long-term effect of acute irritant gas poisoning on cardiopulmonary exercise function in patients after clinical cure. Fourteen patients after an average of 18.5 months of clinical cure of acute irritant gas poisoning were recruited, and 14 healthy individuals were selected as control. All subjects were examined by resting pulmonary function testing (RPFT), cardiopulmonary exercise testing (CPET), and arterial blood gas (ABG) analysis. No statistically significant differences were found between poisoning and control groups for baseline parameters (age, height, and weight) or ABG values (pH, PaO2, PaCO2, and SaO2) (P > 0.05). For most RPFT parameters, including FEV1/FVC, FEV1, FEV1%pred, RV/TLC, DLCO%, and FVC%, no statistically significant differences were observed between poisoning and control groups (P > 0.05). However, MVV% was significantly lower in poisoning group compared with healthy individuals (P < 0.05). Statistically significant differences were observed for some CPET parameters, including peak VO2, peak VO2/kg, peak VE, and lowest VE/VCO2 (P < 0.05), and peak load, V D/V T, and peak PETCO2 (P < 0.01) between the two groups. However, there were no statistically significant differences in peak VO2%pred or peak O2 pulse between poisoning and control groups (P > 0.05). Compared with controls, patients with acute irritant gas poisoning had decreased cardiopulmonary exercise capacity and ventilation effectiveness after clinical cure.
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Affiliation(s)
- Rong Yan
- Department of Occupational Poisoning, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
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Dinh-Xuan AT, Annesi-Maesano I, Berger P, Chambellan A, Chanez P, Chinet T, Degano B, Delclaux C, Demange V, Didier A, Garcia G, Magnan A, Mahut B, Roche N. Contribution of exhaled nitric oxide measurement in airway inflammation assessment in asthma. A position paper from the French Speaking Respiratory Society. Rev Mal Respir 2014; 32:193-215. [PMID: 25704902 DOI: 10.1016/j.rmr.2014.11.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 08/27/2014] [Indexed: 01/06/2023]
Abstract
Nitric oxide (NO) is both a gas and a ubiquitous inter- and intracellular messenger with numerous physiological functions. As its synthesis is markedly increased during inflammatory processes, NO can be used as a surrogate marker of acute and/or chronic inflammation. It is possible to quantify fractional concentration of NO in exhaled breath (FENO) to detect airway inflammation, and thus improve the diagnosis of asthma by better characterizing asthmatic patients with eosinophilic bronchial inflammation, and eventually improve the management of targeted asthmatic patients. FENO measurement can therefore be viewed as a new, reproducible and easy to perform pulmonary function test. Measuring FENO is the only non-invasive pulmonary function test allowing (1) detecting, (2) quantifying and (3) monitoring changes in inflammatory processes during the course of various respiratory disorders, including corticosensitive asthma.
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Affiliation(s)
- A T Dinh-Xuan
- Groupe d'experts de la société de pneumologie de langue française sur la mesure du NO expiré dans l'asthme, société de pneumologie de langue française, 66, boulevard Saint-Michel, 75006 Paris, France; Service de physiologie-explorations fonctionnelles, université Paris-Descartes, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
| | - I Annesi-Maesano
- Groupe d'experts de la société de pneumologie de langue française sur la mesure du NO expiré dans l'asthme, société de pneumologie de langue française, 66, boulevard Saint-Michel, 75006 Paris, France; Inserm et université de médecine Pierre-et-Marie-Curie, 75571 Paris cedex 12, France
| | - P Berger
- Groupe d'experts de la société de pneumologie de langue française sur la mesure du NO expiré dans l'asthme, société de pneumologie de langue française, 66, boulevard Saint-Michel, 75006 Paris, France; Centre de recherche cardio-thoracique Inserm U1045, université de Bordeaux, 33076 Bordeaux cedex, France
| | - A Chambellan
- Groupe d'experts de la société de pneumologie de langue française sur la mesure du NO expiré dans l'asthme, société de pneumologie de langue française, 66, boulevard Saint-Michel, 75006 Paris, France; Inserm UMR 1087, institut du thorax, 44007 Nantes cedex, France
| | - P Chanez
- Groupe d'experts de la société de pneumologie de langue française sur la mesure du NO expiré dans l'asthme, société de pneumologie de langue française, 66, boulevard Saint-Michel, 75006 Paris, France; Service de pneumologie, hôpital Nord, chemin des Bourrelly, 13015 Marseille, France
| | - T Chinet
- Groupe d'experts de la société de pneumologie de langue française sur la mesure du NO expiré dans l'asthme, société de pneumologie de langue française, 66, boulevard Saint-Michel, 75006 Paris, France; Service de pneumologie, CHU Ambroise-Paré, 92104 Boulogne, France
| | - B Degano
- Groupe d'experts de la société de pneumologie de langue française sur la mesure du NO expiré dans l'asthme, société de pneumologie de langue française, 66, boulevard Saint-Michel, 75006 Paris, France; Explorations fonctionnelles, hôpital Jean-Minjoz, centre hospitalier régional universitaire, 25000 Besançon, France
| | - C Delclaux
- Groupe d'experts de la société de pneumologie de langue française sur la mesure du NO expiré dans l'asthme, société de pneumologie de langue française, 66, boulevard Saint-Michel, 75006 Paris, France; Hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 75015 Paris, France
| | - V Demange
- Groupe d'experts de la société de pneumologie de langue française sur la mesure du NO expiré dans l'asthme, société de pneumologie de langue française, 66, boulevard Saint-Michel, 75006 Paris, France; Département épidémiologie en entreprise, INRS, rue du Morvan, 54500 Vandoeuvre-lès-Nancy, France
| | - A Didier
- Groupe d'experts de la société de pneumologie de langue française sur la mesure du NO expiré dans l'asthme, société de pneumologie de langue française, 66, boulevard Saint-Michel, 75006 Paris, France; Service de pneumologie, CHU de Toulouse, 24, chemin de Pouvourville - TSA, 31059 Toulouse cedex 9, France
| | - G Garcia
- Groupe d'experts de la société de pneumologie de langue française sur la mesure du NO expiré dans l'asthme, société de pneumologie de langue française, 66, boulevard Saint-Michel, 75006 Paris, France; Service de physiologie, hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, 94275 Le Kremlin-Bicêtre, France
| | - A Magnan
- Groupe d'experts de la société de pneumologie de langue française sur la mesure du NO expiré dans l'asthme, société de pneumologie de langue française, 66, boulevard Saint-Michel, 75006 Paris, France; Inserm UMR 915, institut du thorax, CHU de Nantes, 44007 Nantes cedex, France
| | - B Mahut
- Groupe d'experts de la société de pneumologie de langue française sur la mesure du NO expiré dans l'asthme, société de pneumologie de langue française, 66, boulevard Saint-Michel, 75006 Paris, France; Cabinet de pédiatrie, 4, avenue de la Providence, 92160 Antony, France
| | - N Roche
- Groupe d'experts de la société de pneumologie de langue française sur la mesure du NO expiré dans l'asthme, société de pneumologie de langue française, 66, boulevard Saint-Michel, 75006 Paris, France; Service de pneumologie et soins intensifs respiratoires, Hôtel Dieu, groupe hospitalier Cochin-Broca, 75014 Paris, France
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Bratcher PE, Gaggar A. Factors influencing the measurement of plasma/serum surfactant protein D levels by ELISA. PLoS One 2014; 9:e111466. [PMID: 25365324 PMCID: PMC4218753 DOI: 10.1371/journal.pone.0111466] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 09/29/2014] [Indexed: 12/22/2022] Open
Abstract
Background Extensive variations in human surfactant protein D (SP-D) levels in circulation as measured by ELISA exist in the published literature. In order to determine the source of these variations, factors influencing the measurement by ELISA were explored. Materials and Methods Peripheral blood from healthy individuals was collected into various vacutainers during the same blood draw. Recombinant SP-D was diluted into different matrices and used for a standard curve. Samples were analyzed by capture ELISA using one of two distinct detection antibodies. Results The type of matrix had some effects on detection of recombinant SP-D. The type of anticoagulant used and dilution factor had very little effect, except for in plasma collected in EDTA vacutainers. The extent of variation in published values seemed to be due to the ELISA configuration employed, and, in agreement with this, we found that by switching the detection antibody, there was a 50% decrease in the extrapolated SP-D value of serum and plasma samples. Storage of samples resulted in slight changes in measured SP-D levels. Conclusions The ELISA configuration employed to measure circulating levels of SP-D has a significant effect on the extrapolated values. In both configurations tested, the use of EDTA as a coagulant resulted in inconsistent values, and we, therefore, suggest the avoidance of this anticoagulant when assaying for SP-D by ELISA. While the demonstrated effects of several factors on measurement of SP-D may not account for all the disparities amongst the previous studies, they stress that variations in methodologies for measuring the same protein can result in very inconsistent results.
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Affiliation(s)
- Preston E. Bratcher
- Department of Medicine and Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- * E-mail:
| | - Amit Gaggar
- Department of Medicine and Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- University of Alabama at Birmingham, UAB Lung Health Center, Birmingham, Alabama, United States of America
- Medicine Service, United States Department of Veterans Affairs Medical Center, Birmingham, Alabama, United States of America
- Program in Protease and Matrix Biology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
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Dumas O, Siroux V, Luu F, Nadif R, Zock JP, Kauffmann F, Le Moual N. Cleaning and asthma characteristics in women. Am J Ind Med 2014; 57:303-11. [PMID: 23955502 DOI: 10.1002/ajim.22244] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND We aimed to assess the associations between occupational exposure to cleaning products, a gender-related exposure, and asthma characteristics, considering clinical, immunological and inflammatory aspects. METHODS Analyses were conducted in 391 women (73 with adult-onset asthma) from the follow-up of the Epidemiological Study on the Genetics and Environment of Asthma (EGEA). Occupational exposure to cleaning/disinfecting products was estimated using the asthma-specific job-exposure-matrix (44 women exposed). RESULTS Occupational exposures were associated with more symptomatic asthma (odds ratio (95% CI): 2.8(1.2-6.4)) and severe asthma (5.1(1.7-15.3)). An association was suggested for poorly controlled asthma (2.2(0.9-5.5)). Associations were observed for asthma without positive skin prick test (3.0(1.1-8.3)), with a low IgE level (2.8(1.2-6.2)), and with a low eosinophil count (3.2(1.5-7.1)). CONCLUSIONS Results strengthen the evidence of a deleterious role of cleaning products in asthma and are consistent with the hypothesis of non-allergic mechanisms in relation to workplace cleaning exposures.
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Affiliation(s)
- Orianne Dumas
- Inserm; Center for Research in Epidemiology and Population Health (CESP); U1018; Respiratory and Environmental Epidemiology Team; F-94807, Villejuif France
- Univ Paris-Sud; UMRS 1018; F-94807, Villejuif France
| | - Valérie Siroux
- Inserm U823; Centre de Recherche Albert Bonniot; La Tronche France
- Université Joseph Fourier; Grenoble France
| | - Frédéric Luu
- Inserm; Center for Research in Epidemiology and Population Health (CESP); U1018; Respiratory and Environmental Epidemiology Team; F-94807, Villejuif France
- Univ Paris-Sud; UMRS 1018; F-94807, Villejuif France
| | - Rachel Nadif
- Inserm; Center for Research in Epidemiology and Population Health (CESP); U1018; Respiratory and Environmental Epidemiology Team; F-94807, Villejuif France
- Univ Paris-Sud; UMRS 1018; F-94807, Villejuif France
| | - Jan-Paul Zock
- Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
- Hospital del Mar Research Institute (IMIM); Barcelona Spain
- CIBER Epidemiología y Salúd Publica (CIBERESP); Barcelona Spain
| | - Francine Kauffmann
- Inserm; Center for Research in Epidemiology and Population Health (CESP); U1018; Respiratory and Environmental Epidemiology Team; F-94807, Villejuif France
- Univ Paris-Sud; UMRS 1018; F-94807, Villejuif France
| | - Nicole Le Moual
- Inserm; Center for Research in Epidemiology and Population Health (CESP); U1018; Respiratory and Environmental Epidemiology Team; F-94807, Villejuif France
- Univ Paris-Sud; UMRS 1018; F-94807, Villejuif France
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Bédard A, Varraso R, Sanchez M, Clavel-Chapelon F, Zock JP, Kauffmann F, Le Moual N. Cleaning sprays, household help and asthma among elderly women. Respir Med 2013; 108:171-80. [PMID: 24238771 DOI: 10.1016/j.rmed.2013.10.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 10/21/2013] [Accepted: 10/23/2013] [Indexed: 01/09/2023]
Abstract
OBJECTIVE There is increasing evidence on the deleterious role in asthma of the use of household cleaning products in spray forms in adults. Household help might induce misclassification errors. The aim of the present analysis was to study associations between household exposure to cleaning sprays and current asthma in elderly women, taking into account household help. METHODS A nested case-control survey on respiratory health was undertaken among a random sample of French women from the E3N study. Data were available for 570 women (235 with current asthma and 335 without asthma history; 68 years old on average, 59% never smokers). Three estimates of domestic exposure were used: 1) self-reported, 2) using principal component analysis, 3) a composite score for sprays. Associations between domestic exposures and asthma were assessed by logistic regression, adjusted for age, educational level, BMI and smoking status. Analyses were further stratified on household help in order to evaluate a potential misclassification bias. RESULTS Among women without household help (n = 325), a significant association was observed between weekly use of at least one spray and current asthma (OR [95% CI]: 1.86[1.04-3.33]). No association was observed among women with household help. CONCLUSIONS Weekly household use of cleaning sprays may have a deleterious effect on asthma. It is important to take into account household help to limit misclassification bias.
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Affiliation(s)
- Annabelle Bédard
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Respiratory and Environmental Epidemiology Team, F-94807 Villejuif, France; Univ Paris Sud, UMRS 1018, F-94807 Villejuif, France.
| | - Raphaëlle Varraso
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Respiratory and Environmental Epidemiology Team, F-94807 Villejuif, France; Univ Paris Sud, UMRS 1018, F-94807 Villejuif, France
| | - Margaux Sanchez
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Respiratory and Environmental Epidemiology Team, F-94807 Villejuif, France; Univ Paris Sud, UMRS 1018, F-94807 Villejuif, France
| | - Françoise Clavel-Chapelon
- Univ Paris Sud, UMRS 1018, F-94807 Villejuif, France; Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, hormones et santé de la femme Team, Gustave Roussy Institute, F-94805 Villejuif, France
| | - Jan-Paul Zock
- Centre for Research in Environmental Epidemiology (CREAL), 08003 Barcelona, Spain; IMIM, Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 08003 Spain
| | - Francine Kauffmann
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Respiratory and Environmental Epidemiology Team, F-94807 Villejuif, France; Univ Paris Sud, UMRS 1018, F-94807 Villejuif, France
| | - Nicole Le Moual
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Respiratory and Environmental Epidemiology Team, F-94807 Villejuif, France; Univ Paris Sud, UMRS 1018, F-94807 Villejuif, France
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Vandenplas O, D'Alpaos V, Evrard G, Jamart J, Thimpont J, Huaux F, Renauld JC. Asthma related to cleaning agents: a clinical insight. BMJ Open 2013; 3:e003568. [PMID: 24056489 PMCID: PMC3780339 DOI: 10.1136/bmjopen-2013-003568] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To determine the agents causing asthmatic reactions during specific inhalation challenges (SICs) in workers with cleaning-related asthma symptoms and to assess the pattern of bronchial responses in order to identify the mechanisms involved in cleaning-related asthma. DESIGN A retrospective case series analysis. SETTING The study included all participants who completed an SIC procedure with the cleaning/disinfection products suspected of causing work-related asthma over the period 1992-2011 in a tertiary centre, which is the single specialised centre of the French-speaking part of Belgium where all participants with work-related asthma are referred to for SIC. RESULTS The review identified 44 participants who completed an SIC with cleaning/disinfection agents. Challenge exposure to the suspected cleaning agents elicited a ≥20% fall in forced expiratory volume in 1 s (FEV1) in 17 (39%) participants. The cleaning products that induced a positive SIC contained quaternary ammonium compounds (n=10), glutaraldehyde (n=3), both of these agents (n=1) and ethanolamines (n=2). Positive SICs were associated with a significant decrease in the median (IQR) value of the provocative concentration of histamine causing a 20% fall in FEV1 (PC20) from 1.4 (0.2-4.2) mg/mL at baseline to 0.5 (0.4-3.0) mg/mL after the challenge and a significant increase in sputum eosinophils from 1.8 (0.8-7.2)% at baseline to 10.0 (4.1-15.9)% 7 h after the challenge exposure while these parameters did not significantly change in participants with a negative SIC. Overall, 11 of 17 participants with positive SICs showed greater than threefold decrease in postchallenge histamine PC20 value, a >2% increase in sputum eosinophils, or both of these outcomes. CONCLUSIONS These data indicate that a substantial proportion of workers who experience asthma symptoms related to cleaning materials show a pattern of bronchial reaction consistent with sensitiser-induced occupational asthma. The results also suggest that quaternary ammonium compounds are the principal cause of sensitiser-induced occupational asthma among cleaners.
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Affiliation(s)
- Olivier Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire de Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
- Fonds des Maladies Professionnelles, Brussels, Belgium
| | - Vinciane D'Alpaos
- Department of Chest Medicine, Centre Hospitalier Universitaire de Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - Geneviève Evrard
- Department of Chest Medicine, Centre Hospitalier Universitaire de Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - Jacques Jamart
- Scientific Support Unit, Centre Hospitalier Universitaire de Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - Joel Thimpont
- Fonds des Maladies Professionnelles, Brussels, Belgium
| | - François Huaux
- Industrial Toxicology and Occupational Medicine Unit, Université Catholique de Louvain, Brussels, Belgium
| | - Jean-Christophe Renauld
- Experimental Medicine Unit, Ludwig Institute for Cancer Research, Université Catholique de Louvain, Brussels, Belgium
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