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Bobic L, Harbolic A, Warner GR. Reproductive & Developmental Toxicity of quaternary ammonium compounds. Biol Reprod 2024:ioae107. [PMID: 38959857 DOI: 10.1093/biolre/ioae107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 06/19/2024] [Accepted: 07/01/2024] [Indexed: 07/05/2024] Open
Abstract
Quaternary ammonium compounds (QACs) are a class of chemicals commonly used as disinfectants in household and healthcare settings. Their usage has significantly increased in recent years due to the COVID-19 pandemic. In addition, QACs have replaced the recently banned disinfectants triclosan and triclocarban in consumer products. QACs are found in daily antimicrobial and personal care products such as household disinfectants, mouthwash, and hair care products. Due to the pervasiveness of QACs in daily use products, humans are constantly exposed. However, little is known about the health effects of everyday QAC exposure, particularly effects on human reproduction and development. Studies that investigate the harmful effects of QACs on reproduction are largely limited to high-dose studies, which may not be predictive of low dose, daily exposure, especially as QACs may be endocrine disrupting chemicals. This review analyzes recent studies on QAC effects on reproductive health, identifying knowledge gaps, and recommending future directions in QAC-related research.
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Affiliation(s)
- Leyla Bobic
- Department of Chemistry and Environmental Science, New Jersey Institute of Technology, Newark, NJ
| | - Allison Harbolic
- Department of Chemistry and Environmental Science, New Jersey Institute of Technology, Newark, NJ
| | - Genoa R Warner
- Department of Chemistry and Environmental Science, New Jersey Institute of Technology, Newark, NJ
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2
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Mwanga HH, Dumas O, Migueres N, Le Moual N, Jeebhay MF. Airway Diseases Related to the Use of Cleaning Agents in Occupational Settings. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00214-9. [PMID: 38432401 DOI: 10.1016/j.jaip.2024.02.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/13/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Abstract
Exposure to disinfectants and cleaning products (DCPs) is now a well-established risk factor for work-related asthma (WRA). However, questions remain on the specific causal agents and pathophysiological mechanisms. Few studies have also reported an association between DCPs and rhinitis or chronic obstructive pulmonary disease. This review discusses the recent evidence pertaining to airway diseases attributable to occupational exposure to DCPs. In contrast to other agents, the incidence of WRA due to DCPs has increased over time. The use of DCPs in spray form has clearly been identified as an added risk factor. The mechanisms for WRA associated with DCPs remain poorly studied; however, both allergic and nonallergic responses have been described, with irritant mechanisms thought to play a major role. An early diagnostic workup based on clinical assessment accompanied by evaluation of lung function and immunological and airway inflammatory markers is important to guide optimal care and exposure avoidance to the implicated agent. Future research should focus on the effects of "green" products, pathophysiological mechanisms, and quantitative exposure assessment including the use of barcode-based methods to identify specific agents. There is an urgent need to strengthen preventive measures and interventions to reduce the burden of airway diseases associated with DCPs.
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Affiliation(s)
- Hussein H Mwanga
- Department of Environmental and Occupational Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; Division of Occupational Medicine and Centre for Environmental & Occupational Health Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Orianne Dumas
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, Villejuif, France
| | - Nicolas Migueres
- Division of Pulmonology, Department of Chest Diseases, University Hospital of Strasbourg and Fédération de Médecine translationnelle, Strasbourg University, Strasbourg, France; UMR 7357 Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie ICUBE, Strasbourg, France
| | - Nicole Le Moual
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, Villejuif, France.
| | - Mohamed F 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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Pan H, Jarvis D, Potts J, Casas L, Nowak D, Heinrich J, Aymerich JG, Urrutia I, Martinez-Moratalla J, Gullón JA, Pereira-Vega A, Raherison C, Chanoine S, Demoly P, Leynaert B, Gislason T, Probst N, Abramson MJ, Jõgi R, Norbäck D, Sigsgaard T, Olivieri M, Svanes C, Fuertes E. Gas cooking indoors and respiratory symptoms in the ECRHS cohort. Int J Hyg Environ Health 2024; 256:114310. [PMID: 38183794 DOI: 10.1016/j.ijheh.2023.114310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/22/2023] [Accepted: 12/12/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Gas cooking is an important source of indoor air pollutants, and there is some limited evidence that it might adversely be associated with respiratory health. Using repeated cross-sectional data from the multi-centre international European Community Respiratory Health Survey, we assessed whether adults using gas cookers have increased risk of respiratory symptoms compared to those using electric cookers and tested whether there was effect modification by a priori selected factors. METHODS Data on respiratory symptoms and gas cooking were collected from participants at 26-55 and 38-67 years (median time between examinations 11.4 years) from interviewer-led questionnaires. Repeated associations between gas cooking (versus electric) and respiratory symptoms were estimated using multivariable mixed-effects logistic regression models adjusted for age, sex, study arm, smoking status, education level, and included random intercepts for participants within study centres. Analyses were repeated using a 3-level variable for type of cooker and gas source. Effect modification by ventilation habits, cooking duration, sex, age atopy, asthma, and study arm were examined. RESULTS The sample included 4337 adults (43.7% males) from 19 centres in 9 countries. Gas cooking increased the risk of "shortness of breath whilst at rest" (OR = 1.38; 95%CI: 1.06-1.79) and "wheeze with breathlessness" (1.32; 1.00-1.74). For several other symptoms, effect estimates were larger in those who used both gas hobs and ovens, had a bottled gas source and cooked for over 60 min per day. Stratifying results by sex and age found stronger associations in females and younger adults. CONCLUSION This multi-centre international study, using repeat data, suggested using gas cookers in the home was more strongly associated than electric cookers with certain respiratory symptoms in adults. As gas cooking is common, these results may play an important role in population respiratory health.
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Affiliation(s)
- Holly Pan
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Debbie Jarvis
- National Heart and Lung Institute, Imperial College London, London, UK; MRC Centre for Environment & Health, London, UK
| | - James Potts
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Lidia Casas
- Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Germany
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Germany
| | - Judith Garcia Aymerich
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Isabel Urrutia
- Respiratory Department, Galdakao Hospital, OSI Barrualde-Galdakao, Biscay, Spain
| | - Jesus Martinez-Moratalla
- Servicio de Neumología del Complejo Hospitalario Universitario de Albacete. (CHUA) Albacete, Spain; Servicio de Salud de Castilla - La Mancha (SESCAM), Spain; Facultad de Medicina de Albacete. Universidad de Castilla - La Mancha, Albacete, Spain
| | | | | | | | | | - Pascal Demoly
- University Hospital of Montpellier, IDESP, Univ Montpellier - Inserm, Montpellier, France
| | - Bénédicte Leynaert
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Center for Epidemiology and Population Health (CESP), Integrative Respiratory Epidemiology Team, 94807, Villejuif, France; Landspitali University Hospital, Department of Sleep, Reykjavik Iceland
| | - Thorarinn Gislason
- University of Iceland, Medical Faculty, Reykjavik, Iceland; Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Rain Jõgi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Dan Norbäck
- Occupational and Environmental Medicine, Department of Medical Science, University Hospital, Uppsala University, 75237, Uppsala, Sweden
| | - Torben Sigsgaard
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Mario Olivieri
- Unit of Occupational Medicine, Department of Diagnostics and Public Health, Policlinico "G. Rossi", Verona, Italy; Center for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway
| | - Cecilie Svanes
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Elaine Fuertes
- National Heart and Lung Institute, Imperial College London, London, UK; MRC Centre for Environment & Health, London, UK.
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Moosavi SS, Zolghadr AR. Effect of quaternary ammonium surfactants on biomembranes using molecular dynamics simulation. RSC Adv 2023; 13:33175-33186. [PMID: 37954424 PMCID: PMC10634318 DOI: 10.1039/d3ra05030k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/31/2023] [Indexed: 11/14/2023] Open
Abstract
Research conducted both prior to and after the emergence of the COVID-19 pandemic reveals a notable rise in human exposure to cleaning products, hand sanitizers, and personal care items. Moreover, there has been a corresponding increase in the environmental release of these chemicals. Cleaning and disinfecting products often contain quaternary ammonium compounds (QACs) with alkyl chains as long as 8-12 carbon atoms. The attachment of quaternary ammonium surfactants to the membrane resulted in the deformation of the bilayer and membrane disruption. Before interactions with cell membranes, these surfactant molecules may form different aggregates depending on their architecture. Interaction of surfactant monomers or clusters with the cell membrane changes the physiochemical properties of the biomembranes. To investigate this interaction and its influence on membrane properties, we conducted molecular dynamics simulations of cationic quaternary ammonium surfactants interacting with dipalmitoylphosphatidylcholine (DPPC) membranes. Our simulations revealed significant interactions between the surfactants and the phospholipids, leading to substantial alterations in the structure of the bilayer. The results are compared with the simulated anionic (SDS) and nonionic surfactants/bilayer systems. Various aspects were considered, including the aggregation process, migration behavior, and eventual equilibrium of these molecules at the interface between the membrane and water. This analysis used various techniques such as density profiles, distribution functions, cluster analysis, order parameters, hydrogen bonding (H-bonding), and mean-square displacements. The results indicate that while surfactants with shorter alkyl tails (N-(2-hydroxyethyl)-N,N-dimethyloctan-1-aminium chloride (HEDMOAC)) make strong hydrogen bonds with the phosphate group and ester oxygen of the phosphatidylcholine bilayer and enter toward the bilayer in the monomer form, surfactants of longer alkyl tails aggregated on the membrane head-water interface and interact minimally with the head groups of the DPPC bilayer. For DDEDMEAC, a quaternary ammonium surfactant with a hydrophobic alkyl chain consisting of two decanoate groups, alteration of the structural and dynamical properties of the bilayer is expected to be governed by two different factors. First, the structural order of DPPC increases as surfactant aggregates interact with the membrane head group. Second, the decrease in the order of the bilayer occurs due to the insertion of surfactant monomers within the hydrophobic region of the bilayer. Strong interactions between constituents of tetraoctylammonium bromide (TOABr) and lipid head groups lead to a reduction in interlipid interactions and order, which further results in increased porosity of cellular membranes. Understanding the extent of these interactions plays a pivotal role in the toxicological assessment of these surfactants.
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Affiliation(s)
- Sedigheh Saddat Moosavi
- Department of Chemistry, Shiraz University Shiraz 71946-84795 Iran +98 713 646 0788 +98 713 613 7157
| | - Amin Reza Zolghadr
- Department of Chemistry, Shiraz University Shiraz 71946-84795 Iran +98 713 646 0788 +98 713 613 7157
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Temkin AM, Geller SL, Swanson SA, Leiba NS, Naidenko OV, Andrews DQ. Volatile organic compounds emitted by conventional and "green" cleaning products in the U.S. market. CHEMOSPHERE 2023; 341:139570. [PMID: 37709066 DOI: 10.1016/j.chemosphere.2023.139570] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 09/16/2023]
Abstract
Exposure to cleaning products has been associated with harm to the respiratory system, neurotoxicity, harm to the reproductive system, and elevated risk of cancer, with greatest adverse impacts for workers exposed in an occupational setting. Social and consumer interest in cleaning products that are safer for health created a market category of "green" products defined here as products advertised as healthier, non-toxic, or free from harmful chemicals as well as products with a third-party certification for safety or environmental features. In the present study we examined the air quality impacts of cleaning products and air fresheners, measuring the number, concentrations, and emission factors of volatile organic compounds (VOCs) in an air chamber following product application. Across seven common product categories, 30 products were tested overall including 14 conventional, 9 identified as "green" with fragrance, and 7 identified as "green" and fragrance-free. A total of 530 unique VOCs were quantified with 205 additional VOCs detected below the limits of quantification. Of the quantifiable VOCs, 193 were considered hazardous according to either the California's Department of Toxic Substances Control Candidate Chemicals List or the European Chemical Agency's Classification and Labeling Inventory. The total concentration of VOCs and total emission factors across all products with detections ranged from below limits of detection to 18,708 μg/m3, 38,035 μg/g product and 3803 μg/application. Greater total concentration, total emission factors, and numbers of VOCs were generally observed in conventional cleaning products compared to products identified as "green", particularly compared to fragrance-free products. A hazard index approach was utilized to assess relative risk from measured VOC emissions. The five products with the highest hazard indices were conventional products with emissions of 2-butoxyethanol, isopropanol, toluene and chloroform. Overall, this analysis suggests that the use of "green" cleaning products, especially fragrance-free products, may reduce exposure to VOC emissions.
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Affiliation(s)
- Alexis M Temkin
- Environmental Working Group, 1250 I St NW Suite 1000, Washington DC, 20005, USA.
| | - Samara L Geller
- Environmental Working Group, 1250 I St NW Suite 1000, Washington DC, 20005, USA
| | - Sydney A Swanson
- Environmental Working Group, 1250 I St NW Suite 1000, Washington DC, 20005, USA
| | | | - Olga V Naidenko
- Environmental Working Group, 1250 I St NW Suite 1000, Washington DC, 20005, USA
| | - David Q Andrews
- Environmental Working Group, 1250 I St NW Suite 1000, Washington DC, 20005, USA
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6
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Denning DW, Pfavayi LT. Poorly controlled asthma - Easy wins and future prospects for addressing fungal allergy. Allergol Int 2023; 72:493-506. [PMID: 37544851 DOI: 10.1016/j.alit.2023.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/25/2023] [Accepted: 06/28/2023] [Indexed: 08/08/2023] Open
Abstract
Poorly controlled asthma is especially common in low resource countries. Aside from lack of access to, or poor technique with, inhaled beta-2 agonists and corticosteroids, the most problematic forms of asthma are frequently associated with both fungal allergy and exposure, especially in adults leading to more asthma exacerbations and worse asthma. The umbrella term 'fungal asthma' describes many disorders linked to fungal exposure and/or allergy to fungi. One fungal asthma endotype, ABPA, is usually marked by a very high IgE and its differential diagnosis is reviewed. Both ABPA and fungal bronchitis in bronchiectasis are marked by thick excess airway mucus production. Dermatophyte skin infection can worsen asthma and eradication of the skin infection improves asthma. Exposure to fungi in the workplace, home and schools, often in damp or water-damaged buildings worsens asthma, and remediation improves symptom control and reduces exacerbations. Antifungal therapy is beneficial for fungal asthma as demonstrated in nine of 13 randomised controlled studies, reducing symptoms, corticosteroid need and exacerbations while improving lung function. Other useful therapies include azithromycin and some biologics approved for the treatment of severe asthma. If all individuals with poorly controlled and severe asthma could be 'relieved' of their fungal allergy and infection through antifungal therapy without systemic corticosteroids, the health benefits would be enormous and relatively inexpensive, improving the long term health of over 20 million adults and many children. Antifungal therapy carries some toxicity, drug interactions and triazole resistance risks, and data are incomplete. Here we summarise what is known and what remains uncertain about this complex topic.
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Affiliation(s)
- David W Denning
- Manchester Fungal Infection Group, The University of Manchester and Manchester Academic Health Science Centre, Manchester, UK.
| | - Lorraine T Pfavayi
- Institute of Immunology & Infection Research, Ashworth Laboratories, School of Biological Sciences, University of Edinburgh, Edinburgh, UK
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7
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Suleiman AM. Comparison of ConsExpo estimated exposure levels to glycol ethers during professional cleaning work to existing regulatory occupational exposure limit values. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2023; 29:604-612. [PMID: 35363595 DOI: 10.1080/10803548.2022.2061150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objectives. Researchers have shown that cleaning workers have an increased risk of asthma and rhinitis, mainly due to exposure to chemical substances present in the cleaning products they use. Among the important substances are glycol ethers, increasingly used as components in cleaning products. This study aimed to assess exposure levels of glycol ether in professional cleaning products and compare them to existing regulatory exposure limit values. Methods. Information from safety data sheets of the products is used to identify the glycol ethers present in the cleaning products and their respective concentrations. Other sources were used to obtain the relevant data required for use in the tool to generate exposure assessments. Exposure levels for various cleaning work exposure scenarios were estimated using the ConsExpo Web tool. Results. The estimated exposure values are significantly lower than the existing regulatory occupational exposure limit (OEL) values for the different glycol ethers. Conclusions. The study showed that the risk of exposure to glycol ethers by inhalation from professional cleaning products is minimal as exposure estimates were much below the regulatory OEL values.
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8
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Arnold W, Blum A, Branyan J, Bruton TA, Carignan CC, Cortopassi G, Datta S, DeWitt J, Doherty AC, Halden RU, Harari H, Hartmann EM, Hrubec TC, Iyer S, Kwiatkowski CF, LaPier J, Li D, Li L, Muñiz Ortiz JG, Salamova A, Schettler T, Seguin RP, Soehl A, Sutton R, Xu L, Zheng G. Quaternary Ammonium Compounds: A Chemical Class of Emerging Concern. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:7645-7665. [PMID: 37157132 PMCID: PMC10210541 DOI: 10.1021/acs.est.2c08244] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/24/2023] [Accepted: 03/24/2023] [Indexed: 05/10/2023]
Abstract
Quaternary ammonium compounds (QACs), a large class of chemicals that includes high production volume substances, have been used for decades as antimicrobials, preservatives, and antistatic agents and for other functions in cleaning, disinfecting, personal care products, and durable consumer goods. QAC use has accelerated in response to the COVID-19 pandemic and the banning of 19 antimicrobials from several personal care products by the US Food and Drug Administration in 2016. Studies conducted before and after the onset of the pandemic indicate increased human exposure to QACs. Environmental releases of these chemicals have also increased. Emerging information on adverse environmental and human health impacts of QACs is motivating a reconsideration of the risks and benefits across the life cycle of their production, use, and disposal. This work presents a critical review of the literature and scientific perspective developed by a multidisciplinary, multi-institutional team of authors from academia, governmental, and nonprofit organizations. The review evaluates currently available information on the ecological and human health profile of QACs and identifies multiple areas of potential concern. Adverse ecological effects include acute and chronic toxicity to susceptible aquatic organisms, with concentrations of some QACs approaching levels of concern. Suspected or known adverse health outcomes include dermal and respiratory effects, developmental and reproductive toxicity, disruption of metabolic function such as lipid homeostasis, and impairment of mitochondrial function. QACs' role in antimicrobial resistance has also been demonstrated. In the US regulatory system, how a QAC is managed depends on how it is used, for example in pesticides or personal care products. This can result in the same QACs receiving different degrees of scrutiny depending on the use and the agency regulating it. Further, the US Environmental Protection Agency's current method of grouping QACs based on structure, first proposed in 1988, is insufficient to address the wide range of QAC chemistries, potential toxicities, and exposure scenarios. Consequently, exposures to common mixtures of QACs and from multiple sources remain largely unassessed. Some restrictions on the use of QACs have been implemented in the US and elsewhere, primarily focused on personal care products. Assessing the risks posed by QACs is hampered by their vast structural diversity and a lack of quantitative data on exposure and toxicity for the majority of these compounds. This review identifies important data gaps and provides research and policy recommendations for preserving the utility of QAC chemistries while also seeking to limit adverse environmental and human health effects.
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Affiliation(s)
- William
A. Arnold
- University
of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Arlene Blum
- Green
Science Policy Institute, Berkeley, California 94709, United States
- University
of California, Berkeley, California 94720, United States
| | - Jennifer Branyan
- California
Department of Toxic Substances Control, Sacramento, California 95814, United States
| | - Thomas A. Bruton
- California
Department of Toxic Substances Control, Sacramento, California 95814, United States
| | | | - Gino Cortopassi
- University
of California, Davis, California 95616, United States
| | - Sandipan Datta
- University
of California, Davis, California 95616, United States
| | - Jamie DeWitt
- East
Carolina University, Greenville, North Carolina 27834, United States
| | - Anne-Cooper Doherty
- California
Department of Toxic Substances Control, Sacramento, California 95814, United States
| | - Rolf U. Halden
- Arizona
State University, Tempe, Arizona 85287, United States
| | - Homero Harari
- Icahn
School of Medicine at Mount Sinai, New York, New York 10029, United States
| | | | - Terry C. Hrubec
- Edward Via College of Osteopathic Medicine, Blacksburg, Virginia 24060, United States
| | - Shoba Iyer
- California Office of Environmental Health Hazard Assessment, Oakland, California 94612, United States
| | - Carol F. Kwiatkowski
- Green
Science Policy Institute, Berkeley, California 94709, United States
- North Carolina State University, Raleigh, North Carolina 27695 United States
| | - Jonas LaPier
- Green
Science Policy Institute, Berkeley, California 94709, United States
| | - Dingsheng Li
- University
of Nevada, Reno, Nevada 89557, United States
| | - Li Li
- University
of Nevada, Reno, Nevada 89557, United States
| | | | - Amina Salamova
- Indiana University, Atlanta, Georgia 30322, United States
| | - Ted Schettler
- Science and Environmental Health Network, Bolinas, California 94924, United States
| | - Ryan P. Seguin
- University of Washington, Seattle, Washington 98195, United States
| | - Anna Soehl
- Green
Science Policy Institute, Berkeley, California 94709, United States
| | - Rebecca Sutton
- San Francisco Estuary Institute, Richmond, California 94804, United States
| | - Libin Xu
- University of Washington, Seattle, Washington 98195, United States
| | - Guomao Zheng
- Southern University of Science and Technology, Shenzhen, Guangdong 518055, China
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9
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Le Moual N, Dumas O, Bonnet P, Eworo Nchama A, Le Bot B, Sévin E, Pin I, Siroux V, Mandin C. Exposure to Disinfectants and Cleaning Products and Respiratory Health of Workers and Children in Daycares: The CRESPI Cohort Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105903. [PMID: 37239629 DOI: 10.3390/ijerph20105903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
Although cleaning tasks are frequently performed in daycare, no study has focused on exposures in daycares in relation to respiratory health. The CRESPI cohort is an epidemiological study among workers (n~320) and children (n~540) attending daycares. The purpose is to examine the impact of daycare exposures to disinfectants and cleaning products (DCP) on the respiratory health of workers and children. A sample of 108 randomly selected daycares in the region of Paris has been visited to collect settled dust to analyze semi-volatile organic compounds and microbiota, as well as sample indoor air to analyze aldehydes and volatile organic compounds. Innovative tools (smartphone applications) are used to scan DCP barcodes in daycare and inform their use; a database then matches the barcodes with the products' compositions. At baseline, workers/parents completed a standardized questionnaire, collecting information on DCP used at home, respiratory health, and potential confounders. Follow-up regarding children's respiratory health (monthly report through a smartphone application and biannual questionnaires) is ongoing until the end of 2023. Associations between DCP exposures and the respiratory health of workers/children will be evaluated. By identifying specific environments or DCP substances associated with the adverse respiratory health of workers and children, this longitudinal study will contribute to the improvement of preventive measures.
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Affiliation(s)
- Nicole Le Moual
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, 94807 Villejuif, France
| | - Orianne Dumas
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, 94807 Villejuif, France
| | - Pierre Bonnet
- Scientific and Technical Center for Building (CSTB), Indoor Environment Quality Unit, 77420 Champs-sur-Marne, France
| | - Anastasie Eworo Nchama
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, 94807 Villejuif, France
| | - Barbara Le Bot
- Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, Inserm, École des Hautes Etudes en Santé Publique (EHESP), University of Rennes, 35000 Rennes, France
| | | | - Isabelle Pin
- Team of Environmental Epidemiology Applied to the Development and Respiratory Health, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France
| | - Valérie Siroux
- Team of Environmental Epidemiology Applied to the Development and Respiratory Health, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France
| | - Corinne Mandin
- Scientific and Technical Center for Building (CSTB), Indoor Environment Quality Unit, 77420 Champs-sur-Marne, France
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10
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Herrin MA, Sherris AR, Dearborn LC, Loftus CT, Szpiro AA, Moore PE, Adgent MA, Barrett ES, Nguyen RHN, Carroll KN, Karr CJ. Association between maternal occupational exposure to cleaning chemicals during pregnancy and childhood wheeze and asthma. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1166174. [PMID: 38045485 PMCID: PMC10691794 DOI: 10.3389/fepid.2023.1166174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background Asthma is a leading cause of childhood morbidity in the U.S. and a significant public health concern. The prenatal period is a critical window during which environmental influences, including maternal occupational exposures, can shape child respiratory health. Cleaning chemicals are commonly encountered in occupational settings, yet few studies have examined the potential link between prenatal occupational exposures to cleaning chemicals and risk of childhood wheeze and asthma. Methods We evaluated the potential influence of maternal occupational exposure to cleaning chemicals during pregnancy on pediatric asthma and wheeze at child age 4-6 years in 453 mother-child pairs from two longitudinal pregnancy cohorts, TIDES and GAPPS, part of the ECHO prenatal and early childhood pathways to health (ECHO-PATHWAYS) consortium. Maternal occupational exposure to cleaning chemicals was defined based on reported occupation and frequency of occupational use of chemicals during pregnancy. Child current wheeze and asthma outcomes were defined by parental responses to a widely-used, standardized respiratory outcomes questionnaire administered at child age 4-6 years. Multivariable Poisson regression with robust standard errors was used to estimate relative risk (RR) of asthma in models adjusted for confounding. Effect modification by child sex was assessed using product interaction terms. Results Overall, 116 mothers (25.6%) reported occupational exposure to cleaning chemicals during pregnancy, 11.7% of children had current wheeze, and 10.2% had current asthma. We did not identify associations between prenatal exposure to cleaning chemicals and current wheeze [RRadjusted 1.03, 95% confidence interval (CI): 0.56, 1.90] or current asthma (RRadjusted 0.89, CI: 0.46, 1.74) in the overall sample. Analyses of effect modification suggested an adverse association among females for current wheeze (RR 1.82, CI: 0.76, 4.37), compared to males (RR 0.68, CI: 0.29, 1.58), though the interaction p-value was >0.05. Conclusion We did not observe evidence of associations between maternal prenatal occupational exposure to cleaning chemicals and childhood wheeze or asthma in the multi-site ECHO-PATHWAYS consortium. We leveraged longitudinal U.S. pregnancy cohorts with rich data characterization to expand on limited and mixed literature. Ongoing research is needed to more precisely characterize maternal occupational chemical exposures and impacts on child health in larger studies.
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Affiliation(s)
- Melissa A Herrin
- Department of Medicine, School of Medicine, University of Washington, Seattle, WA, United States
| | - Allison R Sherris
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
| | - Logan C Dearborn
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
| | - Christine T Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, United States
| | - Paul E Moore
- Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Margaret A Adgent
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - Ruby H N Nguyen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Kecia N Carroll
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, United States
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States
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11
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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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12
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Lovén K, Gudmundsson A, Assarsson E, Kåredal M, Wierzbicka A, Dahlqvist C, Nordander C, Xu Y, Isaxon C. Effects of cleaning spray use on eyes, airways, and ergonomic load. BMC Public Health 2023; 23:99. [PMID: 36639638 PMCID: PMC9840290 DOI: 10.1186/s12889-022-14954-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 12/27/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Cleaning workers are exposed to chemicals and high physical workload, commonly resulting in airway problems and pain. In this study the response in the upper airways and the physical workload following airborne and ergonomic exposure of cleaning spray was investigated. METHODS A survey was answered by professional cleaning workers to investigate their use of cleaning sprays and the perceived effects on eyes, airways and musculoskeletal pain. A human chamber exposure study was then conducted with 11 professional cleaning workers and 8 non-professional cleaning workers to investigate the airborne exposure, acute effects on eyes and airways, and physical load during cleaning with sprays, foam application and microfiber cloths premoistened with water. All cleaning products used were bleach, chlorine, and ammonia free. The medical assessment included eye and airway parameters, inflammatory markers in blood and nasal lavage, as well as technical recordings of the physical workload. RESULTS A high frequency of spray use (77%) was found among the 225 professional cleaning workers that answered the survey. Based on the survey, there was an eight times higher risk (p < 0.001) of self-experienced symptoms (including symptoms in the nose, eyes and throat, coughing or difficulty breathing) when they used sprays compared to when they cleaned with other methods. During the chamber study, when switching from spray to foam, the airborne particle and volatile organic compound (VOC) concentrations showed a decrease by 7 and 2.5 times, respectively. For the whole group, the peak nasal inspiratory flow decreased (-10.9 L/min, p = 0.01) during spray use compared to using only water-premoistened microfiber cloths. These effects were lower during foam use (-4.7 L/min, p = 0.19). The technical recordings showed a high physical workload regardless of cleaning with spray or with water. CONCLUSION Switching from a spraying to a foaming nozzle decreases the exposure of both airborne particles and VOCs, and thereby reduces eye and airway effects, and does not increase the ergonomic load. If the use of cleaning products tested in this study, i.e. bleach, chlorine, and ammonia free, cannot be avoided, foam application is preferable to spray application to improve the occupational environment.
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Affiliation(s)
- Karin Lovén
- grid.4514.40000 0001 0930 2361Ergonomics and Aerosol Technology, Lund University, Lund, Sweden
| | - Anders Gudmundsson
- grid.4514.40000 0001 0930 2361Ergonomics and Aerosol Technology, Lund University, Lund, Sweden
| | - Eva Assarsson
- grid.4514.40000 0001 0930 2361Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Monica Kåredal
- grid.4514.40000 0001 0930 2361Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Aneta Wierzbicka
- grid.4514.40000 0001 0930 2361Ergonomics and Aerosol Technology, Lund University, Lund, Sweden
| | - Camilla Dahlqvist
- grid.4514.40000 0001 0930 2361Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Catarina Nordander
- grid.4514.40000 0001 0930 2361Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Yiyi Xu
- grid.8761.80000 0000 9919 9582Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Christina Isaxon
- grid.4514.40000 0001 0930 2361Ergonomics and Aerosol Technology, Lund University, Lund, Sweden
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13
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Bucher ML, Anderson FL, Lai Y, Dicent J, Miller GW, Zota AR. Exposomics as a tool to investigate differences in health and disease by sex and gender. EXPOSOME 2023; 3:osad003. [PMID: 37122372 PMCID: PMC10125831 DOI: 10.1093/exposome/osad003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 05/02/2023]
Abstract
The health and disease of an individual is mediated by their genetics, a lifetime of environmental exposures, and interactions between the two. Genetic or biological sex, including chromosome composition and hormone expression, may influence both the types and frequency of environmental exposures an individual experiences, as well as the biological responses an individual has to those exposures. Gender identity, which can be associated with social behaviors such as expressions of self, may also mediate the types and frequency of exposures an individual experiences. Recent advances in exposome-level analysis have progressed our understanding of how environmental factors affect health outcomes; however, the relationship between environmental exposures and sex- and gender-specific health remains underexplored. The comprehensive, non-targeted, and unbiased nature of exposomic research provides a unique opportunity to systematically evaluate how environmental exposures interact with biological sex and gender identity to influence health. In this forward-looking narrative review, we provide examples of how biological sex and gender identity influence environmental exposures, discuss how environmental factors may interact with biological processes, and highlight how an intersectional approach to exposomics can provide critical insights for sex- and gender-specific health sciences.
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Affiliation(s)
| | - Faith L Anderson
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, NY, USA
| | - Yunjia Lai
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, NY, USA
| | - Jocelyn Dicent
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, NY, USA
| | - Gary W Miller
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, NY, USA
| | - Ami R Zota
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, NY, USA
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14
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Addressing sex and gender to improve asthma management. NPJ Prim Care Respir Med 2022; 32:56. [PMID: 36539451 PMCID: PMC9764319 DOI: 10.1038/s41533-022-00306-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/29/2022] [Indexed: 12/24/2022] Open
Abstract
Sex (whether one is 'male' or 'female', based on biological characteristics) and gender (defined by socially constructed roles and behaviors) influence asthma diagnosis and management. For example, women generally report more severe asthma symptoms than men; men and women are exposed to different asthma-causing triggers; men tend to be more physically active than women. Furthermore, implicit, often unintended gender bias by healthcare professionals (HCPs) is widespread, and may result in delayed asthma diagnosis, which can be greater in women than men. The sex and gender of the HCP can also impact asthma management. Pregnancy, menstruation, and menopause can all affect asthma in several ways and may be associated with poor asthma control. This review provides guidance for considering sex- and gender-associated impacts on asthma diagnosis and management and offers possible approaches to support HCPs in providing personalized asthma care for all patients, regardless of their sex or gender.
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15
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Baron S, Cuervo I, Winkel G, Flores D, Gonzalez A, Harari H. Employment Quality and Mental and Self-Reported Health Inequities among Latinx Housecleaners: The Safe and Just Cleaners Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15973. [PMID: 36498045 PMCID: PMC9741237 DOI: 10.3390/ijerph192315973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Precarious employment, such as housecleaning, is one important structural contributor to health inequities. We used an employment quality (EQ) framework to characterize the impact of employment conditions on mental and self-reported ill-health among Latinx housecleaners in the New York City metropolitan area. Using a community-based participatory research approach, we collected cross-sectional survey data from 402 housecleaners between August 2019 and February 2020 to characterize housecleaners' EQ and its association with depression, perceived stress, and self-reported health. We also measured work-related irritant eye, skin, and respiratory symptoms, which have been shown in previous research to be associated with housecleaners' exposure to chemical components of cleaning products. Our housecleaner cohort was largely female and immigrant and most had worked at least five years. Survey items capturing the EQ dimensions of unbalanced interpersonal relations, low material resources, and violations of workers' rights were associated with increased odds of depression, perceived stress, and self-reported ill-health. Work-related irritant eye, skin, and respiratory symptoms were also independently associated with mental and self-reported ill-health and some of the effects of EQ on health were potentially partially mediated through their association with work-related irritant symptoms. Findings can inform directions for community-based educational and policy initiatives to improve housecleaners' employment quality.
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Affiliation(s)
- Sherry Baron
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Queens, New York, NY 11367, USA
| | - Isabel Cuervo
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Queens, New York, NY 11367, USA
| | - Gary Winkel
- Population Health Science and Policy Department, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | | | | | - Homero Harari
- Selikoff Centers for Occupational Health, Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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16
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Ahmed S, Pinnock H, Dowrick A, Steed L. Generational perspective on asthma self-management in the Bangladeshi and Pakistani community in the United Kingdom: A qualitative study. Health Expect 2022; 25:2534-2547. [PMID: 35999685 PMCID: PMC9615058 DOI: 10.1111/hex.13579] [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: 01/28/2022] [Revised: 07/05/2022] [Accepted: 07/22/2022] [Indexed: 11/27/2022] Open
Abstract
Background Self‐management strategies improve asthma outcomes, although interventions for South Asian populations have been less effective than in White populations. Both self‐management and culture are dynamic, and factors such as acculturation and generation have not always been adequately reflected in existing cultural interventions. We aimed to explore the perspectives of Bangladeshi and Pakistani people in the United Kingdom, across multiple generations (first, second and third/fourth), on how they self‐manage their asthma, with a view to suggesting recommendations for cultural interventions. Methods We purposively recruited Bangladeshi and Pakistani participants, with an active diagnosis of asthma from healthcare settings. Semi‐structured interviews in the participants' choice of language (English, Sylheti, Standard Bengali or Urdu) were conducted, and data were analysed thematically. Results Twenty‐seven participants (13 Bangladeshi and 14 Pakistani) were interviewed. There were generational differences in self‐management, influenced by complex cultural processes experienced by South Asians as part of being an ethnic minority group. Individuals from the first generation used self‐management strategies congruent to traditional beliefs such as ‘sweating’ and often chose to travel to South Asian countries. Generations born and raised in the United Kingdom learnt and experimented with self‐management based on their fused identities and modified their approach depending on whether they were in familial or peer settings. Acculturative stress, which was typically higher in first generations who had migration‐related stressors, influenced the priority given to asthma self‐management throughout generations. The amount and type of available asthma information as well as social discussions within the community and with healthcare professionals also shaped asthma self‐management. Conclusions Recognizing cultural diversity and its influence of asthma self‐management can help develop effective interventions tailored to the lives of South Asian people. Patient or Public Contribution Patient and Public Involvement colleagues were consulted throughout to ensure that the study and its materials were fit for purpose.
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Affiliation(s)
- Salina Ahmed
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.,School of Health Sciences, University of Greenwich, London, UK
| | - Hilary Pinnock
- Usher Institute, College of Medicine and Veterinary Science, The University of Edinburgh, Edinburgh, UK
| | - Anna Dowrick
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.,Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Liz Steed
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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17
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Saraiva-Romanholo BM, de Genaro IS, de Almeida FM, Felix SN, Lopes MRC, Amorim TS, Vieira RP, Arantes-Costa FM, Martins MA, de Fátima Lopes Calvo Tibério I, Prado CM. Exposure to Sodium Hypochlorite or Cigarette Smoke Induces Lung Injury and Mechanical Impairment in Wistar Rats. Inflammation 2022; 45:1464-1483. [PMID: 35501465 DOI: 10.1007/s10753-022-01625-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 12/11/2020] [Accepted: 01/11/2022] [Indexed: 11/05/2022]
Abstract
Pulmonary irritants, such as cigarette smoke (CS) and sodium hypochlorite (NaClO), are associated to pulmonary diseases in cleaning workers. We examined whether their association affects lung mechanics and inflammation in Wistar rats. Exposure to these irritants alone induced alterations in the lung mechanics, inflammation, and remodeling. The CS increased airway cell infiltration, acid mucus production, MMP-12 expression, and alveolar enlargement. NaClO increased the number of eosinophils and macrophages in the bronchoalveolar lavage fluid, with cells expressing IL-13, MMP-12, MMP-9, TIMP-1, and iNOS in addition to increased IL-1β and TNF-α levels. Co-exposure to both irritants increased epithelial and smooth muscle cell area, acid mucus production, and IL-13 expression in the airways, while it reduced the lung inflammation. In conclusion, the co-exposure of CS with NaClO reduced the pulmonary inflammation, but increased the acidity of mucus, which may protect lungs from more injury. A cross-resistance in people exposed to multiple lung irritants should also be considered.
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Affiliation(s)
- Beatriz Mangueira Saraiva-Romanholo
- Sao Paulo Hospital (IAMSPE), Sao Paulo, Brazil.
- Department of Medicine, School of Medicine, University of Sao Paulo, LIM 20 Av. Dr. Arnaldo, 455 - Sala 1210, 1º andar, CEP: 01246903, Sao Paulo, Brazil.
- University City of Sao Paulo (UNICID), Sao Paulo, Brazil.
- Laboratory of Studies in Pulmonary Inflammation, Department of Biosciences, Federal University of Sao Paulo (UNIFESP), Santos, Brazil.
| | - Isabella Santos de Genaro
- Sao Paulo Hospital (IAMSPE), Sao Paulo, Brazil
- Department of Medicine, School of Medicine, University of Sao Paulo, LIM 20 Av. Dr. Arnaldo, 455 - Sala 1210, 1º andar, CEP: 01246903, Sao Paulo, Brazil
| | - Francine Maria de Almeida
- Department of Medicine, School of Medicine, University of Sao Paulo, LIM 20 Av. Dr. Arnaldo, 455 - Sala 1210, 1º andar, CEP: 01246903, Sao Paulo, Brazil
| | - Soraia Nogueira Felix
- Sao Paulo Hospital (IAMSPE), Sao Paulo, Brazil
- Department of Medicine, School of Medicine, University of Sao Paulo, LIM 20 Av. Dr. Arnaldo, 455 - Sala 1210, 1º andar, CEP: 01246903, Sao Paulo, Brazil
| | | | | | - Rodolfo Paula Vieira
- Post-Graduation Program in Bioengineering and in Biomedical Engineering, Brazil University, Sao Paulo, Brazil
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), Sao Jose dos Campos, Brazil
- Post-Graduation Program in Sciences of Human Movement and Rehabilitation, Federal University of São Paulo (UNIFESP), Santos, Brazil
- School of Medicine, Anhembi Morumbi University, Sao Jose dos Campos, SP, Brazil
| | - Fernanda Magalhães Arantes-Costa
- Department of Medicine, School of Medicine, University of Sao Paulo, LIM 20 Av. Dr. Arnaldo, 455 - Sala 1210, 1º andar, CEP: 01246903, Sao Paulo, Brazil
| | - Milton Arruda Martins
- Department of Medicine, School of Medicine, University of Sao Paulo, LIM 20 Av. Dr. Arnaldo, 455 - Sala 1210, 1º andar, CEP: 01246903, Sao Paulo, Brazil
| | - Iolanda de Fátima Lopes Calvo Tibério
- Department of Medicine, School of Medicine, University of Sao Paulo, LIM 20 Av. Dr. Arnaldo, 455 - Sala 1210, 1º andar, CEP: 01246903, Sao Paulo, Brazil
| | - Carla Máximo Prado
- Laboratory of Studies in Pulmonary Inflammation, Department of Biosciences, Federal University of Sao Paulo (UNIFESP), Santos, Brazil
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18
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Martin G, Pujos L, Magrini MB. Micro-Level Sustainability Transition Pathways of Institutional Food Services in France. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.943020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Very few studies have dealt with sustainability transitions in the agrifood sector, especially in institutional food services (IFS), and notably at a micro level. Based on 29 interviews with head cooks in France, we characterized the micro-level sustainability transition pathways that institutional catering units have been following, taking essentially four sustainable practices into consideration: organic food use, ultra-processed food use, vegetarian meals and waste management. We identified four transition pathways according to the speed, size, dimensionality and time-period of changes in those practices. We showed how these pathways are linked to the diversity of transition contexts; internal (e.g., skills) and external (e.g., local suppliers) resources and constraints. This original empirical study revealed the diversity and feasibility of sustainability transition pathways in IFS. It also showed that they do not require unreasonable increases in resources. Positive narratives on transitions need developing, together with diagnosis tools to guide them.
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Pacheco Da Silva E, Sit G, Goldberg M, Leynaert B, Nadif R, Ribet C, Roche N, Zins M, Varraso R, Dumas O, Le Moual N. Household use of green and homemade cleaning products, wipe application mode, and asthma among French adults from the CONSTANCES cohort. INDOOR AIR 2022; 32:e13078. [PMID: 35904383 PMCID: PMC9545541 DOI: 10.1111/ina.13078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/13/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
While exposure to irritant and sprayed cleaning products at home is known to have a harmful role in asthma, the potential health effect of other categories or forms has not been investigated. We studied the associations of household use of cleaning products, including green, homemade products, and disinfecting wipes, with asthma based on data from the large French population-based CONSTANCES cohort. Participants completed standardized questionnaires on respiratory health and household use of cleaning products. Cross-sectional associations of cleaning products with current asthma, adjusted for gender, age, smoking status, BMI, and educational level, were evaluated by logistic regressions. Analyses were conducted in 41 570 participants (mean age: 47 years, 56% women, weekly use of the six specific products/forms studied varied from 11% to 37%). Weekly use of irritants (OR = 1.23 [1.13-1.35]), scented (OR = 1.15 [1.06-1.26]), green (OR = 1.09 [1.00-1.20]), and homemade products (OR = 1.19 [1.06-1.34]), as well as sprays (OR = 1.18 [1.08-1.29]), disinfecting wipes (OR = 1.21 [1.09-1.34]) were significantly associated with asthma, with significant trends according to the frequency of use. When they were not co-used with irritants/sprays, associations were reduced and persisted only for disinfecting wipes. Weekly use of disinfecting wipes at home was associated with current asthma, but fewer risks were observed for the use of green and homemade products.
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Affiliation(s)
- Emilie Pacheco Da Silva
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, InsermÉquipe d'Épidémiologie Respiratoire Intégrative, CESPVillejuifFrance
| | - Guillaume Sit
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, InsermÉquipe d'Épidémiologie Respiratoire Intégrative, CESPVillejuifFrance
| | - Marcel Goldberg
- Université de Paris, Unité "Cohortes en Population" INSERMUniversité Paris Saclay, UVSQ, UMSParisFrance
| | - Bénédicte Leynaert
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, InsermÉquipe d'Épidémiologie Respiratoire Intégrative, CESPVillejuifFrance
| | - Rachel Nadif
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, InsermÉquipe d'Épidémiologie Respiratoire Intégrative, CESPVillejuifFrance
| | - Céline Ribet
- Université de Paris, Unité "Cohortes en Population" INSERMUniversité Paris Saclay, UVSQ, UMSParisFrance
| | - Nicolas Roche
- Pneumologie, Hôpital CochinAPHP.Centre – Université de ParisParisFrance
| | - Marie Zins
- Université de Paris, Unité "Cohortes en Population" INSERMUniversité Paris Saclay, UVSQ, UMSParisFrance
| | - Raphaëlle Varraso
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, InsermÉquipe d'Épidémiologie Respiratoire Intégrative, CESPVillejuifFrance
| | - Orianne Dumas
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, InsermÉquipe d'Épidémiologie Respiratoire Intégrative, CESPVillejuifFrance
| | - Nicole Le Moual
- Université Paris‐Saclay, UVSQ, Univ. Paris‐Sud, InsermÉquipe d'Épidémiologie Respiratoire Intégrative, CESPVillejuifFrance
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Speiser E, Pinto Zipp G, DeLuca DA, Paula Cupertino A, Arana-Chicas E, Gourna Paleoudis E, Bethea TN, Kligler B, Cartujano-Barrera F. Environmental Health Needs Among Latinas in Cleaning Occupations: A Mixed Methods Approach. ENVIRONMENTAL HEALTH INSIGHTS 2022; 16:11786302221100045. [PMID: 35614881 PMCID: PMC9125105 DOI: 10.1177/11786302221100045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/14/2022] [Indexed: 06/15/2023]
Abstract
In the U.S., approximately half of maids and housekeeping cleaners are Latino or Hispanic, while the vast majority are women (88.3%). This largely immigrant, underserved workforce faces complex factors, which may contribute to adverse health outcomes. To understand relevant barriers and challenges, this mixed-methods study explored the environmental health needs of a heterogeneous group of Latinas in New Jersey (NJ) who clean occupationally, and consisted of 3 focus groups (N = 15) with a cross-sectional survey (N = 9), both conducted in Spanish. Participants were recruited from community-based English as a Second Language classes in Hackensack, NJ. Analysis of focus group audio recordings included descriptive and in vivo coding followed by inductive coding to explore thematic analysis. The survey responses were evaluated using descriptive statistics. As per the survey results, the environmental health needs of this population include sore muscles, back problems, asthma, other respiratory issues, migraine or headache, and skin issues (rash, etc.). In the group discussions, the roles of genetics, food, and chemical exposures in cancer etiology were of great interest and a variety of opinions on the topic were explored. Both the focus group discussions and survey responses suggested that this population also faces barriers including lack of training, chemical exposures and inadequate personal protective equipment (PPE). These barriers are compounded by daily environmental exposures from personal home cleaning practices. The development of culturally- and linguistically-appropriate interventions are warranted to better protect the health of essential occupational cleaners who keep homes, businesses and schools clean.
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Affiliation(s)
- Erin Speiser
- The Deirdre Imus Environmental Health Center®, Hackensack Meridian Health, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Genevieve Pinto Zipp
- Department of Interprofessional Health Sciences & Health Administration, School of Health and Medical Sciences, Seton Hall University, Nutley, NJ, USA
| | - Deborah A DeLuca
- Department of Interprofessional Health Sciences & Health Administration, School of Health and Medical Sciences, Seton Hall University, Nutley, NJ, USA
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Evelyn Arana-Chicas
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Elli Gourna Paleoudis
- Office of Research Administration, Hackensack Meridian Health, Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, NJ, USA
| | - Traci N Bethea
- Office of Minority Health and Health Disparities Research and Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Benjamin Kligler
- The Deirdre Imus Environmental Health Center®, Hackensack Meridian Health, Hackensack University Medical Center, Hackensack, NJ, USA
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21
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da Paz ER, de Lima CMF, Felix SN, Schaeffer B, Galvão CES, Correia AT, Righetti RF, de Arruda Martins M, de Fátima Lopes Calvo Tibério I, Saraiva-Romanholo BM. Airway inflammatory profile among cleaning workers from different workplaces. BMC Pulm Med 2022; 22:170. [PMID: 35488256 PMCID: PMC9052628 DOI: 10.1186/s12890-022-01949-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 04/11/2022] [Indexed: 01/01/2023] Open
Abstract
Background Cleaning workers represent a significant proportion of the active population worldwide, with poor remuneration, particularly in developing countries. Despite this, they remain a relatively poorly studied occupational group. They are constantly exposed to agents that can cause symptoms and respiratory problems. This study aimed to evaluate upper airway inflammation in professional cleaning workers in three different occupational settings by comparing nasal cytology inflammation and clinical profiles. Methods We performed a cross-sectional study on the prevalence of upper airway inflammation and symptoms of asthma/rhinitis related to cleaning work, according to workplace. A total of 167 participants were divided into four groups: hospital, university, housekeeper and control. A nasal swab was collected for upper airway inflammation evaluation. Clinical profiles and respiratory symptom employee evaluations were performed using specific questionnaires (European Community Respiratory Health Survey—ECRS and the International Study of Asthma and Allergies in Childhood—ISAAC). Results Cleaning workers showed increased neutrophils and lymphocytes; the hospital and university groups showed increased macrophages compared to the housekeeper and control groups. The hospital and housekeeper groups showed increased eosinophils when they performed cleaning services for up to one year and reported having more asthma symptoms than the control group. Cleaning workers showed increased rhinitis symptoms. The university group showed increased rhinitis symptoms aggravated by the workplace compared with the hospital and housekeeper groups. Cleaning workers showed an increased affirmative response when directly asked about rhinitis symptoms compared to the control group. Conclusions Cleaning workers showed airway inflammation, asthma symptoms and rhinitis, regardless of the occupational environment to which they were exposed, as well as showed increased rhinitis and asthma symptoms. Hospital cleaning workers showed increased macrophages, lymphocytes and eosinophils compared to the others. The length of time spent performing cleaning work was not related to nasal inflammation or respiratory symptoms in this population. However, there were differences in workplaces. Registered on ClinicalTrials.gov. Trial registration number: NCT03311048. Registration date: 10.16.2017. Retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01949-5.
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Affiliation(s)
- Edinéia Rosa da Paz
- Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Hospital Do Servidor Público Do Estado de São Paulo, Sao Paulo, SP, Brazil
| | | | - Soraia Nogueira Felix
- Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Hospital Do Servidor Público Do Estado de São Paulo, Sao Paulo, SP, Brazil.
| | - Bruna Schaeffer
- Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
| | | | - Aristides Tadeu Correia
- Departamento de Cardiopneumologia, Instituto do Coração, InCor-HCFMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil.,Laboratório de Investigação Médica- LIM 61, Serviço de Cirurgia Torácica, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Renato Fraga Righetti
- Hospital Sírio-Libanês, Serviço de Reabilitação, Sao Paulo, SP, Brazil.,Laboratório de Terapêutica Experimental (LIM-20), Faculdade de Medicina da USP (FMUSP), Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Milton de Arruda Martins
- Laboratório de Terapêutica Experimental (LIM-20), Faculdade de Medicina da USP (FMUSP), Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Beatriz Mangueira Saraiva-Romanholo
- Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Hospital Do Servidor Público Do Estado de São Paulo, Sao Paulo, SP, Brazil.,Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil.,Laboratório de Terapêutica Experimental (LIM-20), Faculdade de Medicina da USP (FMUSP), Universidade de Sao Paulo, Sao Paulo, Brazil
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22
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Jenkins CR, Boulet LP, Lavoie KL, Raherison-Semjen C, Singh D. Personalized Treatment of Asthma: The Importance of Sex and Gender Differences. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:963-971.e3. [PMID: 35150902 DOI: 10.1016/j.jaip.2022.02.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/18/2022] [Accepted: 02/03/2022] [Indexed: 12/19/2022]
Abstract
An individual's sex (nominally male or female, based on biological attributes) and gender (a complex term referring to socially constructed roles, behaviors, and expressions of identity) influence the clinical course of asthma in several ways. The physiologic development of the lungs and effects of sex hormones may explain why more boys than girls have asthma, and after puberty, more women than men have asthma. Female sex hormones have an impact throughout the life span and are associated with poor asthma control. Gender may influence exposure to asthma triggers, and sex and gender can influence the prevalence of comorbidities and interactions with health care professionals. Despite widely reported sex- and gender-based differences in asthma and asthma management, these issues frequently are not considered by health care professionals. There is also inconsistency regarding the use of "sex" and "gender" in scientific discourse; research is needed to define sex- and gender-based differences better and how they might interact to influence asthma outcomes. This review outlines the impact an individual's sex and gender can have on the pathogenesis, clinical course, diagnosis, treatment, and management of asthma.
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Affiliation(s)
| | | | - Kim L Lavoie
- Department of Psychology, University of Québec at Montreal and Montreal Behavioural Medicine Centre, CIUSSS-NIM, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
| | - Chantal Raherison-Semjen
- Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe, France; INSERM U1219, EpiCene Team, University of Bordeaux, Bordeaux, France
| | - Dave Singh
- University of Manchester, Manchester University NHS Foundation Trust, Manchester, United Kingdom
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23
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OUP accepted manuscript. Ann Work Expo Health 2022; 66:998-1009. [DOI: 10.1093/annweh/wxac034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 04/20/2022] [Accepted: 04/27/2022] [Indexed: 11/14/2022] Open
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24
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Kathare M, Julander A, Erfani B, Schenk L. OUP accepted manuscript. Ann Work Expo Health 2022; 66:741-753. [PMID: 35217863 PMCID: PMC9250289 DOI: 10.1093/annweh/wxac006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/20/2021] [Accepted: 01/25/2022] [Indexed: 11/13/2022] Open
Abstract
Using data from the Swedish Products Register, hosted by the Swedish Chemicals Agency (KemI), national occupational injury and disease statistics, and call records from the Swedish Poisons Information Centre (PIC) we characterize health hazards of marketed cleaning products and recorded injuries, disease, and incidents linked to cleaning or disinfection agents. The results show that cleaning agents pose many kinds of health hazards, although corrosion and irritation hazards dominate, in particular for the eyes (54% of all included products). Few products were recognized as inhalation hazards. The nature of the health hazards is reflected in the occupational disease and injury statistics and PIC records for eyes and skin but not for the respiratory tract. Among occupational disease cases attributed to cleaning or disinfection agents, 61% concern skin and 26% the respiratory tract. Among occupational injury cases 64% concern chemical burns. However, only a small part (<0.5%) of all reported diseases and injuries were explicitly attributed to cleaning or disinfection agents. On average, there were 11 cases of disease attributed to cleaning or disinfection agents per million workers and year. For occupational injuries the corresponding number was 8. The data concern a broad range of sectors and occupations, but notable sectors were healthcare, accommodation and food service, and manufacturing. Women were more likely to suffer from disease, men and women equally likely to suffer from injury. PIC cases were evenly distributed between men and women, but the clear risk cases more frequently involved men. Occupational diseases increased many-fold in 2020 while injuries decreased, which could be due to COVID-19 changing use patterns of cleaning and disinfection agents at work. We conclude that cleaning agents pose a variety of risks to a large part of the workforce, although particular attention for preventive efforts may need to be directed to the healthcare, accommodation and food service, and manufacturing sectors.
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Affiliation(s)
- Maitreyi Kathare
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anneli Julander
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Sustainable work and management, IVL Swedish Environmental Research Institute, Stockholm, Sweden
| | - Behnaz Erfani
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Linda Schenk
- Author to whom correspondence should be addressed. Tel: +46-8-5248-7968; fax: +46-8-33-69-81; e-mail:
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25
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Speiser E, Pinto Zipp G, DeLuca DA, Cupertino AP, Arana-Chicas E, Gourna Paleoudis E, Kligler B, Cartujano-Barrera F. Knowledge, attitudes and behaviors of Latinas in cleaning occupations in northern New Jersey: a cross-sectional mixed methods study. J Occup Med Toxicol 2021; 16:52. [PMID: 34872565 PMCID: PMC8646340 DOI: 10.1186/s12995-021-00343-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the United States, 88.3% of all 1,163,000 maids and housekeeping cleaners are female, and approximately half of them Latinas. Latinas are understudied and underrepresented in health research, particularly involving chemical exposure in cleaning practices, lack of job training, and inadequate access to personal protective equipment. The purpose of this study is twofold: 1) to examine the knowledge (via training experiences), attitudes and behaviors of a heterogeneous group of Latinas who clean occupationally and 2) to assess their cleaning practices at work and at home. METHODS This mixed-method study consisted of two phases: 1) three focus groups to explore knowledge (via training experiences), attitudes, and behaviors regarding cleaning practices (N = 15) and 2) a 43-question cross-sectional survey. Focus group audio recordings were analyzed using descriptive and in vivo coding and then coded inductively to explore thematic analysis. Statistical analysis of the survey evaluated means, frequency and percentage for each of the responses. RESULTS Participants (n = 9) were women (mean age = 48.78 and SD = 6.72) from South America (n = 5), Mexico (n = 1), El Salvador (n = 1) and Dominican Republic (n = 2). The mean length of time living in the US was 18.78 years and over half (55.6%) worked in the cleaning industry for 10 or more years. Findings from the three focus groups (n = 15) included that training in cleaning often occurred informally at a very young age at home. Participants reported cleaning in groups where tasks are rotated and/or shared. Most were the primary person cleaning at home, suggesting increased exposure. Gloves and masks were the most frequently used PPE, but use was not consistent. For participants who purchase their own products, driving factors included price, smell and efficacy. Some participants used products supplied or preferred by the employer. CONCLUSIONS Latinas in cleaning occupations face a range of social and health barriers including lack of safety and health training, inadequate PPE and low literacy. To address these issues, the development of an intervention is warranted to provide training and resources for this critical population of essential workers.
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Affiliation(s)
- Erin Speiser
- The Deirdre Imus Environmental Health Center®, Hackensack University Medical Center, Hackensack, NJ USA
| | - Genevieve Pinto Zipp
- Department of Interprofessional Health Sciences & Health Administration, School of Health and Medical Sciences, Seton Hall University, Nutley, NJ USA
| | - Deborah A. DeLuca
- Department of Interprofessional Health Sciences & Health Administration, School of Health and Medical Sciences, Seton Hall University, Nutley, NJ USA
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY USA
| | - Evelyn Arana-Chicas
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY USA
| | | | - Benjamin Kligler
- The Deirdre Imus Environmental Health Center®, Hackensack University Medical Center, Hackensack, NJ USA
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26
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Tjalvin G, Svanes Ø, Igland J, Bertelsen RJ, Benediktsdóttir B, Dharmage S, Forsberg B, Holm M, Janson C, Jõgi NO, Johannessen A, Malinovschi A, Pape K, Real FG, Sigsgaard T, Torén K, Vindenes HK, Zock JP, Schlünssen V, Svanes C. Maternal preconception occupational exposure to cleaning products and disinfectants and offspring asthma. J Allergy Clin Immunol 2021; 149:422-431.e5. [PMID: 34674855 DOI: 10.1016/j.jaci.2021.08.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 07/08/2021] [Accepted: 08/31/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Emerging research suggests health effects in offspring after parental chemical exposures before conception. Many future mothers are exposed to potent chemicals at work, but potential offspring health effects are hardly investigated. OBJECTIVE We sought to investigate childhood asthma in relation to mother's occupational exposure to cleaning products and disinfectants before conception. METHODS The multicenter Respiratory Health In Northern Europe/Respiratory Health In Northern Europe, Spain and Australia generation study investigated asthma and wheeze starting at age less than 10 years in 3318 mother-offspring pairs. From an asthma-specific Job-Exposure Matrix and mothers' occupational history, we defined maternal occupational exposure to indoor cleaning agents (cleaning products/detergents and disinfectants) starting before conception, in the 2-year period around conception and pregnancy, or after birth. Never-employed mothers were excluded. Exposed groups include cleaners, health care workers, cooks, and so forth. Associations were analyzed using mixed-effects logistic regression and ordinary logistic regression with clustered robust SEs and adjustment for maternal education. RESULTS Maternal occupational exposure to indoor cleaning starting preconception and continuing (n = 610) was associated with offspring's childhood asthma: odds ratio 1.56 (95% CI, 1.05-2.31), childhood asthma with nasal allergies: 1.77 (1.13-2.77), and childhood wheeze and/or asthma: 1.71 (95% CI, 1.19-2.44). Exposure starting around conception and pregnancy (n = 77) was associated with increased childhood wheeze and/or asthma: 2.25 (95% CI, 1.03-4.91). Exposure starting after birth was not associated with asthma outcomes (1.13 [95% CI, 0.71-1.80], 1.15 [95% CI, 0.67-1.97], 1.08 [95% CI, 0.69-1.67]). CONCLUSIONS Mother's occupational exposure to indoor cleaning agents starting before conception, or around conception and pregnancy, was associated with more childhood asthma and wheeze in offspring. Considering potential implications for vast numbers of women in childbearing age using cleaning agents, and their children, further research is imperative.
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Affiliation(s)
- Gro Tjalvin
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
| | - Øistein Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Randi Jacobsen Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway; Oral Health Center of Expertise in Western Norway, Bergen, Norway
| | - Bryndís Benediktsdóttir
- Medical Faculty, University of Iceland, Reykjavík, Iceland; Department of Sleep, Landspitali University Hospital Reykjavík, Reykjavík, Iceland
| | - Shyamali Dharmage
- Allergy and Lung Health Unit, University of Melbourne, Melbourne, Australia
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Mathias Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Nils Oskar Jõgi
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway; Tartu University Lung Clinic, Tartu, Estonia
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Kathrine Pape
- National Research Centre for the Working Environment, Aarhus, Denmark; Department of Public Health, Aarhus University, Environment, Work and Health, Danish Ramazzini Centre, Aarhus, Denmark
| | - Francisco Gomez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Torben Sigsgaard
- Department of Public Health, Aarhus University, Environment, Work and Health, Danish Ramazzini Centre, Aarhus, Denmark
| | - Kjell Torén
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hilde Kristin Vindenes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Jan-Paul Zock
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Vivi Schlünssen
- National Research Centre for the Working Environment, Aarhus, Denmark; Department of Public Health, Aarhus University, Environment, Work and Health, Danish Ramazzini Centre, Aarhus, Denmark
| | - Cecilie Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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27
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Xie W, Dumas O, Varraso R, Boggs KM, Camargo CA, Stokes AC. Association of Occupational Exposure to Inhaled Agents in Operating Rooms With Incidence of Chronic Obstructive Pulmonary Disease Among US Female Nurses. JAMA Netw Open 2021; 4:e2125749. [PMID: 34542617 PMCID: PMC8453320 DOI: 10.1001/jamanetworkopen.2021.25749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
IMPORTANCE Employment in operating rooms (ORs) may involve exposure to several inhaled agents, including surgical smoke and disinfectants, which are associated with adverse respiratory health effects. However, the association of long-term employment in ORs and chronic obstructive pulmonary disease (COPD) remains unknown. OBJECTIVE To examine the association of working in an OR with incidence of COPD among female nurses in the US. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the Nurses' Health Study for US female registered nurses who provided information on questionnaires regarding OR employment history in 1984 and job type in 1982 and who had no history of COPD in 1984 (baseline). Data analyses were conducted from April 1, 2020, to January 31, 2021. EXPOSURES Duration of nursing in the OR and job type. MAIN OUTCOMES AND MEASURES The associations of any employment as an OR nurse, duration of employment, and duration and job type with incidence of self-reported, physician-diagnosed COPD. Hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards regression models stratified by age and calendar year. Models were adjusted for covariates, with model 1 adjusting for age, model 2 also adjusting for cigarette smoking status and pack-year of smoking, and model 3 also adjusting for race and ethnicity, US Census region, and body mass index. RESULTS Among 75 011 female nurses included in the analyses, the mean (SD) age at baseline was 50.5 (7.2) years; 29% had a history of employment in an OR, and 3% had 15 or more years of OR experience. In model 3, employment in an OR for 15 or more years was associated with a 46% increased risk of developing COPD compared with no history of OR employment (HR, 1.46; 95% CI, 1.10-1.93). Compared with nurses who never worked in an OR and had an administrative or nursing education function or a nonnursing job in 1982, the risk of developing COPD was greater among nurses who provided outpatient care (HR, 1.24; 95% CI, 1.04-1.47) and nurses employed in inpatient units (HR, 1.31; 95% CI, 1.07-1.59) who had no history of OR employment and was 69% greater among nurses with OR experience of 15 years or more (HR, 1.69; 95% CI, 1.25-2.28). CONCLUSIONS AND RELEVANCE In this cohort study, OR employment of 15 years or more was associated with an increased risk of developing COPD among female nurses. Additional studies with more recent and direct environmental monitoring data of multiple occupational exposures are needed to assess the relative role of exposure to surgical smoke and disinfectants in the observed association.
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Affiliation(s)
- Wubin Xie
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
| | - Orianne Dumas
- Université Paris-Saclay, University Paris-Sud, Inserm, Équipe d’Épidémiologie Respiratoire Intégrative, Villejuif, France
| | - Raphaëlle Varraso
- Université Paris-Saclay, University Paris-Sud, Inserm, Équipe d’Épidémiologie Respiratoire Intégrative, Villejuif, France
| | - Krislyn M. Boggs
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Carlos A. Camargo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Andrew C. Stokes
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
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28
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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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Cumulative Occupational Exposures and Lung-Function Decline in Two Large General-Population Cohorts. Ann Am Thorac Soc 2021; 18:238-246. [PMID: 33090904 DOI: 10.1513/annalsats.202002-113oc] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Rationale: Few longitudinal studies have assessed the relationship between occupational exposures and lung-function decline in the general population with a sufficiently long follow-up.Objectives: To examine the potential association in two large cohorts: the ECRHS (European Community Respiratory Health Survey) and the SAPALDIA (Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults).Methods: General-population samples of individuals aged 18 to 62 were randomly selected in 1991-1993 and followed up approximately 10 and 20 years later. Spirometry (without bronchodilation) was performed at each visit. Coded complete job histories during follow-up visits were linked to a job-exposure matrix, generating cumulative exposure estimates for 12 occupational exposures. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were jointly modeled in linear mixed-effects models, fitted in a Bayesian framework, taking into account age and smoking.Results: A total of 40,024 lung-function measurements from 17,833 study participants were analyzed. We found accelerated declines in FEV1 and the FEV1/FVC ratio for exposure to biological dust, mineral dust, and metals (FEV1 = -15.1 ml, -14.4 ml, and -18.7 ml, respectively; and FEV1/FVC ratio = -0.52%, -0.43%, and -0.36%, respectively; per 25 intensity-years of exposure). These declines were comparable in magnitude with those associated with long-term smoking. No effect modification by sex or smoking status was identified. Findings were similar between the ECRHS and the SAPALDIA cohorts.Conclusions: Our results greatly strengthen the evidence base implicating occupation, independent of smoking, as a risk factor for lung-function decline. This highlights the need to prevent or control these exposures in the workplace.
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Tarlo SM. Time for Action on Cleaning and Disinfecting Agents. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:2366-2367. [PMID: 34112479 DOI: 10.1016/j.jaip.2021.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Susan M Tarlo
- Respiratory Division, Department of Medicine, University Health Network, Toronto Western Hospital, University of Toronto Department of Medicine, and Dalla Lana Department of Public Health, Toronto, Ontario, Canada.
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Lindström I, Lantto J, Karvala K, Soini S, Ylinen K, Suojalehto H, Suuronen K. Occupations and exposure events in acute and subacute irritant-induced asthma. Occup Environ Med 2021; 78:793-800. [PMID: 33790028 PMCID: PMC8526874 DOI: 10.1136/oemed-2020-107323] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/16/2021] [Accepted: 03/08/2021] [Indexed: 11/16/2022]
Abstract
Background Exposures leading to irritant-induced asthma (IIA) are poorly documented. Methods We retrospectively screened the medical records of patients with IIA diagnosed in an occupational medicine clinic during 2000–2018. We classified the cases into acute (onset after single exposure) and subacute (onset after multiple exposures) IIA. We analysed in detail, occupations, causative agents and their air levels in the workplace, exposure events and the root causes of high exposure. Results Altogether 69 patients were diagnosed with IIA, 30 with acute and 39 with subacute IIA. The most common occupational groups were industrial operators (n=23, 33%), metal and machinery workers (n=16, 11%) and construction workers (n=12, 8%). Among industrial operators significantly more cases had subacute IIA than acute IIA (p=0.002). Forty cases (57%) were attributable to some type of corrosive acidic or alkaline chemical. Acute IIA followed accidents at work in different types of occupation, while subacute IIA was typical among industrial operators performing their normal work tasks under poor work hygiene conditions. The most common root cause was lack of information or false guidance in acute IIA (n=11, 36%) and neglect of workplace hygiene measures in subacute IIA (n=29, 74%). Conclusions Accidents are the main causes of acute IIA, whereas subacute IIA can develop in normal work in risk trades with poor work hygiene. Airborne strong acids or bases seem to be the most important causative agents of acute and subacute IIA. The different risk profiles of acute and subacute IIA should be considered in the prevention and identification of the cases.
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Affiliation(s)
- Irmeli Lindström
- Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jussi Lantto
- Pulmonary Medicine, Helsinki University Hospital Heart and Lung Center, Helsinki, Finland.,University of Helsinki Faculty of Medicine, Helsinki, Finland
| | - Kirsi Karvala
- Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland.,Varma Mutual Pension Insurance Company, Helsinki, Finland
| | - Satu Soini
- Occupational Health, Finnish Institute of Occupational Health, Oulu, Finland
| | - Katriina Ylinen
- Work Environmental Laboratories, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Hille Suojalehto
- Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Katri Suuronen
- Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland
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Assessing Risks Awareness in Operating Rooms among Post-Graduate Students: A Pilot Study. SUSTAINABILITY 2021. [DOI: 10.3390/su13073860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: In this study, we promote a global approach to occupational risk perception in order to improve occupational health and safety training programs. The study investigates the occupational risk perception of operating room healthcare workers using an Analytic Hierarchy Process approach. Methods: A pilot study was carried out through a cross-sectional survey in a university hospital in Southern Italy. An ad hoc questionnaire was administered to enrolled medical post-graduate students working in the operating room. Results: Fifty medical specialists from seven fields (anaesthetists, digestive system surgeons, general surgeons, maxillofacial surgeons, thoracic surgeons, urologists, and gynaecologists) were questioned about perceived occupational risk by themselves. Biological, ionizing radiation, and chemical risks were the most commonly perceived in order of priority (w = 0.300, 0.219, 0.210). Concerning the biological risk, gynaecologists unexpected perceived this risk as less critical (w = 0.2820) than anaesthesiologists (w = 0.3354), which have the lowest perception of the risk of ionizing radiation (w = 0.1657). Conclusions: Prioritization methods could improve risk perception in healthcare settings and help detect training needs and perform sustainable training programs.
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Dumas O, Bédard A, Marbac M, Sedki M, Temam S, Chanoine S, Severi G, Boutron-Ruault MC, Garcia-Aymerich J, Siroux V, Varraso R, Le Moual N. Household Cleaning and Poor Asthma Control Among Elderly Women. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:2358-2365.e4. [PMID: 33631408 DOI: 10.1016/j.jaip.2021.02.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/03/2021] [Accepted: 02/09/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Asthma control is suboptimal in nearly half of adults with asthma. Household exposure to disinfectants and cleaning products (DCP) has been associated with adverse respiratory effects, but data on their association with asthma control are scant. OBJECTIVES To investigate the association between household use of DCP and asthma control in a large cohort of French elderly women. METHODS We used data from a case-control study on asthma (2011-2013) nested in the E3N cohort. Among 3023 women with current asthma, asthma control was defined by the Asthma Control Test (ACT). We used a standardized questionnaire to assess the frequency of cleaning tasks and DCP use. We also identified household cleaning patterns using a clustering approach. Associations between DCP and ACT were adjusted for age, smoking status, body mass index, and education. RESULTS Data on ACT and DCP use were available for 2223 women (70 ± 6 years old). Asthma was controlled (ACT = 25), partly controlled (ACT = 20-24), and poorly controlled (ACT ≤ 19) in 29%, 46%, and 25% of the participants, respectively. Weekly use of sprays and chemicals was associated with poorly controlled asthma (odds ratio [95% confidence interval]: 1 spray: 1.31 [0.94-1.84], ≥2 sprays: 1.65 [1.07-2.53], P trend: .01; 1 chemical: 1.24 [0.94-1.64], ≥2 chemicals: 1.47 [1.03-2.09], P trend: .02). Risk for poor asthma control increased with the patterns "very frequent use of products" (1.74 [1.13-2.70]) and "infrequent cleaning tasks and intermediate use of products" (1.62 [1.05-2.51]). CONCLUSION Regular use of DCP may contribute to poor asthma control in elderly women. Limiting their use may help improve asthma management.
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Affiliation(s)
- Orianne Dumas
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, Villejuif, France
| | - Annabelle Bédard
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, Villejuif, France
| | | | - Mohammed Sedki
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Pôle méthodologies et statistique, CESP, Villejuif, France
| | - Sofia Temam
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, Villejuif, France; MGEN Foundation for Public Health (FESP-MGEN), Paris, France
| | - Sébastien Chanoine
- IAB, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, INSERM U1209, University of Grenoble-Alpes, CHU de Grenoble, Grenoble, France
| | - Gianluca Severi
- Université Paris-Saclay, UVSQ, Inserm, CESP, Equipe "Exposome, Hérédité, Cancer et Santé" Villejuif, France
| | | | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Valérie Siroux
- IAB, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, INSERM U1209, University of Grenoble-Alpes, CHU de Grenoble, Grenoble, France
| | - Raphaëlle Varraso
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, Villejuif, France
| | - Nicole Le Moual
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, Villejuif, France
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Different Characteristics of Childhood Asthma Related to Polyhexamethylene Guanidine Hydrochloride (PHMG) Exposure. Ann Am Thorac Soc 2021; 18:1523-1532. [PMID: 33561373 DOI: 10.1513/annalsats.202007-807oc] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Exposure to humidifier disinfectants (HDs) can increase the risk of asthma but the characteristics of HD-related asthma are currently unclear. Polyhexamethylene guanidine hydrochloride (PHMG)-containing HD was the most commonly used and the most frequently associated with HD-associated lung injury. OBJECTIVES To investigate the characteristics of PHMG-induced asthma. METHODS This general population-based birth cohort study utilized data from the Panel Study of Korean Children from 2008 (n = 846). Spirometry, bronchial provocation tests, detailed history recording, and physical examinations were performed on seven-year-old patients (n=362). Exploratory analysis of plasma proteomics was performed. RESULTS Compared with healthy control, FEV1 was the lowest in PHMG-exposed asthma group. (z score = -0.806; 95% CI, -1.492 to -0.119) The positive rate of bronchial hyperresponsiveness was lower in children with PHMG-exposed asthma compared to children with asthma without HD exposure (13.3% vs. 47.4%). Long-term exposure to low-intensity PHMG before age three was associated with asthma symptoms. Periostin was higher in asthma without HD exposure compared to the healthy control. The inducible T cell costimulator ligand and hepatocyte growth factor activator were lower in PHMG-exposed asthma compared to asthma without exposure. Hepatocyte growth factor activator a positive correlation with FVC (z-score) in asthma with PHMG exposure (r=0.78, P<0.01). CONCLUSIONS The asthma associated with low intensity exposure to PHMG is characterized by lower lung function, lower positive rates of bronchial hyperresponsiveness, and varied distributions of plasma proteins. These findings suggest that asthma related to PHMG exposure may constitute a different mechanism of asthma pathophysiology.
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Laytragoon Lewin N, Karlsson JE, Robinsson D, Fagerberg M, Kentsson M, Sayardoust S, Nilsson M, Shamoun L, Andersson BÅ, Löfgren S, Rutqvist LE, Lewin F. Influence of single nucleotide polymorphisms among cigarette smoking and non-smoking patients with coronary artery disease, urinary bladder cancer and lung cancer. PLoS One 2021; 16:e0243084. [PMID: 33507988 PMCID: PMC7842923 DOI: 10.1371/journal.pone.0243084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 11/13/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction Cigarette smoke is suggested to be a risk factor for coronary artery disease (CAD), urinary bladder cancer (UBCa) or lung cancer (LCa). However, not all heavy smokers develop these diseases and elevated cancer risk among first-degree relatives suggests an important role of genetic factor. Methods Three hundred and ten healthy blood donors (controls), 98 CAD, 74 UBCa and 38 LCa patients were included in this pilot study. The influence of 92 single nucleotide polymorphisms (SNPs) and impact of cigarette smoking were analysed. Results Out of 92 SNPs tested, differences in distribution of 14 SNPs were detected between controls and patient groups. Only CTLA4 rs3087243 showed difference in both CAD and UBCa patient group compared to control group. Stratified by smoking status, the impact of smoking was associated to frequencies of 8, 3 and 4 SNPs in CAD, UBCa, LCa patients, respectively. None of these 92 SNPs showed a statistically significant difference to more than one type of disease among smoking patients. In non-smoking patients, 7, 3 and 6 SNPs were associated to CAD, UBCa, LCa, respectively. Out of these 92 SNPs, CTLA4 rs3087243 was associated to both non-smoking CAD and UBCa. The XRCC1 rs25487 was associated to both non-smoking UBCa and LCa. Conclusion SNPs might be important risk factors for CAD, UBCa and LCa. Distribution of the SNPs was specific for each patient group, not a random event. Impact of cigarette smoking on the disease was associated to the specific SNP sequences. Thus, smoking individuals with SNPs associated to risk of these serious diseases is an important target group for smoking cessation programs.
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Affiliation(s)
| | - Jan-Erik Karlsson
- Dept of Internal Medicine, Ryhov Hospital, Jönköping, Sweden
- Dept of Health Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | | | | | - Magnus Kentsson
- Dept of Internal Medicine, Ryhov Hospital, Jönköping, Sweden
| | | | - Mats Nilsson
- Futurum, Academy of Health and Care, Region Jönköping, Jönköping, Sweden
- Dept Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Levar Shamoun
- Dept Laboratory Medicine, Ryhov Hospital, Jönköping, Sweden
| | | | - Sture Löfgren
- Dept Laboratory Medicine, Ryhov Hospital, Jönköping, Sweden
| | | | - Freddi Lewin
- Dept Oncology, Ryhov Hospital, Jönköping, Sweden
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Quinete N, Hauser-Davis RA. Drinking water pollutants may affect the immune system: concerns regarding COVID-19 health effects. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:1235-1246. [PMID: 33156499 PMCID: PMC7644792 DOI: 10.1007/s11356-020-11487-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/30/2020] [Indexed: 05/12/2023]
Abstract
The current coronavirus pandemic is leading to significant impacts on the planet, changing our way of life. Although the COVID-19 virus mechanisms of action and pathogenesis are still under extensive research, immune system effects are evident, leading, in many cases, to respiratory distress. Although apparent pollution reduction has been noticed by the population, environmental and human health impacts due to the increased use of plastic waste and disinfectants is concerning. One of the main routes of human exposure to pollutants is through drinking water. Thus, this point of view discusses some major contaminants in drinking water known to be immunotoxic, exploring sources and drinking water routes and emphasizing the known mechanisms of action that could likely compromise the effective immune response of humans, particularly raising concerns regarding people exposed to the COVID-19 virus. Based on a literature review, metals, plastic components, plasticizers, and per- and polyfluoroalkyl substances may display the potential to exacerbate COVID-19 respiratory symptoms, although epidemiological studies are still required to confirm the synergistic effects between these pollutants and the virus.
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Affiliation(s)
- Natalia Quinete
- Institute of Environment & Department of Chemistry and Biochemistry, Florida International University, 11200 SW 8th Street, Modesto A. Maidique Campus, Miami, FL, 33199, USA.
| | - Rachel Ann Hauser-Davis
- Laboratório de Avaliação e Promoção da Saúde Ambiental, Instituto Oswaldo Cruz, Fiocruz, Av. Brazil, 4.365, Manguinhos, Rio de Janeiro, RJ, 21040-360, Brazil
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Benjamin ML, Arnold S, Rao M, Davis K, Maier A, Virkutyte J. Ventilation and posture effects on inhalation exposures to volatile cleaning ingredients in a simulated domestic worker cleaning environment. INDOOR AIR 2021; 31:128-140. [PMID: 32648981 DOI: 10.1111/ina.12715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 05/13/2020] [Accepted: 07/06/2020] [Indexed: 06/11/2023]
Abstract
Associations between cleaning chemical exposures and asthma have previously been identified in professional cleaners and healthcare workers. Domestic workers, including housecleaners and caregivers, may receive similar exposures but in residential environments with lower ventilation rates. Study objectives were to compare exposures to occupational exposure limits (OELs), to determine relative contributions from individual cleaning tasks to overall exposure, and to evaluate the effects of ventilation and posture on exposure. Airborne chemical concentrations of sprayed cleaning chemicals (acetic acid or ammonia) were measured during typical cleaning tasks in a simulated residential work environment. Whole-house cleaning exposures (18 cleaning tasks) were measured using integrated personal sampling methods. Individual task exposures were measured with a sampling line attached to subjects' breathing zones, with readings recorded by a ppbRAE monitor, equipped with a photoionization detector calibrated for ammonia and acetic acid measurements. Integrated sampling results indicated no exposures above OELs occurred, but 95th percentile air concentrations would require risk management decisions. Exposure reductions were observed with increased source distance, with lower exposures from mopping floors compared to kneeling. Exposure reductions were also observed for most but not all tasks when ventilation was used, with implications that alternative exposure reduction methods may be needed.
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Affiliation(s)
- Michael L Benjamin
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Susan Arnold
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Marepalli Rao
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kermit Davis
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Jurate Virkutyte
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Eldeirawi K, Huntington-Moskos L, Nyenhuis SM, Polivka B. Increased disinfectant use among adults with asthma in the era of COVID-19. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 9:1378-1380.e2. [PMID: 33385592 PMCID: PMC7832809 DOI: 10.1016/j.jaip.2020.12.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/10/2020] [Accepted: 12/15/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Kamal Eldeirawi
- Department of Population Health Nursing Science, College of Nursing, University of Illinois at Chicago, Chicago, Ill.
| | | | - Sharmilee M Nyenhuis
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, Ill
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Abstract
PURPOSE OF REVIEW Evidence for adverse respiratory effects of occupational exposure to disinfectants and cleaning products (DCPs) has grown in the last two decades. The relationship between DCPs and asthma is well documented but questions remain regarding specific causal agents. Beyond asthma, associations between DCPs and COPD or chronic rhinitis are plausible and have been examined recently. The purpose of this review is to summarize recent advances on the effect of occupational exposure to DCP and chronic airway diseases. RECENT FINDINGS Recent epidemiological studies have often focused on healthcare workers and are characterized by efforts to improve assessment of exposure to specific DCPs. Despite increasing knowledge on the effect of DCPs on asthma, the burden of work-related asthma caused by DCPs has not decreased in the past decade, emphasizing the need to strengthen prevention efforts. Novel data suggest an association between occupational exposure to DCPs and other chronic airway diseases, such as rhinitis, COPD, and poor lung function. SUMMARY Epidemiological and experimental data showed that many chemicals contained in DCPs are likely to cause airway damage, indicating that prevention strategies should target multiple products. Further research is needed to evaluate the impact of DCP exposure on occupational airway diseases beyond asthma.
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40
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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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Kelly FJ, Mudway IS, Fussell JC. Air Pollution and Asthma: Critical Targets for Effective Action. Pulm Ther 2020; 7:9-24. [PMID: 33161530 PMCID: PMC7648850 DOI: 10.1007/s41030-020-00138-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/19/2020] [Indexed: 12/28/2022] Open
Abstract
Evidence to advocate for cleaner air for people with asthma is not in short supply. We know that air pollution is associated with the development and worsening of the condition and that mitigating interventions can improve respiratory outcomes. We have clear targets, particularly traffic emissions, especially in urban areas, and plenty of potentially effective actions. Road traffic must be reduced, and what remains should be cleaner and greener. Urban green spaces, safe cycle networks and wider pavements will promote active travel and leisure time exercise. Healthcare professionals must ensure people are aware of their air quality, its impact on asthma and the appropriate behaviour to safeguard health. What remains are realistic policies and effective measures, based on the correct scientific evidence, to be taken forth with political courage and investment so that air pollution no longer contributes to the development or worsening of respiratory ill health.
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Affiliation(s)
- Frank J Kelly
- NIHR Health Protection Research Unit in Environmental Exposures and Health, School of Public Health, Imperial College London, Sir Micheal Uren Building, White City Campus, 80-92 Wood Lane, London, W12 0BZ, UK.
| | - Ian S Mudway
- NIHR Health Protection Research Unit in Environmental Exposures and Health, School of Public Health, Imperial College London, Sir Micheal Uren Building, White City Campus, 80-92 Wood Lane, London, W12 0BZ, UK
| | - Julia C Fussell
- NIHR Health Protection Research Unit in Environmental Exposures and Health, School of Public Health, Imperial College London, Sir Micheal Uren Building, White City Campus, 80-92 Wood Lane, London, W12 0BZ, UK
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Rosenman KD, Reilly MJ, Wang L. Calls to a State Poison Center Concerning Cleaners and Disinfectants From the Onset of the COVID-19 Pandemic Through April 2020. Public Health Rep 2020; 136:27-31. [PMID: 33059533 PMCID: PMC7856373 DOI: 10.1177/0033354920962437] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
An increased use of disinfectants during the coronavirus disease 2019 (COVID-19) pandemic may increase the number of adverse health effects among people who apply them or among those who are in the area being disinfected. For the 3-month period from January 1 to March 30, 2020, the number of calls about exposure to cleaners and disinfectants made to US poison centers in all states increased 20.4%, and the number of calls about exposure to disinfectants increased 16.4%. We examined calls about cleaners and disinfectants to the Michigan Poison Center (MiPC) since the onset of the COVID-19 pandemic. We compared all calls related to exposure to cleaners or disinfectants, calls with symptoms, and calls in which a health care provider was seen during the first quarters of 2019 and 2020 and in relationship to key COVID-19 dates. From 2019 to 2020, the number of all disinfectant calls increased by 42.8%, the number of calls with symptoms increased by 57.3%, the average number of calls per day doubled after the first Michigan COVID-19 case, from 4.8 to 9.0, and the proportion of calls about disinfectants among all exposure calls to the MiPC increased from 3.5% to 5.0% (P < .001). Calls for exposure to cleaners did not increase significantly. Exposure occurred at home for 94.8%97.1% of calls, and ingestion was the exposure route for 59.7% of calls. Information about the adverse health effects of disinfectants and ways to minimize exposure should be included in COVID-19 pandemic educational materials.
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Affiliation(s)
- Kenneth D. Rosenman
- Division of Occupational and Environmental Medicine, Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA,Kenneth D. Rosenman, MD, Michigan State University, Division of Occupational and Environmental Medicine, 909 Wilson Rd, Room 117 West Fee, East Lansing, MI 48824, USA;
| | - Mary Jo Reilly
- Division of Occupational and Environmental Medicine, Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Ling Wang
- Division of Occupational and Environmental Medicine, Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA
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Parks J, Takaro TK. Exposure to cleaning products and childhood asthma: more than just a link? Expert Rev Respir Med 2020; 14:1185-1188. [PMID: 32990115 DOI: 10.1080/17476348.2020.1813572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Jaclyn Parks
- Faculty of Health Sciences, Simon Fraser University , Burnaby, BC, Canada
| | - Tim K Takaro
- Faculty of Health Sciences, Simon Fraser University , Burnaby, BC, Canada
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Occupational lung diseases in the 21st century: the changing landscape and future challenges. Curr Opin Pulm Med 2020; 26:142-148. [PMID: 31895883 DOI: 10.1097/mcp.0000000000000658] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Occupational exposures remain an underrecognized and preventable cause of lung disease in high-income countries. The present review highlights the emergence of cleaning-related respiratory disease and the re-emergence of silicosis as examples of trends in occupational lung diseases in the 21st century. RECENT FINDINGS Employment trends, such as the shift from large-scale manufacturing to a service economy, the growth of the healthcare sector, and changing consumer products have changed the spectrum of work-related lung diseases. Following decades of progress in reducing traditional hazards such as silica in U.S. workplaces, cases of advanced silicosis have recently re-emerged with the production of engineered stone countertops. With growth in the healthcare and service sectors in the United States, cleaning products have become an important cause of work-related asthma and have recently been associated with an increased risk of chronic obstructive pulmonary disease (COPD) in women. However, these occupational lung diseases largely go unrecognized by practicing clinicians. SUMMARY The present article highlights how changes in the economy and work structure can lead to new patterns of inhalational workplace hazards and respiratory disease, including cleaning-related respiratory disease and silicosis. Pulmonary clinicians need to be able to recognize and diagnose these occupational lung diseases, which requires a high index of suspicion and a careful occupational history.
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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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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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Kim V, Wang W, Mannino D, Diaz A. Association of birthplace and occupational exposures with chronic bronchitis in US Hispanics/Latinos, 2008-2011. Occup Environ Med 2020; 77:344-350. [PMID: 32165546 DOI: 10.1136/oemed-2019-106081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 01/27/2020] [Accepted: 02/21/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES In the US, chronic bronchitis (CB) is common and is associated with substantial morbidity and mortality. Data on CB in the Hispanic/Latino population-a large, diverse US minority-are scarce. We aimed to test whether the prevalence of CB varies across Hispanic/Latino heritages and to identify CB risk factors, including occupational exposures, in this population. METHODS We analysed data from the Hispanic Community Health Study/Study of Latinos, a US population-based probability sample of participants aged 18-74 years (n=16 415) including those with Mexican, Puerto Rican, Dominican, Cuban, Central American and South American heritages. Participants who had a completed respiratory questionnaire and valid spirometric data were included in the analysis (n=13 259). CB, place of birth, heritage, occupational exposures and other risk factors were based on standardised questionnaires. The prevalence of CB was estimated using survey logistic regression-conditional marginal analysis. RESULTS The estimated (mean (95% CI)) overall adjusted prevalence of CB was 12.1% (9.3 to 15.6), with a large variation across heritages. Dominican heritage had a fivefold higher prevalence than South American heritage. US-born participants had a higher adjusted prevalence than their non-US-born counterparts (16.8% (12.5 to 22.1) vs 11.0% (8.5 to 14.10); p=0.022). Compared with non-exposed participants, those exposed to cleaning or disinfecting solutions had a higher adjusted prevalence of CB (12.6% (9.1 to 17.1) vs 11.8% (9.2 to 15.1); p=0.024). CONCLUSIONS The prevalence of CB was higher among Dominicans than other Hispanic/Latino heritages. CB was more prevalent among US-born participants and those exposed to cleaning and disinfecting solutions.
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Affiliation(s)
- Victor Kim
- Thoracic Medicine and Surgery, Temple University, Philadelphia, Pennsylvania, US
| | - Wei Wang
- Division of Sleep Medicine, Brigham and Women's Hospital, Boston, Massachusetts, US
| | - David Mannino
- US Medical Affairs, GlaxoSmithKline, Lexington, Kentucky, US.,Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington, KY, US
| | - Alejandro Diaz
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, US
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Parks J, McCandless L, Dharma C, Brook J, Turvey SE, Mandhane P, Becker AB, Kozyrskyj AL, Azad MB, Moraes TJ, Lefebvre DL, Sears MR, Subbarao P, Scott J, Takaro TK. Association of use of cleaning products with respiratory health in a Canadian birth cohort. CMAJ 2020; 192:E154-E161. [PMID: 32071106 PMCID: PMC7030878 DOI: 10.1503/cmaj.190819] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Comprehensive longitudinal studies are important for understanding the complex risk factors, pathways, exposures and interactions that lead to the development and persistence of asthma. We aimed to examine associations between use of household cleaning products in early life and childhood respiratory and allergic disease using data from the Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study. METHODS We summed responses from parental questionnaires that indicated the frequency of use of 26 household cleaning products in the homes of 2022 children from this birth cohort when they were 3-4 months of age to create a cumulative Frequency of Use Score (FUS). We used multivariable logistic regression models to assess whether frequent compared with less frequent use was associated with recurrent wheeze, atopy or asthma diagnosis, as defined by the questionnaire and clinical assessments at age 3 years. Data were collected between 2008 and 2015. RESULTS Children in homes with a higher frequency of use of cleaning products in infancy, as determined by an interquartile range increase, had higher odds of recurrent wheeze (adjusted odds ratio [OR] 1.35, 95% confidence interval [CI] 1.11-1.64), recurrent wheeze with atopy (adjusted OR 1.49, 95% CI 1.02-2.16) and asthma diagnosis (adjusted OR 1.37, 95% CI 1.09-1.70), but no increase in the odds of atopy at age 3 years (adjusted OR 1.14, 95% CI 0.96-1.35). Compared with the lowest tertile of FUS exposure, infants in the highest tertile had higher odds of acquiring asthma. Stratification of the results showed that females had higher ORs than males for all outcomes, although the p values for this sex difference did not reach statistical significance. INTERPRETATION Frequent use of household cleaning products in early life was associated with an increased risk for childhood wheeze and asthma but not atopy at age 3 years. Our findings add to the understanding of how early life exposures to cleaning products may be associated with the development of allergic airway disease and help to identify household behaviours as a potential area for intervention.
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Affiliation(s)
- Jaclyn Parks
- Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont
| | - Lawrence McCandless
- Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont
| | - Christoffer Dharma
- Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont
| | - Jeffrey Brook
- Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont
| | - Stuart E Turvey
- Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont
| | - Piush Mandhane
- Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont
| | - Allan B Becker
- Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont
| | - Anita L Kozyrskyj
- Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont
| | - Meghan B Azad
- Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont
| | - Theo J Moraes
- Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont
| | - Diana L Lefebvre
- Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont
| | - Malcolm R Sears
- Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont
| | - Padmaja Subbarao
- Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont
| | - James Scott
- Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont
| | - Tim K Takaro
- Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont.
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Raherison C, Hamzaoui A, Nocent-Ejnaini C, Essari LA, Ouksel H, Zysman M, Prudhomme A. [Woman's asthma throughout life: Towards a personalized management?]. Rev Mal Respir 2020; 37:144-160. [PMID: 32057504 DOI: 10.1016/j.rmr.2019.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/18/2019] [Indexed: 11/30/2022]
Abstract
In a woman's life, asthma can affect her in a variety of ways, with the onset of premenstrual asthma currently under-diagnosed. It is estimated that about 20% of women with asthma have premenstrual asthma, which is more common in patients with severe asthma. Women with asthma are at high risk of exacerbations and of severe asthma. Asthma is the most common chronic disease during pregnancy with potential maternal and foetal complications. Asthma medications are safe for the foetus and it is essential to continue pre-existing treatment and adapt it to the progress of asthma during the pregnancy. Sex steroids modulate the structure and function of bronchial and immune cells. Understanding their role in asthma pathogenesis is complicated by the ambivalent effects of bronchodilating and pro-inflammatory oestrogens as well as the diversity of response to their association with progesterone. Menopausal asthma is a clinical entity and is part of one of the phenotypes of severe non-allergic and low steroid-sensitive asthma. Targeted assessment of the domestic and professional environment allows optimization of asthma management.
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Affiliation(s)
- C Raherison
- Service des maladies respiratoires, pôle cardiothoracique, INSERM U1219, université de Bordeaux, CHU Bordeaux, 146, rue Léo-Saignat, 33604 Bordeaux, France.
| | - A Hamzaoui
- Pavillon B, unité de recherche UR12 SP15, hôpital Abderrahmen Mami, faculté de médecine, université de Tunis El Manar, Ariana, Tunisie
| | | | - L-A Essari
- Département de pneumologie, CHRU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - H Ouksel
- Département de pneumologie, CHU d'Angers, Angers, France
| | - M Zysman
- UMR_S955, université Paris-Est Créteil (UPEC), 94000 Créteil, France; Inserm, U955, Team 4, 94000 Créteil, France
| | - A Prudhomme
- Service de pneumologie, CHG Tarbes, Tarbes, France
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Rosenman K, Reilly MJ, Pechter E, Fitzsimmons K, Flattery J, Weinberg J, Cummings K, Borjan M, Lumia M, Harrison R, Dodd K, Schleiff P. Cleaning Products and Work-Related Asthma, 10 Year Update. J Occup Environ Med 2020; 62:130-137. [PMID: 31895737 PMCID: PMC7839059 DOI: 10.1097/jom.0000000000001771] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To describe the frequency of work-related asthma (WRA) and characteristics of individuals with exposure to cleaning products 1998 to 2012, compared with 1993 to 1997. METHODS Cases of WRA from products used for cleaning or disinfecting surfaces were identified from California, Massachusetts, Michigan (1998 to 2012), New Jersey (1998 to 2011), and New York (2009 to 2012). RESULTS There were 1199 (12.4%) cleaning product cases among all 9667 WRA cases; 77.8% women, 62.1% white non-Hispanic, and average age of 43 years. The highest percentages worked in healthcare (41.1%), and were building cleaners (20.3%), or registered nurses (14.1%). CONCLUSIONS The percentage of WRA cases from exposure to cleaning products from 1998 to 2012 was unchanged from 1993 to 1997 indicating that continued and additional prevention efforts are needed to reduce unnecessary use, identify safer products, and implement safer work processes.
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Affiliation(s)
- Kenneth Rosenman
- Michigan State University, Michigan (Dr Rosenman, Ms Reilly); Massachusetts Department of Public Health, Massachusetts (Ms Pechter, Ms Fitzsimmons); California Department of Public Health (Ms Flattery, Dr Harrison); Public Health Institute, Contractor to California Department of Public Health (Ms Weinberg), California; New York State Department of Health (Ms Cummings), New York; New Jersey Department of Health (Dr Borjan, Dr Lumia), New Jersey; and National Institute for Occupational Safety and Health, Cincinnati, Ohio (Ms Dodd, Ms Schleiff)
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