title: The use of household cleaning sprays and adult asthma: an international longitudinal study.
abstract: BACKGROUND
  Cleaning work and professional use of certain cleaning products have been associated with asthma, but respiratory effects of nonprofessional home cleaning have rarely been studied.
  
  
  OBJECTIVE
  To investigate the risk of new-onset asthma in relation to the use of common household cleaners.
  
  
  METHODS
  Within the follow-up of the European Community Respiratory Health Survey in 10 countries, we identified 3,503 persons doing the cleaning in their homes and who were free of asthma at baseline. Frequency of use of 15 types of cleaning products was obtained in a face-to-face interview at follow-up. We studied the incidence of asthma defined as physician diagnosis and as symptoms or medication usage at follow-up. Associations between asthma and the use of cleaning products were evaluated using multivariable Cox proportional hazards or log-binomial regression analysis.
  
  
  RESULTS
  The use of cleaning sprays at least weekly (42% of participants) was associated with the incidence of asthma symptoms or medication (relative risk [RR], 1.49; 95% confidence interval [CI], 1.12-1.99) and wheeze (RR, 1.39; 95% CI, 1.06-1.80). The incidence of physician-diagnosed asthma was higher among those using sprays at least 4 days per week (RR, 2.11; 95% CI, 1.15-3.89). These associations were consistent for subgroups and not modified by atopy. Dose-response relationships (P < 0.05) were apparent for the frequency of use and the number of different sprays. Risks were predominantly found for the commonly used glass-cleaning, furniture, and air-refreshing sprays. Cleaning products not applied in spray form were not associated with asthma.
  
  
  CONCLUSIONS
  Frequent use of common household cleaning sprays may be an important risk factor for adult asthma.
authors.affiliation: CREAL/IMIM, Dr. Aiguader 88, E-08003 Barcelona, Spain. jpzock@imim.es
authors.forename: Jan-Paul
authors.initials: JP
authors.lastname: Zock
authors.forename: Estel
authors.initials: E
authors.lastname: Plana
authors.forename: Deborah
authors.initials: D
authors.lastname: Jarvis
authors.forename: Josep M
authors.initials: JM
authors.lastname: Antó
authors.forename: Hans
authors.initials: H
authors.lastname: Kromhout
authors.forename: Susan M
authors.initials: SM
authors.lastname: Kennedy
authors.forename: Nino
authors.initials: N
authors.lastname: Künzli
authors.forename: Simona
authors.initials: S
authors.lastname: Villani
authors.forename: Mario
authors.initials: M
authors.lastname: Olivieri
authors.forename: Kjell
authors.initials: K
authors.lastname: Torén
authors.forename: Katja
authors.initials: K
authors.lastname: Radon
authors.forename: Jordi
authors.initials: J
authors.lastname: Sunyer
authors.forename: Anna
authors.initials: A
authors.lastname: Dahlman-Hoglund
authors.forename: Dan
authors.initials: D
authors.lastname: Norbäck
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
mesh_terms: D000328:Adult; D000336:Aerosols; D001249:Asthma / Q000453:epidemiology*; D003257:Consumer Product Safety; D003902:Detergents / Q000009:adverse effects*; D004202:Disinfectants / Q000009:adverse effects*; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012135:Respiratory Sounds; D012997:Solvents / Q000009:adverse effects*
chemical_list: D000336:Aerosols; D003902:Detergents; D004202:Disinfectants; D012997:Solvents