title: A workforce-based study of occupational exposures and asthma symptoms in cleaning workers.
abstract: OBJECTIVE
  To study associations between use of cleaning products and asthma symptoms in cleaning workers.
  
  
  METHODS
  Information on respiratory symptoms, history of asthma, workplaces, use of cleaning products and acute inhalation incidents were obtained through a self-administered questionnaire. 917 employees of 37 cleaning companies in Barcelona were studied. 761 (83%) were current cleaners, 86 (9%) former cleaners and 70 (8%) had never worked as cleaners. Multivariable logistic regression analyses were used to evaluate the associations between specific exposures among current cleaners and wheeze without having a cold, chronic cough and current asthma. Associations with an asthma symptom score were also studied using negative binomial regression analyses to report mean ratios.
  
  
  RESULTS
  After adjusting for sex, age, nationality and smoking status, the prevalence of current asthma was non-significantly higher among current (OR 1.9; 95% CI 0.5 to 7.8) and former cleaners (OR 1.9; CI 0.6 to 5.5) than in never cleaners. Cleaners working in hospitals during the last year had a significantly increased prevalence of wheeze, current asthma and a 1.8 (95% CI 1.2 to 2.8) times higher mean asthma score. Use of hydrochloric acid was strongly associated with asthma score (mean ratio 1.7; 95% CI 1.1 to 2.6). Use of ammonia, degreasers, multiple purpose products and waxes was also associated with asthma score.
  
  
  CONCLUSIONS
  Cleaning work in places with high demand for disinfection, high cleaning standards and use of cleaning products containing respiratory irritants is associated with higher risk of asthma symptoms. This suggests irritants have an important role in cleaning-related asthma.
authors.affiliation: Centre for Research in Environmental Epidemiology, Barcelona Biomedical Research Park, Dr Aiguader, 88 08003 Barcelona, Spain. dvizcaya@creal.cat
authors.forename: David
authors.initials: D
authors.lastname: Vizcaya
authors.forename: Maria C
authors.initials: MC
authors.lastname: Mirabelli
authors.forename: Josep-Maria
authors.initials: JM
authors.lastname: Antó
authors.forename: Ramon
authors.initials: R
authors.lastname: Orriols
authors.forename: Felip
authors.initials: F
authors.lastname: Burgos
authors.forename: Lourdes
authors.initials: L
authors.lastname: Arjona
authors.forename: Jan-Paul
authors.initials: JP
authors.lastname: Zock
mesh_terms: D000328:Adult; D001249:Asthma / Q000139:chemically induced / Q000453:epidemiology*; D016022:Case-Control Studies; D003371:Cough / Q000139:chemically induced / Q000453:epidemiology*; D003902:Detergents / Q000633:toxicity*; D005260:Female; D006801:Humans; D007509:Irritants / Q000633:toxicity; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D015995:Prevalence; D012135:Respiratory Sounds; D012307:Risk Factors; D057566:Self Report; D013030:Spain / Q000453:epidemiology
chemical_list: D003902:Detergents; D007509:Irritants