title: Occupational exposure to cleaning products and asthma in hospital workers.
abstract: OBJECTIVE
  Cleaning products may cause work-related asthma, but information regarding the specific exposures involved is scarce. We aimed to determine the associations between asthma and occupational exposure to cleaning agents in hospital workers.
  
  
  METHODS
  Analyses were conducted in 179 (136 women) hospital workers and a reference population of 545 subjects (18-79 years) from the French case-control and familial Epidemiological study on the Genetics and Environment of Asthma (2003-2007). Exposures to cleaning agents were estimated using three methods: self-report, expert assessment and an asthma-specific job-exposure matrix (JEM). Associations between cleaning products and current asthma were evaluated by logistic regressions, stratified by sex and adjusted for age and smoking status.
  
  
  RESULTS
  According to expert assessment, 55% of male and 81% of female hospital workers were exposed to cleaning/disinfecting tasks weekly (p<0.001). No association was observed between cleaning/disinfecting tasks and current asthma in men or in women whatever the assessment method used. In women, exposure to decalcifiers (expert assessment) was associated with current asthma (OR (95% CI):2.38 (1.06 to 5.33)). In hospital workers classified as exposed according to both the expert assessment and the JEM, additional associations were observed for exposure to ammonia (3.05 (1.19 to 7.82)) and to sprays with moderate/high intensity (2.87 (1.02 to 8.11)).
  
  
  CONCLUSIONS
  Female hospital workers are often exposed to numerous cleaning products, some of which were markedly associated with current asthma. Low numbers prevented a meaningful analysis in men. Objective and more accurate estimates of occupational exposure to cleaning products are needed to better understand the adverse effects of cleaning products.
authors.affiliation: Respiratory and environmental Epidemiology, CESP/U 1018 Inserm, 16, avenue Paul Vaillant Couturier, Villejuif Cedex 94807, France. orianne.dumas@inserm.fr
authors.forename: Orianne
authors.initials: O
authors.lastname: Dumas
authors.forename: Carole
authors.initials: C
authors.lastname: Donnay
authors.forename: Dick J J
authors.initials: DJ
authors.lastname: Heederik
authors.forename: Michel
authors.initials: M
authors.lastname: Héry
authors.forename: Dominique
authors.initials: D
authors.lastname: Choudat
authors.forename: Francine
authors.initials: F
authors.lastname: Kauffmann
authors.forename: Nicole
authors.initials: N
authors.lastname: Le Moual
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000641:Ammonia / Q000009:adverse effects*; D001249:Asthma / Q000209:etiology*; D002118:Calcium; D016022:Case-Control Studies; D004202:Disinfectants / Q000009:adverse effects*; D004203:Disinfection; D005260:Female; D005602:France / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D009790:Occupations; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors; D017132:Workplace; D055815:Young Adult
chemical_list: D004202:Disinfectants; D000641:Ammonia; D002118:Calcium