Work-related respiratory symptoms among health centres cleaners: a cross-sectional study.
OBJECTIVE
Several studies, mostly based on questionnaire-derived data, have shown an increased risk of allergic diseases, especially asthma, among cleaners. The risk factors and etiological mechanisms are still being investigated. Occupational exposure to various chemical and biological agents may induce specific sensitization and/or irritant effects. The aim of our study was to estimate the prevalence of work-related symptoms suggesting the presence of allergic disease reported by cleaners, and to relate them to the results of commercially available and standardized objective tests used for screening detection of occupational sensitization and chronic respiratory disorders.


METHODS
A cross-sectional study was performed among 142 Polish workers of cleaning service in their workplaces. A detailed questionnaire, skin prick tests to common allergens and chemicals used by these workers for cleaning purposes (chloramine T, chlorhexidine, formaldehyde, glutaraldehyde, benzalconium chloride), total and specific serum IgE antibodies to disinfectants and rest spirometry were performed in all the subjects.


RESULTS
Fifty nine percent of all the subjects declared occurrence of at least 1 symptom suggesting allergic ailment during cleaning activities at work. Skin prick tests and specific serum IgE antibodies to disinfectants were negative in all the subjects. In 8 cases wheezing was detected during auscultation, but only in 5 of them obstructive pattern in rest spirometry was found.


CONCLUSIONS
Occupational allergic causation of symptoms among cleaners could be less likely than work-related symptoms associated with exacerbations of new-onset or pre-existing respiratory diseases. Therefore, in this group of workers, mainly the non-specific irritant impact of chemicals on airways should be taken into consideration.
Department of Occupational Diseases and Toxicology, Nofer Institute of Occupational Medicine, Łódź, Poland, lipinska@imp.lodz.pl.
Agnieszka
A
Lipińska-Ojrzanowska
Marta
M
Wiszniewska
Dominika
D
Świerczyńska-Machura
Tomasz
T
Wittczak
Ewa
E
Nowakowska-Świrta
Cezary
C
Pałczyński
Jolanta
J
Walusiak-Skorupa
D000328:Adult; D003231:Conjunctivitis / Q000139:chemically induced; D003371:Cough / Q000139:chemically induced; D003430:Cross-Sectional Studies; D004202:Disinfectants / Q000276:immunology / Q000633:toxicity*; D004417:Dyspnea / Q000139:chemically induced; D005260:Female; D006797:Housekeeping, Hospital; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced*; D016273:Occupational Exposure / Q000009:adverse effects*; D012135:Respiratory Sounds / Q000209:etiology; D012871:Skin Diseases / Q000139:chemically induced; D012882:Skin Tests; D013147:Spirometry; D011795:Surveys and Questionnaires; D055815:Young Adult
D004202:Disinfectants; D007073:Immunoglobulin E