title: Cleaning products and short-term respiratory effects among female cleaners with asthma.
abstract: OBJECTIVE
  We evaluated the short-term effects of exposure to cleaning products on lung function and respiratory symptoms among professional cleaning women.
  
  
  METHODS
  Twenty-one women with current asthma and employed as professional cleaners participated in a 15-day panel study. During 312 person-days of data collection, participants self-reported their use of cleaning products and respiratory symptoms in daily diaries and recorded their forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF) three times per day using a handheld spirometer. We evaluated associations of cleaning product use with upper and lower respiratory tract symptoms using Poisson mixed regression models and with changes in FEV1 and PEF using linear mixed regression analyses.
  
  
  RESULTS
  Participants reported using an average of 2.4 cleaning products per day, with exposure to at least one strong irritant (eg, ammonia, bleach, hydrochloric acid) on 56% of person-days. Among participants without atopy, lower respiratory tract symptoms were associated with the use of hydrochloric acid and detergents. Measurements of FEV1 and PEF taken in the evening were 174 mL (95% CI 34 to 314) and 37 L/min (CI 4 to 70), respectively, lower on days when three or more sprays were used. Evening and next morning FEV1 were both lower following the use of hydrochloric acid (-616 and -526 mL, respectively) and solvents (-751 and -1059 mL, respectively). Diurnal variation in FEV1 and PEF increased on days when ammonia and lime-scale removers were used.
  
  
  CONCLUSIONS
  The use of specific cleaning products at work, mainly irritants and sprays, may exacerbate asthma.
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain University of Montreal Hospital Research Centre (CRCHUM), Montreal, Canada Departament de Ciències Experimental i de la Salut, Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Vizcaya
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain.
authors.forename: Maria C
authors.identifier: http://orcid.org/0000-0002-3540-0085
authors.initials: MC
authors.lastname: Mirabelli
authors.affiliation: The University of Texas Health Science Center at Houston, School of Public Health, San Antonio Regional Campus, San Antonio, Texas, USA Center for Research in Occupational Health (CiSAL), University Pompeu Fabra (UPF), Barcelona, Catalonia, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Gimeno
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Departament de Ciències Experimental i de la Salut, Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain IMIM (Hospital del Mar Medical Research Institute), Barcelona, Catalonia, Spain.
authors.forename: Josep-Maria
authors.initials: JM
authors.lastname: Antó
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Center for Research in Occupational Health (CiSAL), University Pompeu Fabra (UPF), Barcelona, Catalonia, Spain IMIM (Hospital del Mar Medical Research Institute), Barcelona, Catalonia, Spain The University of Texas School of Public Health, Houston, Texas, USA.
authors.forename: George L
authors.initials: GL
authors.lastname: Delclos
authors.affiliation: Departament de Ciències Experimental i de la Salut, Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain.
authors.forename: Marcela
authors.initials: M
authors.lastname: Rivera
authors.affiliation: Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Bunyola, Majorca, Balearic Islands, Spain Servei de Pneumologia, Hospitals de Girona i Salt. Institut d'Investigació Biomòdica de Girona (IDIBGI), Girona, Catalonia, Spain.
authors.forename: Ramon
authors.initials: R
authors.lastname: Orriols
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain IMIM (Hospital del Mar Medical Research Institute), Barcelona, Catalonia, Spain.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Arjona
authors.affiliation: Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Bunyola, Majorca, Balearic Islands, Spain Servei de Pneumologia, Hospital Clínic, IDIBAPS, Barcelona, Catalonia, Spain.
authors.forename: Felip
authors.initials: F
authors.lastname: Burgos
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Departament de Ciències Experimental i de la Salut, Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Jan-Paul
authors.initials: JP
authors.lastname: Zock
mesh_terms: D000328:Adult; D000336:Aerosols / Q000009:adverse effects; D000641:Ammonia / Q000009:adverse effects; D001249:Asthma / Q000503:physiopathology*; D003902:Detergents / Q000009:adverse effects*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006851:Hydrochloric Acid / Q000009:adverse effects; D007509:Irritants / Q000009:adverse effects; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology*; D008875:Middle Aged; D009784:Occupational Diseases / Q000503:physiopathology*; D016273:Occupational Exposure / Q000009:adverse effects*; D009790:Occupations; D010366:Peak Expiratory Flow Rate; D012123:Pulmonary Ventilation; D057566:Self Report; D012997:Solvents / Q000009:adverse effects*
chemical_list: D000336:Aerosols; D003902:Detergents; D007509:Irritants; D012997:Solvents; D000641:Ammonia; D006851:Hydrochloric Acid