title: Women using bleach for home cleaning are at increased risk of non-allergic asthma.
abstract: Bleach is widely used for household cleaning. Although it is recognized that occupational use of bleach may have adverse respiratory health effects, it is unknown whether common domestic use of bleach may be a risk factor for asthma.
  
  
  
  To assess whether the domestic use of bleach for home cleaning is associated with asthma and other respiratory outcomes.
  
  
  
  Questionnaire-based information on respiratory symptoms and cleaning habits and data from skin prick-tests, bronchial responsiveness challenge and white blood cells were analyzed in 607 women participating in the follow-up of the Epidemiological Study on the Genetics and Environment of Asthma (EGEA). Bleach use was evaluated in 3 categories (<1 day/week; 1-3 days/week; 4-7 days/week "frequent").
  
  
  
  Overall, 37% of the women reported using bleach weekly. Women using bleach frequently (11%) were more likely to have current asthma as compared to non-users (adjusted Odds-Ratio (aOR) = 1.7; 95% Confidence Interval (95%CI) 1.0-3.0). Among women with asthma, frequent use of bleach was significantly associated with higher blood neutrophil cell counts. Bleach use was significantly associated with non-allergic asthma (aOR 3.3; 95%CI 1.5-7.1), and more particularly with non-allergic adult-onset asthma (aOR 4.9; 95%CI 2.0-11.6). Consistently, among women without allergic sensitization, significant positive associations were found between use of bleach and bronchial hyperresponsiveness, asthma like-symptoms and chronic cough. No association was observed for allergic asthma.
  
  
  
  Frequent use of bleach for home-cleaning is associated with non-allergic adult-onset asthma, elevated neutrophil counts and lower-airway symptoms in women.
authors: Inserm, UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Epidemiology Team, F-75890, Paris, France; Univ Paris-Saclay, Faculty of Medicine, Kremlin-Bicêtre, France.
authors: Bobette
authors: B
authors: Matulonga
authors: Inserm, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807, Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France; Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid, Spain.
authors: Marta
authors: M
authors: Rava
authors: University Grenoble Alpes, IAB, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, F-38042, Grenoble, France; Inserm U823, IAB, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, F-38042, Grenoble, France.
authors: Valérie
authors: V
authors: Siroux
authors: Louvain Center for Toxicology and Applied Pharmacology (LTAP), Catholic University of Louvain, 1200, Brussels, Belgium.
authors: Alfred
authors: A
authors: Bernard
authors: Inserm, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807, Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France.
authors: Orianne
authors: O
authors: Dumas
authors: University Grenoble Alpes, IAB, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, F-38042, Grenoble, France; Inserm U823, IAB, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, F-38042, Grenoble, France; CHU de Grenoble, La Tronche, F-38043, Grenoble, France.
authors: Isabelle
authors: I
authors: Pin
authors: Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors: Jan-Paul
authors: JP
authors: Zock
authors: Inserm, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807, Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France.
authors: Rachel
authors: R
authors: Nadif
authors: Inserm, UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Epidemiology Team, F-75890, Paris, France; University Paris Diderot Paris 7, UMR 1152, F-75890, Paris, France. Electronic address: benedicte.leynaert@inserm.fr.
authors: Bénédicte
authors: B
authors: Leynaert
authors: Inserm, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807, Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France.
authors: Nicole
authors: N
authors: Le Moual
mesh_terms: D000328:Adult; D001249:Asthma / Q000139:chemically induced* / Q000150:complications / Q000453:epidemiology; D057886:Bleaching Agents / Q000009:adverse effects*; D016535:Bronchial Hyperreactivity / Q000139:chemically induced* / Q000503:physiopathology; D001985:Bronchial Provocation Tests / Q000379:methods; D016022:Case-Control Studies; D005260:Female; D006795:Household Products / Q000009:adverse effects; D006796:Household Work; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology; D009784:Occupational Diseases / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects; D012137:Respiratory System / Q000503:physiopathology; D012307:Risk Factors
chemical_list: D057886:Bleaching Agents
keywords: Bleach; Cleaning products; Epidemiology; Household irritants; Non-allergic asthma; Respiratory health