The use of household cleaning sprays and adult asthma: an international longitudinal study

Abstract

Rationale: Cleaning work and professional use of certain cleaning products have been associated with asthma, but respiratory effects of nonprofessional home cleaning have rarely been studied.

Objectives: To investigate the risk of new-onset asthma in relation to the use of common household cleaners.

Methods: Within the follow-up of the European Community Respiratory Health Survey in 10 countries, we identified 3,503 persons doing the cleaning in their homes and who were free of asthma at baseline. Frequency of use of 15 types of cleaning products was obtained in a face-to-face interview at follow-up. We studied the incidence of asthma defined as physician diagnosis and as symptoms or medication usage at follow-up. Associations between asthma and the use of cleaning products were evaluated using multivariable Cox proportional hazards or log-binomial regression analysis.

Measurements and main results: The use of cleaning sprays at least weekly (42% of participants) was associated with the incidence of asthma symptoms or medication (relative risk [RR], 1.49; 95% confidence interval [CI], 1.12-1.99) and wheeze (RR, 1.39; 95% CI, 1.06-1.80). The incidence of physician-diagnosed asthma was higher among those using sprays at least 4 days per week (RR, 2.11; 95% CI, 1.15-3.89). These associations were consistent for subgroups and not modified by atopy. Dose-response relationships (P < 0.05) were apparent for the frequency of use and the number of different sprays. Risks were predominantly found for the commonly used glass-cleaning, furniture, and air-refreshing sprays. Cleaning products not applied in spray form were not associated with asthma.

Conclusions: Frequent use of common household cleaning sprays may be an important risk factor for adult asthma.

Figures

Figure 1.

Kaplan-Meier survival curve for physician-diagnosed asthma according to the number of sprays used at least weekly. Onset of disease was defined as date of first attack of asthma.

Figure 2.

Association between the use of cleaning sprays at least once a week and the incidence of asthma symptoms or medication usage by country. Relative risk (RR) and 95% confidence interval (CI), adjusted within countries for study center, sex, age, smoking status, and employment in a cleaning job, are shown. The size of each box is proportional to the reciprocal of the variance of the estimate for the country. The diamond indicates 95% CI of the combined RR from the model, with country as the random effect (P = 0.15, test for heterogeneity). Countries are ranked from low to high frequency of spray use (see Table 5).