EPIASLI

Duration

2007-2010

Coordinator

Jan-Paul Zock

Funded by

FIS/ISCII

EPIASLI 2-Epidemiological Study of Asthma Risk in Cleaners

Background and Aims:

There is increasing evidence that cleaning workers are at risk for occupational asthma, but the specific risk factors and the predominant effect mechanisms are largely unknown. In a previous community-based study in the Barcelona area we observed an increased risk of asthma among women employed in domestic cleaning, but the risk among non-domestic cleaning workers was heterogeneous. The main aim was to perform an epidemiological study among cleaning workers employed in cleaning service companies in the province of Barcelona and to evaluate both risk factors and clinical, functional and inflammatory characteristics of asthma in this workforce.

Methods:

A two-stage sampling frame was applied to identify eligible study participants. The first stage comprised a questionnaire survey among cleaning and administrative workers of the companies. Using this information the rates of asthma and asthma-related symptoms in relation to specific cleaning tasks and products have been evaluated. The second stage was a nested case-control study including 43 workers with symptoms highly suggestive of asthma (with and without evidence of the asthma being related to work) and 54 workers without respiratory problems. Fourteen cleaning workers with diagnosed occupational asthma in an occupational respiratory clinic were also included. Methods included spirometric lung function and bronchial responsiveness testing, allergic sensitisation, fractional exhaled NO, inflammatory and oxidative stress markers in exhaled breath condensate, and pulmonary proteins indicative of lung permeability and lung damage in blood serum. A panel study among cases consisted of diaries of respiratory symptoms and peak expiratory flow and FEV1, including daily registration of cleaning exposures.

Main findings:



Current cleaners have an increased risk of asthma symptoms, in particular those working in healthcare centres.

Exposure to irritants is common and the use of multiple irritant products is associated with asthma symptoms.

Acute inhalations related to mixing cleaning products are associated with an increased risk for asthma symptoms.