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Respiratory health in professional cleaners: Symptoms, lung function, and risk factors
Author(s) -
Brooks Collin,
Slater Tania,
Corbin Marine,
McLean Dave,
Firestone Ridvan Tua,
Zock JanPaul,
Pearce Neil,
Douwes Jeroen
Publication year - 2020
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/cea.13597
Subject(s) - medicine , asthma , bronchodilator , atopy , lung function , wheeze , respiratory system , pulmonary function testing , physical therapy , pediatrics , lung
Background Cleaning is associated with an increased risk of asthma symptoms, but few studies have measured functional characteristics of airway disease in cleaners. Aims To assess and characterize respiratory symptoms and lung function in professional cleaners, and determine potential risk factors for adverse respiratory outcomes. Methods Symptoms, pre‐/post‐bronchodilator lung function, atopy, and cleaning exposures were assessed in 425 cleaners and 281 reference workers in Wellington, New Zealand between 2008 and 2010. Results Cleaners had an increased risk of current asthma (past 12 months), defined as: woken by shortness of breath, asthma attack, or asthma medication (OR = 1.83, 95% CI = 1.18‐2.85). Despite this, they had similar rates of current wheezing (OR = 0.93, 95% CI = 0.65‐1.32) and were less likely to have a doctor diagnosis of asthma ever (OR = 0.62, 95% CI = 0.42‐0.92). Cleaners overall had lower lung function (FEV 1 , FVC; P < .05). Asthma in cleaners was associated with less atopy (OR = 0.35, 95% CI = 0.13‐0.90), fewer wheezing attacks (OR = 0.40, 95% CI = 0.17‐0.97; >3 vs ≤3 times/year), and reduced bronchodilator response (6% vs 9% mean FEV 1 ‐%‐predicted change, P < .05) compared to asthma in reference workers. Cleaning of cafes/restaurants/kitchens and using upholstery sprays or liquid multi‐use cleaner was associated with symptoms, whilst several exposures were also associated with lung function deficits ( P < .05). Conclusions and Clinical Relevance Cleaners are at risk of some asthma‐associated symptoms and reduced lung function. However, as it was not strongly associated with wheeze and atopy, and airway obstruction was less reversible, asthma in some cleaners may represent a distinct phenotype.