Daily occupational exposures to disinfectants and cleaning products increases the risk of current adult-onset asthma and uncontrolled asthma, suggests a study published in The Journal of Allergy and Clinical Immunology: In Practice.^1,2

The study retrospectively analysed data from 4469 adults, aged 54 years (mean), from the French NutriNet-Santé study. Of these, 677 had current asthma (551 with controlled and 126 with uncontrolled asthma), while 3792 neither had asthma nor did they have respiratory symptoms. Women comprised three-fourth of the study population. Almost 53% of the patients with asthma had adult-onset asthma (defined as first asthma attack after 16 years of age). Nearly 70% of the participants were actively employed. The objective of the study was to discover the associations of occupational exposures to irritants, disinfectants and cleaning products and sensitizers (high molecular weight and low molecular weight) with asthma and asthma control.

Results showed an association between ever-exposure to high molecular weight sensitizers and current adult-onset asthma with odds ratio of 1.53. Exposure to low molecular weight sensitizers, irritants and disinfectants and cleaning products were also linked to current adult-onset asthma with OR of 1.42, 1.32 and 1.43, respectively. Those who were currently exposed, including those exposed to high levels of exposure were more likely to have adult-onset asthma. The association was also significant among the study subjects with BMI of 25 kg/m² and higher.

When the association with asthma control was examined, it was found that ever-exposure to high molecular weight sensitizers increased the likelihood of uncontrolled adult-onset asthma by at nearly 3-folds with OR of 2.69. The odds of asthma being uncontrolled also increased with exposure to low molecular weight sensitizers (OR 2.27). Likewise, exposures to irritants (OR (2.32) and disinfectants and cleaning products (2.59) were also significantly associated with uncontrolled adult-onset asthma. The association was significant with medium and high levels of ever-exposures.

 “Results were similar for current exposures, with higher ORs”, note the authors; 3.76 for disinfectants and cleaning products, 3.62 for irritants, 3.43 for high molecular weight sensitizers and 2.81 for low molecular weight sensitizers.

Exposure to organic solvents had no impact on asthma or asthma control.

This study has shown a correlation between occupational exposures to sensitizers and irritants with current adult-onset asthma and uncontrolled asthma. While a history of exposure to allergens is important in patients with asthma, it is equally important to elicit a history of chronic occupational exposure to sensitizers and irritants, specifically the disinfectants and cleaning products that are used on a daily basis as a likely cause of inadequately controlled or uncontrolled asthma. Patients should be advised to wear a mask and keep the room well ventilated when using disinfectants and cleaning products to reduce their exposure and avoid triggering asthma attacks.

References

1. Guillaume Sit, et al. Occupational exposures to irritants and sensitizers, asthma and asthma control in the NutriNet-Santé cohort. J Allergy Clin Immunol Pract. 2022 Sep 12;S2213-2198(22)00933-3. doi: 10.1016/j.jaip.2022.08.047.
2. https://www.healio.com/news/allergy-asthma/20221005/occupational-exposures-to-irritants-sensitizers-associated-with-adultonset-asthma, Oct 5., 2022.