Among older women with asthma, those who use household cleaners and disinfectants weekly are more likely to have poorly controlled asthma, and the risk appears to rise with the number of products used, a French study suggests. Researchers examined data on 2,223 women (mean age 69.7 years) with asthma who completed questionnaires about their cleaning habits as well as medical and demographic characteristics. Half of the women were former (46%) or current smokers (4%), and most had only partly controlled (46%) or poorly controlled (25%) asthma. Weekly use of disinfectants and household cleaning products was associated with greater likelihood of poorly controlled asthma when women used one type of spray (OR 1.31) and higher still when they used two or more types of sprays (OR 1.84). The pattern was similar with weekly use of chemicals in the home, with a greater chance of poorly controlled asthma when women used a single type of chemical (OR 1.24) and a higher chance when they used two or more types of chemicals (OR 1.47). "In the last decade, an increasing number of epidemiological studies have reported an association between the use of disinfectants and cleaning products, either at home or at work, and respiratory diseases such as asthma," said lead study author Orianne Dumas of Inserm and the Center for Research in Epidemiology and Population Health in Villejuif, France. Some previous research has linked exposure to disinfectants and cleaning products not only to asthma development, but also to the exacerbation of asthma symptoms, particularly in women, Dumas said by email. "Asthma control is influenced by multiple factors, including both adequate treatment and avoidance of environmental triggers," Dumas said. "Our study confirms that the use of disinfectants and cleaning products contributes to poor asthma control in women." When researchers examined weekly use of specific types of products, they found an increased risk of poor asthma control associated with window and mirror sprays (OR 1.91), air fresheners (OR 1.54), stain removers (OR 1.89), and bleach (OR 1.34). Almost half of women in the study (48%) had household help. Among women who didn't have any household help, weekly usage of furniture sprays (OR 2.48) and other sprays (OR 5.99) were associated with worse asthma control. Compared to women who did frequent general cleaning, the risk of poor asthma control was higher for those who did medium levels of cleaning (OR 1.62) or who reported very frequent use of cleaning products (OR 1.74). One limitation of the study is that use of household cleaners and disinfectants was self-reported, leaving a potential for recall bias as well as inaccuracies in the dosage or frequency of exposure to specific products, the study team notes in the Journal of Allergy and Clinical Immunology: In Practice. Even so, the results underscore the importance of getting a complete picture of all household exposure to cleaners and disinfectants to help manage asthma, particularly in women who have a higher risk of poor asthma control and a higher exposure to these products than men, said Dr. Carole Ederle of Strasbourg University Hospital in France. "Not only cleaning professionals and nurses seem to be exposed to cleaning products and disinfectants," Dr. Ederle, who wasn't involved in the study, said by email. "The physician should always ask the patient about the use of such products at work and at home when confronted with poorly controlled asthma." —Lisa Rapaport Source
