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Work-related respiratory symptoms among health centres cleaners: A cross-sectional study

  • Original Paper
  • Published:
International Journal of Occupational Medicine and Environmental Health

Abstract

Objectives

Several studies, mostly based on questionnaire-derived data, have shown an increased risk of allergic diseases, especially asthma, among cleaners. The risk factors and etiological mechanisms are still being investigated. Occupational exposure to various chemical and biological agents may induce specific sensitization and/or irritant effects. The aim of our study was to estimate the prevalence of work-related symptoms suggesting the presence of allergic disease reported by cleaners, and to relate them to the results of commercially available and standardized objective tests used for screening detection of occupational sensitization and chronic respiratory disorders.

Material and Methods

A cross-sectional study was performed among 142 Polish workers of cleaning service in their workplaces. A detailed questionnaire, skin prick tests to common allergens and chemicals used by these workers for cleaning purposes (chloramine T, chlorhexidine, formaldehyde, glutaraldehyde, benzalconium chloride), total and specific serum IgE antibodies to disinfectants and rest spirometry were performed in all the subjects.

Results

Fifty nine percent of all the subjects declared occurrence of at least 1 symptom suggesting allergic ailment during cleaning activities at work. Skin prick tests and specific serum IgE antibodies to disinfectants were negative in all the subjects. In 8 cases wheezing was detected during auscultation, but only in 5 of them obstructive pattern in rest spirometry was found.

Conclusions

Occupational allergic causation of symptoms among cleaners could be less likely than work-related symptoms associated with exacerbations of new-onset or pre-existing respiratory diseases. Therefore, in this group of workers, mainly the non-specific irritant impact of chemicals on airways should be taken into consideration.

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References

  1. European Agency for Safety and Health at Work. The occupational safety and health of cleaning workers. Luxembourg: EU-OSHA; 2009. http://dx.doi.org/10.2802/21855.

    Google Scholar 

  2. Zock J. World at work: cleaners. Multiple occupational hazards in a large service sector. Occup Environ Med. 2005;62:581–584. http://dx.doi.org/10.1136/oem.2004.015032.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Jaakkola J, Jaakkola M. Professional cleaning and asthma. Curr Opin Allergy Clin Immunol. 2006;6(2):85–90. http://dx.doi.org/10.1097/01.all.0000216849.64828.55.

    Article  PubMed  Google Scholar 

  4. Rosenman K, Reilly M, Schill D, Valiante D, Flattery J, Harrison R, et al. Cleaning products and work-related asthma. JOEM. 2003;45(5):556–563.

    PubMed  Google Scholar 

  5. Quirce S, Barranco P. Cleaning agents and asthma. J Investig Allergol Clin Immunol. 2010;20(7):542–550.

    CAS  PubMed  Google Scholar 

  6. Pellegrino R, Viegi G, Brusasco V, Carpo R, Burgos F, Casaburi R, et al. Interpretative strategies for lung function tests. Eur Respir J. 2005;26:948–968. http://dx.doi.org/10.1183/09031936.05.00035205.

    Article  CAS  PubMed  Google Scholar 

  7. Kogevinas M, Antó J, Sunyer J, Tobias A, Kromhout H, Burney P. Occupational asthma in Europe and other industrialised areas: A population-based study. European Community Respiratory Health Survey Study Group. Lancet. 1999;353(9166):1750–1754.

    Article  CAS  PubMed  Google Scholar 

  8. Arif A, Delclos G. Association between cleaning-related chemicals and work-related asthma and asthma symptoms among healthcare professionals. Occup Environ Med. 2012;69(1):35–40. http://dx.doi.org/10.1136/oem.2011.064865.

    Article  CAS  PubMed  Google Scholar 

  9. Kramps J, van Toorrenenbergen A, Vooren P, Dijkman J. Occupational asthma due to inhalation of chloramine T. II. Demonstration of specific IgE-antibodies. Int Arch Allergy Appl Immunol. 1981;64(4):428–438. http://dx.doi.org/10.1159/000232723.

    Article  CAS  PubMed  Google Scholar 

  10. Pham N, Weiner J, Reisner, G, Baldo B. Anaphylaxis to chlorhexidine. Case report. Implication of immunoglobulin E antibodies and identification of an allergenic determinant. Clin Exp Allergy. 2000;30(7):1001–1007. http://dx.doi.org/10.1046/j.1365-2222.2000.00887.x.

    Article  CAS  PubMed  Google Scholar 

  11. Layton G, Stanworth D, Amos H. The incidence of IgE and IgG antibodies to chlorhexidine. Clin Exp Allergy. 1989;19(3):307–314. http://dx.doi.org/10.1111/j.1365-2222.1989.tb02388.x.

    Article  CAS  PubMed  Google Scholar 

  12. Garvey L, Kroigaard M, Poulsen L, Skov P, Mosbech H, Malling H, et al. IgE-mediated allergy to chlorhexidine in twelve skin test positive patients — diagnosis verified by specific IgE measurement and histamine release. Data presented at the XXV Congress of the European Academy of Allergology and Clinical Immunology, June 2006 [not published].

    Google Scholar 

  13. McGwin G, Lienert J, Kennedy J. Formaldehyde exposure and asthma in children: A systematic review. Cienc Saude Coletiva. 2012;17(3):809. http://dx.doi.org/10.1590/S1413-81232012000300029.

    Article  Google Scholar 

  14. Zock J, Kogevinas M, Sunyer J, Almar E, Muniozguren N, Payo F, et al. Asthma risk, cleaning activities and use of specific cleaning products among Spanish indoor cleaners. Scand J Work Environ Health. 2001;27:76–81. http://dx.doi.org/10.5271/sjweh.590.

    Article  CAS  PubMed  Google Scholar 

  15. Clausen S, Sobhani S, Poulsen O, Poulsen L, Nielsen G. Study of adjuvant effect of model surfactants from the groups of alkyl sulfates, alkylbenzene sulfonates, alcohol ethoxylates and soaps. Food Chem Toxicol. 2000;38:1065–1074. http://dx.doi.org/10.1016/S0278-6915(00)00092-2.

    Article  CAS  PubMed  Google Scholar 

  16. Obadia M, Liss G, Lou W, Purdham J, Tarlo S. Relationships between asthma and work exposures among non-domestic cleaners in Ontario. Am J Ind Med. 2009;52(9):716–723. http://dx.doi.org/10.1002/ajim.20730.

    Article  PubMed  Google Scholar 

  17. Paoletti P, Carrozzi L, Viegi G, Modena P, Ballerin L, Di Pede F, et al. Distribution of bronchial responsiveness in a general population: Effect on sex, age, smoking, and level pulmonary function. Am J Respir Crit Care Med. 1995;151:1770–1779. http://dx.doi.org/10.1164/ajrccm.151.6.7767519.

    Article  CAS  PubMed  Google Scholar 

  18. Karadzinska-Bislimovska J, Minov J, Risteska-Kuc S, Stoleski S, Mijakoski D. Bronchial hyperresponsiveness in women cooks and cleaners. Arh Hig Rada Toksikol. 2007;58(2):223–231. http://dx.doi.org/10.2478/v10004-007-0017-3.

    Article  PubMed  Google Scholar 

  19. Zock J, Kogevinas M, Surtyer J, Anto J, Burney P. Respiratory health in cleaning and office workers with asthma: Suggestion of irritant induced asthma in cleaners. Eur Respir J. 2000;16Suppl 31:520.

    Google Scholar 

  20. Zock J, Kogevinas M, Jarvis D, Toren K. Asthma characteristics in cleaning workers, workers in other risk jobs and office workers. Eur Respir J. 2002;20:679–685. http://dx.doi.org/10.1183/09031936.02.00279702.

    Article  CAS  PubMed  Google Scholar 

  21. Zock J, Plana E, Jarvis D, Anto J, Kromhout H, Kennedy S, et al. The use of household cleaning sprays and adult asthma: An international longitudinal study. Am J Respir Crit Care Med. 2007;176:735–741. http://dx.doi.org/10.1164/rccm.200612-1793OC.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Wolkoff P, Schneider T, Kildeso J, Degerth R, Jaroszewski M, Schunk H. Risk in cleaning: Chemical and physical exposure. Sci Total Environ. 1998;215:135–156. http://dx.doi.org/10.1016/S0048-9697(98)00110-7.

    Article  CAS  PubMed  Google Scholar 

  23. Medina-Ramon M, Zock J, Kogevinas M, Sunyer J, Torralba Y, Borrel A, et al. Asthma, chronic bronchitis and exposure to irritant agents in occupational domestic cleaning: A nested case-control study. Occup Environ Med. 2005;62:598–606. http://dx.doi.org/10.1136/oem.2004.017640.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Balames J. Occupational airways diseases from chronic-level exposures to irritants. Clin Chest Med. 2002;23:727–735. http://dx.doi.org/10.1016/S0272-5231(02)00031-X.

    Article  Google Scholar 

  25. Kogevinas M, Zock J, Jarvis D, Kromhout H, Lillienberg L, Plana E, et al. Exposure to substances in the workplace and new-onset asthma: An international prospective population-based study (ECRHS II). Lancet. 2007;370:336–341. http://dx.doi.org/10.1016/S0140-6736(07)61164-7.

    Article  CAS  PubMed  Google Scholar 

  26. De Fátima Maçãira E, Algranti E, Medina Coeli Mendonça E, Bussacos MA. Rhinitis and asthma symptoms in non-domestic cleaners from the Sao Paulo metropolitan area. Brasil Occup Environ Med. 2007;64(7):446–453. http://dx.doi.org/10.1136/oem.2006.032094.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Occupational Diseases and Toxicology, Nofer Institute of Occupational Medicine, Łódź, Poland

    Agnieszka Lipińska-Ojrzanowska, Marta Wiszniewska, Tomasz Wittczak, Cezary Pałczyński & Jolanta Walusiak-Skorupa

  2. Department of Occupational Allergy and Environmental Health, Nofer Institute of Occupational Medicine, Łódź, Poland

    Dominika Świerczyńska-Machura, Ewa Nowakowska-Świrta & Cezary Pałczyński

  3. Department of Occupational Diseases and Toxicology, Nofer Institute of Occupational Medicine, św. Teresy 8, 91-348, Łódź, Poland

    Agnieszka Lipińska-Ojrzanowska

Authors
  1. Agnieszka Lipińska-Ojrzanowska
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  2. Marta Wiszniewska
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  3. Dominika Świerczyńska-Machura
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  6. Cezary Pałczyński
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  7. Jolanta Walusiak-Skorupa
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Correspondence to Agnieszka Lipińska-Ojrzanowska.

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Lipińska-Ojrzanowska, A., Wiszniewska, M., Świerczyńska-Machura, D. et al. Work-related respiratory symptoms among health centres cleaners: A cross-sectional study. IJOMEH 27, 460–466 (2014). https://doi.org/10.2478/s13382-014-0272-x

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  • DOI: https://doi.org/10.2478/s13382-014-0272-x

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