CE: Environments & Health: Chemicals in the Home That Can Exacerbate Asthma

Household cleaning agents impact on pediatric asthma: a systematic review and meta-analysis

BACKGROUND

Household cleaning agents promote hygiene along with causing respiratory effects, especially pediatric asthma. This systematic review quantified the association between exposure to household cleaning agents and pediatric asthma.

METHOD

Five databases were searched. Data were analyzed qualitatively and quantitatively. RevMan 5.4 calculated odds ratios (OR) with 95% confidence intervals (CI), and a funnel plot assessed publication bias. The Mixed Methods Appraisal Tool (MMAT) and GRADE framework assessed methodological quality and certainty respectively.

RESULTS

Sixteen studies met the eligibility criteria. Meta-analysis showed a significant association between the use of household cleaning agents and pediatric asthma (OR 2.90 (95% CI: 2.13-3.95; p < 0.01, I2 = 98%). Exposure stages also showed significant (p < 0.01) association with household cleaning agents (OR 2.92 (95% CI: 2.12-4.03, I2 = 98%). No publication bias or high risk of bias was found.

CONCLUSION

A strong association between exposure to household cleaning agents and an increased risk of pediatric asthma was found. .

Airway Diseases Related to the Use of Cleaning Agents in Occupational Settings

Exposure to disinfectants and cleaning products (DCPs) is now a well-established risk factor for work-related asthma (WRA). However, questions remain on the specific causal agents and pathophysiological mechanisms. Few studies have also reported an association between DCPs and rhinitis or chronic obstructive pulmonary disease. This review discusses the recent evidence pertaining to airway diseases attributable to occupational exposure to DCPs. In contrast to other agents, the incidence of WRA due to DCPs has increased over time. The use of DCPs in spray form has clearly been identified as an added risk factor. The mechanisms for WRA associated with DCPs remain poorly studied; however, both allergic and nonallergic responses have been described, with irritant mechanisms thought to play a major role. An early diagnostic workup based on clinical assessment accompanied by evaluation of lung function and immunological and airway inflammatory markers is important to guide optimal care and exposure avoidance to the implicated agent. Future research should focus on the effects of "green" products, pathophysiological mechanisms, and quantitative exposure assessment including the use of barcode-based methods to identify specific agents. There is an urgent need to strengthen preventive measures and interventions to reduce the burden of airway diseases associated with DCPs.