Cleaning agent usage in healthcare professionals and relationship to lung and skin symptoms

The relationship between cleaning product exposure and respiratory and skin symptoms among healthcare workers in a hospital setting: A systematic review and meta‐analysis

“…Nineteen of the 21 “fair” or “good” quality studies evaluated only LRTS or asthma‐like symptoms, such as wheeze, cough, shortness of breath, and breathlessness 3–6,12,15,17,19,22,26–29,32,35–39 . Most reported increased risks of LTRS associated with cleaning tasks and disinfectants 3,5,6,17,22,26,27,29,35–38 .…”

“…For instance, quantitative summaries for new-onset asthma were selected over quantitative summaries for ever asthma diagnoses. The outcome definitions for the studies included in the meta-analysis included current asthma (ever asthma and report of asthma attacks, respiratory symptoms, or treatment of asthma in the past 12 months, or physician-diagnosed asthma that was still present), 1,6,16,26 new-onset asthma, reported asthma, or post-hire asthma (reported onset of physician-diagnosed asthma after entering a healthcare profession), 5,11,17,25,29 and adult-onset asthma (asthma reported at the age of 16 years old or later). 22 The pooled meta-analysis of the 10 studies demonstrated a significant 35% increased risk for asthma among hospital healthcare workers exposed to cleaning or disinfecting tasks or agents (meta-RR = 1.35, 95% CI: 1.09-1.68, p = 0.01, I 2 = 30%) (Figure 2).…”

“…The results of five of the eight cross-sectional studies that evaluated new-onset asthma, reported asthma, or adult-onset asthma were pooled, 5,17,22,25,29 excluding studies that evaluated current asthma. 6,16,26 An additional subgroup analysis was performed to focus on new-onset asthma, adult-onset asthma, posthire asthma and post-hire reported asthma, since asthma caused by occupational cleaning exposures is more expected to occur within these subgroups. When focusing on new-onset asthma, adult-onset asthma, post-hire asthma, or reported asthma outcomes, a nonsignificant 46% increased risk was determined among healthcare workers exposed to cleaning or disinfecting agents or tasks (meta-RR = 1.46, 95% CI: 0.99-2.14, p > 0.05, I 2 = 20%) (Figure 4).…”

“…Ten studies evaluating asthma with fair or good quality scores were selected for a meta-analysis. 1,5,6,11,16,17,22,25,26,29 When studies presented multiple risk estimates for asthma, the quantitative summary that defined occupational asthma the best was selected.…”

“…1,2 Previous studies have reported an increased risk of asthma, asthma-like respiratory symptoms, as well as skin symptoms among healthcare workers exposed to cleaning or disinfecting agents. [3][4][5] Specifically, bleach has been associated with asthma-like respiratory symptoms and hand dermatitis 6 ; however, few studies have evaluated the relationship between respiratory and skin symptoms. Additionally, previous evidence of increased respiratory and skin symptoms among this population was derived from selfreported measures of exposures.…”