House cleaning is bad for women’s lung health, according to a study that has found accelerated decline in lung function among women regularly engaged in cleaning activities.

The longitudinal population-based cohort study, published online Feb. 16 in the American Journal of Respiratory and Critical Care Medicine , looked at the lung health of 6,230 people who were followed for more than 20 years as part of the European Community Respiratory Health Survey.

Analysis based on questionnaires about cleaning practices revealed that women who were responsible for cleaning at home or who worked as professional cleaners showed significantly greater declines in maximum forced vital capacity (FVC) and maximum forced expiratory volume in 1 second (FEV1), compared with women who said they did not regularly clean.

Female occupational cleaners showed a mean FEV1 decline of 22.4 mL/year, women who cleaned regularly at home showed a mean decline of 22.1 mL/year, while those who reported no cleaning activities had an 18.5 mL/year decline in FEV1. For FVC, declines were 15.9 mL/year, 13.1 mL/year, and 8.8 mL/year, respectively. By comparison, the decline in FEV1 among smokers who smoked at a rate of more than 20 pack-years was 27.2 mL/year, and their decline in FVC was 20.7 mL/year. “FVC is an outcome of particular interest as survival in asymptomatic adults without a chronic respiratory diagnosis or persistent respiratory symptoms has been shown to be associated with FVC rather than airway obstruction as defined by the lower than normal FEV1/FVC ratio,” wrote Øistein Svanes, a PhD candidate in the department of clinical science at the University of Bergen, Norway, and his coauthors.

However, there was no association between cleaning practices in men – either professional or domestic – and accelerated lung function decline. The authors suggested that the exposures experienced by men who worked as cleaners may have been different from the exposures experienced by women. They also noted that the small numbers of male cleaners meant the study wasn’t powered to pick up greater declines in lung function.

The study also showed a significant association between use of cleaning products and decline in lung function. Women who used sprays or other cleaning agents at least once a week showed significantly greater declines in FEV1 and FVC, compared with women who didn’t use cleaning products. Again, this effect was not significant in men.

“One possible mechanism for the accelerated decline in cleaners is the repetitive exposure to low-grade irritative cleaning agents over time, thereby causing persistent changes in the airways,” the authors wrote. “Repeated exposure could lead to remodelling of the airways, thereby over time causing an accelerated decline in FVC and FEV1.”

The analysis found no significant increases in the incidence of chronic airway obstruction among regular cleaners, nor among those who used cleaning products. The authors noted that while previous studies had suggested an increase in chronic obstructive pulmonary disease among occupational cleaners, their study reported relatively few cases of COPD.

While the prevalence of asthma was slightly higher in the two groups of women exposed to regular cleaning (12.3% and 13.7%, versus 9.6%), adjustment for asthma in the analysis did not change the associations. This suggests that the declines in lung function seen in regular cleaners were not mediated by cleaning-related asthma, the researchers noted.

They also noted that the women who reported not engaging in any cleaning may represent a particular socioeconomic group, but adjustment for socioeconomic status did not alter the associations.

The European Community Respiratory Health Survey is supported by the European Union, the European Commission, and the Medical Research Council. No conflicts of interest were reported.

SOURCE: Svanes Ø et al. Am J Resp Crit Care Med. 2018 Feb 16. doi: 10.1164/rccm.201706-1311OC.


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