Abstract
RationaleThere is some evidence that maternal smoking increases susceptibility to personal smoking’s detrimental effects. One might question whether early life disadvantage might influence susceptibility to occupational exposure.ObjectivesIn this cross-sectional study we investigated respiratory symptoms, asthma and self-reported chronic obstructive pulmonary disease (COPD) as related to working as a cleaner in Northern European populations, and whether early life factors influenced susceptibility to occupational cleaning’s unhealthy effects.MethodsThe RHINE III questionnaire study assessed occupational cleaning in 13,499 participants. Associations with respiratory symptoms, asthma and self-reported COPD were analysed with multiple logistic regressions, adjusting for sex, age, smoking, educational level, parent´s educational level, BMI and participating centre. Interaction of occupational cleaning with early life disadvantage (maternal smoking, severe respiratory infection <5 years, born during winter months, maternal age at birth >35 years) was investigated.Main ResultsAmong 2138 ever-cleaners the risks of wheeze (OR 1.4, 95% CI 1.3–1.6), adult-onset asthma (1.5 [1.2–1.8]) and self-reported COPD (1.7 [1.3–2.2]) were increased. The risk increased with years in occupational cleaning (adult-onset asthma: ≤1 year 0.9 [0.7–1.3]; 1–4 years 1.5 [1.1–2.0]; ≥4 years 1.6 [1.2–2.1]). The association of wheeze with cleaning activity ≥4 years was significantly stronger for those with early life disadvantage than in those without (1.8 [1.5–2.3] vs. 1.3 [0.96–1.8]; pinteraction 0.035).ConclusionsOccupational cleaners had increased risk of asthma and self-reported COPD. Respiratory symptom risk was particularly increased in persons with factors suggestive of early life disadvantage. We hypothesize that early life disadvantage may increase airway vulnerability to harmful exposure from cleaning agents later in life.
Highlights
Several studies have shown that cleaners have more airway symptoms and asthma than a general population [1, 2], but even though exposure to cleaning agents is a risk factor for asthma, not all cleaners develop such problems
Respiratory symptom risk was increased in persons with factors suggestive of early life disadvantage
An analysis of the European Community Respiratory Health Survey showed that early life disadvantage was associated with adult lung function level, and with accelerated lung function decline [3]
Summary
Several studies have shown that cleaners have more airway symptoms and asthma than a general population [1, 2], but even though exposure to cleaning agents is a risk factor for asthma, not all cleaners develop such problems. Two recent analyses revealed that persons with characteristics reflecting early life disadvantage were more susceptible to the harmful effects of adult smoking: Guerra et al [4] found stronger effects on airflow limitation of personal smoking in those exposed to parental smoking. Stronger detrimental effects of smoking on lung function decline was found in persons exposed to maternal smoking, born during the winter season, with maternal age at birth above 35 years and/or severe childhood respiratory infections (Dratva et al, 2014, manuscript in preparation). In these analyses, early life disadvantage factors appeared to increase the vulnerability to adult active smoking. We hypothesise that early life disadvantage factors may modify adult responses to occupational exposures, such as cleaning agents
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
