Asthma
Elizabeth Briand
Managing asthma can be a daily challenge for the 300 million people worldwide who suffer from the condition, with everything from air pollution to pet dander contributing to attacks. A study published in the April 2024 issue of the Journal of Allergy and Clinical Immunology: In Practice has shed light on another potential trigger: the regular use of household disinfectants and cleaning products, including green products.
“Cleaning products are composed of a complex and diverse mixture of ingredients, with various physical and chemical properties, which can have an irritating or a sensitizing respiratory effect,” said Emilie Pacheco Da Silva, one of the study’s authors and a doctoral student at Université Paris-Saclay and the French National Institute of Health and Medical Research.
For people with asthma, breathing these sensitizers might induce asthma symptoms through allergic mechanisms including eosinophilic inflammation, whereas the mechanisms for irritants, such as bleach, acids, and solvents, are less understood, according to Pacheco Da Silva. The inhalation of irritants, though, “may damage the airway epithelium and promote a neutrophilic inflammation as well as an oxidative stress,” said Pacheco Da Silva.
Results of the study showed that the weekly use of household cleaners was strongly associated with uncontrolled asthma. And for those using the products daily, there was a two-to-three-times greater risk of uncontrolled asthma. Even the green products and disinfecting wipes—without their airborne sprays—showed an association with uncontrolled asthma. People whose asthma was under control seemed to exhibit less of a response to the substances, the research found.
Finding connections
Through a standard questionnaire, researchers assessed patients’ asthma control and use of household disinfectants and cleaning products, including green products, in two application modes: sprays and wipes. The survey included more than 37,000 adults in France who used these products at least once a week.
The strong links between green cleaning products and asthma surprised the research team.
“With this study, we wanted to test the hypothesis that using green products at home could induce fewer risks for respiratory health than using conventional products, such as irritants and sprays, due to the fact that their formulations are considered to be less harmful at least for the environment,” said Pacheco Da Silva. “We were surprised to evidence an association for green products of quite similar magnitude as for irritants and sprayed cleaning products.”
The fact that cleaning wipes elicited a similar response among patients with asthma was less of a surprise.
“We expected to find associations for the use of wipes at home because they consist of towels saturated with a high concentration of disinfectants and other chemicals,” said Pacheco Da Silva. Because chemicals are used to keep the towels moist, there can be higher exposure for the user versus applying a different liquid product to a cleaning cloth or paper towel.
According to the research team, additional investigation is needed to determine exactly what is causing the reactions in people with asthma, and how responses could be mitigated—both for sprays and wipes.
“The risks evidenced might be specifically attributed to both their chemical composition and their application mode,” said Pacheco Da Silva. “Indeed, sprays are a well-known asthma risk factor because this application mode generates chemical particles of micrometric size in the air, which facilitate their penetration and deposition into the lower respiratory tract.”
Reducing risks
For patients with asthma, Pacheco Da Silva recommends limiting weekly use of cleaning products at home as much as possible, in particular those used in a wipe or a spray format, since they seem to increase the risk of inhalation. In addition, she said patients should ventilate the room during and after using cleaning products.
Pharmacists can help spread the word on these findings and encourage their patients with asthma to be aware of how much they use household cleaning products, even when they are labeled as green and environmentally friendly. ■