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“The repeated use of cleaning products can trigger asthma”

Global Talent spoke with Jan-Paul Zock, a Dutchman who lives and works in Barcelona, on a recent trip to London. His area of research focuses on the harmful particles contained in aerosol cleaning products. The benefits these chemicals bring to homes and workplaces apparently translate into health risks for those who breathe them.

JORDI MONTANER | SEPTEMBER 3TH, 2010

Why are asthma cases multiplying?
Environmental factors are gaining increasing importance in the etiology of asthma. We have found in Barcelona that the continued use of aerosols by cleaning workers can trigger asthma. These are products that release chlorine and disinfectants in the air we breathe in harmful proportions.

Should we be worried?
If you have asthma you should take precautions. We have evidence that exposure to some cleaning products can cause respiratory problems and worsen existing asthma. On the other hand, many cleaning workers suffering from asthmatic symptoms would cease to have problems if they were prevented from inhaling these products. So there is still a lot of room for prevention.

How do you research this? What methodology do you use?
Our Center for Research in Environmental Epidemiology (CREAL) looked at the problem from an ideal starting point focusing on the cleaning staff working in hospitals and health centers, where hygiene and cleanliness are requirements of first order. We found that these professionals, for no phenotypic or genotypic reason, are more vulnerable to asthma than other employees. This fact led us to investigate, through clinical and working trials, the asthma biomarkers which are associated with commonly used cleaning products. If we extrapolate the potential harmfulness of these products to everyone who uses them in their homes, we have a big problem. There are already several studies that find that the rate of asthma among janitors, professional cleaners, housekeepers and porters is disproportionately higher than in the rest of the workforce.

At home, some people improvise with lemon juice or vinegar, but in hospitals, schools, restaurants or big companies, what can you do?
This is not anything new. It has been known that many cleaning agents are respiratory irritants, some are even allergic properties. Everyone knows that long-term exposure to bleach, ammonia, softeners or other acids, solvents and stain removers is not good for one’s health. We have found that repeated use of these products more than once per week is associated with a 20% increase in wheezing and other asthma symptoms.

"The repeated use of cleaning products is associated with a 20% increase in wheezing and other asthma symptoms" The danger comes from the product or the quantity used?
The exposure (and risk) are determined by several factors: the frequency and duration of the use of these products, the concentration of active ingredients (higher concentrations are more harmful) and the ventilation of the area being cleaned. Studies evaluating these circumstances always look at workplaces (large spaces). Households are more difficult to study since we can not determine with the same level of precision the link between asthma and exposure to cleaning products, which are typically used less frequently and are more complex to monitor.

Is there a single product we should take special care to avoid?
The ones that contain a high level of chlorine. In addition, many products combine components that do nothing but enhance their health risks and act synergistically.

Have you tried contacting the manufacturers of these products to curb their harmful effects?
We are epidemiologists and our task is to identify health risks. It is up to the public administrations to assess the extent of the problem and then take the appropriate measures. In any case, people at risk of asthma should take precautions for themselves.

Is that enough?
It is necessary, in their case. Just one example. When I was researching in the Netherlands, I took part in an occupational health study among some workers assigned to a food industry that dealt with potatoes. We found an abnormal prevalence of respiratory problems among these workers, and we wanted to investigate its causes. After some thorough analysis, we discovered that the key was not in the air but the water that these workers employed in a closed circuit in which several colonies of bacteria reproduced. Just a few changes in the packaging process solved the problem.

How to prevent asthma associated with cleaning products? The Instituto Sindical de Trabajo, Ambiente y Salud (ISTAS, the Institute of Work, Environment and Health) provides information on the risk of chemicals on their website.

THE EFFECTS OF POLLUTED AIR

Every day we incorporate into our bodies about one billion particles through the air we breathe. Every day about 10,000 liters of air circulate through our lungs. The area with which all these particles and all that air make contact is about 150 m2 (the surface area of a big apartment). These data help illustrate that regular inhalation of the fumes of bleach, ammonia, solvents and other substances contained in cleaning products can have a significant impact on our health.
There is no doubt that in asthmatic individuals there exists an important relationship between the disease and air quality. We know, for example, that an increased exposure of a patient with asthma to air pollution from traffic on streets and highways increases the number of breathing problems. Furthermore, the ozone and nitrogen oxides in the air we breathe are responsible for a rise in asthma symptoms, hospitalizations, the use of asthma medication, COPD exacerbations, emergency room visits due to COPD crises, respiratory tract infections and impaired lung functions.
Over 400 scientific studies have documented the role of the bronchial epithelium as a physical barrier against allergies, secreting cytoprotective and mucociliary molecules and activating immune, inflammatory and mesenchymal cells. Air particles from pollution increase the mortality of the epithelial cells along the airways. Oxidative stress is particularly harmful in individuals with asthma. Information obtained from in-vitro cultures show that the restoration of epithelial tissue in asthma patients is reduced significantly because of the disease.
The epithelial cells of an asthma patient secrete more mucus than cells from non-asthmatic individuals. It has been shown in this regard that diesel exhaust particles cause a rise in mucous secretion in asthmatic patients through the mucin gene and the activation of EGF receptors. Biopsy data, moreover, prove that the basolateral surface is more susceptible to the cytotoxic effects of cigarette smoke.

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