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Cleaning agent occupational asthma in the West Midlands, UK: 2000-16
G I Walters1,2, P S Burge1,2, V C Moore1
1Birmingham Regional NHS Occupational Lung Disease Service, Birmingham Chest Clinic, Queensway, Birmingham, UK.
Occupational Medicine (Oxford, England)
|September 6, 2018
Summary
Occupational asthma (OA) from cleaning agents is a growing concern, particularly in healthcare settings. Chloramines, glutaraldehyde, and quaternary ammonium compounds are key culprits, necessitating workplace vigilance.
Area of Science:
- Occupational Medicine
- Pulmonology
- Environmental Health
Background:
- Occupational asthma (OA) is a significant global health issue, frequently linked to cleaning agents.
- Both irritant and sensitization pathways contribute to OA development from various chemical exposures.
Purpose of the Study:
- To identify and characterize cleaning agents responsible for occupational asthma diagnoses.
- To analyze trends in cleaning agent-induced OA within a UK specialist occupational lung disease service from 2000 to 2016.
Main Methods:
- Retrospective analysis of the Birmingham NHS Occupational Lung Disease Service clinical database.
- Data collection included patient demographics, atopic status, smoking history, symptom onset, and diagnostic investigations.
- Specific investigations involved Occupational Asthma SYStem analysis and specific inhalational challenge tests.
Main Results:
- Eighty cases of cleaning agent-induced OA were identified, with 77% of patients being female and 76% developing OA de novo.
- The most frequent causative agents were chloramines (31%), glutaraldehyde (26%), and quaternary ammonium compounds (11%).
- Healthcare (55%), education (18%), and leisure (8%) were the most commonly implicated industries.
Conclusions:
- Common cleaning agents like chlorine-releasing agents, quaternary ammonium compounds, and aldehydes are associated with occupational asthma.
- Changes in cleaning practices, especially in UK healthcare, influence the types of agents causing OA.
- Ongoing surveillance for OA is crucial in environments like hospitals, nursing homes, leisure centers, and swimming pools where these agents are prevalent.
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