Volume 124, Issue 4 , Pages 731-738.e1, October 2009
Domestic use of hypochlorite bleach, atopic sensitization, and respiratory symptoms in adults
Background
Professional use of hypochlorite (bleach) has been associated with respiratory symptoms. Bleach is capable of inactivating allergens, and there are indications that its domestic use may reduce the risk of allergies in children.
Objective
To study the associations between household use of bleach and atopic sensitization, allergic diseases, and respiratory health status in adults.
Methods
We identified 3626 participants of the European Community Respiratory Health Survey II in 10 countries who did the cleaning in their homes and for whom data on specific serum IgE to 4 environmental allergens were available. Frequency of bleach use and information on respiratory symptoms were obtained in face-to-face interviews. House dust mite and cat allergens in mattress dust were measured in a subsample. Associations between the frequency of bleach use and health outcomes were evaluated by using multivariable mixed logistic regression analyses.
Results
The use of bleach was associated with less atopic sensitization (odds ratio [OR], 0.75; 95% CI, 0.63-0.89). This association was apparent for specific IgE to both indoor (cat) and outdoor (grass) allergens, and was consistent in various subgroups, including those without any history of respiratory problems (OR, 0.85). Dose-response relationships (P < .05) were apparent for the frequency of bleach use and sensitization rates. Lower respiratory tract symptoms, but not allergic symptoms, were more prevalent among those using bleach 4 or more days per week (OR, 1.24-1.49). The use of bleach was not associated with indoor allergen concentrations.
Conclusion
People who clean their homes with hypochlorite bleach are less likely to be atopic but more likely to have respiratory symptoms.
Key words: Hypochlorite bleach, household, atopy, allergy, respiratory
Abbreviations used: BHR, Bronchial hyperresponsiveness, ECRHS, European Community Respiratory Health Survey, OR, Odds ratio, SES, Socioeconomic status
The coordination of the European Community Respiratory Health Survey II was supported by the European Commission as part of their Quality of Life program. This work was also funded by the US National Institutes of Health (grant 1R01HL062633) and the Carlos III Health Institute of the Spanish Ministry of Health and Consumption (Fondo de Investigaciones Santarias [FIS] grant 01/3058). The following bodies funded the local studies in the European Community Respiratory Health Survey II included in this article: Albacete, FIS (grants 97/0035-01, 99/0034-01, and 99/0034-02), Hospital Universitario de Albacete, Consejeria de Sanidad; Antwerp, Fund for Scientific Research, Flanders, Belgium (grant G.0402.00), University of Antwerp, Flemish Health Ministry; Barcelona, SEPAR, Public Health Service (grant R01 HL62633-01), FIS (grants 97/0035-01, 99/0034-01, and 99/0034-02), CIRIT (grant 1999SGR 00241), Red Respira ISCII; Basel, Swiss National Science Foundation, Swiss Federal Office for Education and Science, Swiss National Accident Insurance Fund, USC NIEHS Center (grant 5P30 ES07048); Bergen, Norwegian Research Council, Norwegian Asthma and Allergy Association, Glaxo Wellcome AS, Norway Research Fund; Erfurt, GSF-National Research Centre for Environment and Health, Deutsche Forschungsgemeinschaft (grant FR 1526/1-1); Galdakao, Basque Health Department; Göteborg, Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Grenoble, Programme Hospitalier de Recherche Clinique-DRC de Grenoble 2000 no. 2610, Ministry of Health, Direction de la Recherche Clinique, Ministere de l'Emploi et de la Solidarite, Direction Generale de la Sante, CHU de Grenoble, Comite des Maladies Respiratoires de l'Isere; Hamburg, GSF-National Research Centre for Environment and Health, Deutsche Forschungsgemeinschaft (grant MA 711/4-1); Ipswich and Norwich, Asthma UK (formerly known as the National Asthma Campaign); Huelva, FIS (grants 97/0035-01, 99/0034-01, and 99/0034-02); Oviedo, FIS (grants 97/0035-01, 99/0034-01, and 99/0034-02);Paris, Ministere de l'Emploi et de la Solidarite, Direction Generale de la Sante, UCB-Pharma (France), Aventis (France), Glaxo France, Programme Hospitalier de Recherche Clinique-DRC de Grenoble 2000 no. 2610, Ministry of Health, Direction de la Recherche Clinique, CHU de Grenoble; Pavia, GlaxoSmithKline Italy, Italian Ministry of University and Scientific and Technological Research, Local University Funding for research 1998 and 1999; Tartu, Estonian Science Foundation; Turin, ASL 4 Regione Piemonte, AO CTO/ICORMA Regione Piemonte, Italian Ministry of University and Scientific and Technological Research; GlaxoSmithKline Italy; Umeå, Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Uppsala, Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Verona, University of Verona; Italian Ministry of University and Scientific and Technological Research; GlaxoSmithKline Italy.
Disclosure of potential conflict of interest: G. Benke has received research support from the National Health and Medical Research Council of Australia. P. D. Blanc has received research support from the National Institutes of Health, UC Tobacco Related Diseases, and FAMRI and has served as an expert witness on hepatotoxicity and inhalation injury. J. Sunyer has received research support from the European Union, Ministry of Health, Spain, and the Ministry of Health, Catalonia. The rest of the authors have declared that they have no conflict of interest.
PII: S0091-6749(09)00874-4
doi:10.1016/j.jaci.2009.06.007
© 2009 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
Volume 124, Issue 4 , Pages 731-738.e1, October 2009
