Frequent Exposure to Cleaning Products in Early Childhood Linked With Asthma, Wheezing

Frequent use of household cleaning products during a child’s early life was associated with increased risk of wheeze and asthma—but not atopy—by the age of 3, according to study findings published in CMAJ.

Investigators from Canada collected parental responses from 2022 children in the form of questionnaires between 2008 and 2015. The study authors wanted to determine which cleaning products were used in the home during early childhood development, how often, and those products’ effect on the health of the child living in the home. The survey asked how frequently 26 household cleaning products were used from the time of the child’s birth to the time they were 3 or 4 months old. Then, the investigators assessed product use in association with recurrent wheeze, atopy, or asthma diagnoses by the age of 3-years-old.

The study authors wrote that by identifying triggers for respiratory system issues in early childhood, preventive measures may be able to be implemented. Young children are vulnerable for 3 primary reasons, they added. First, because they spend between 80%-90% of their early life indoors; secondly, because of their increased respiration rate; and finally, their proximity to the ground, which can increase gaseous and dermal exposures to cleaning products.

Most of the participants were white (65%), had no tobacco spoke exposure through 3-4 months of age (76%), and did not have a parental history of asthma (65%), the investigators reported. Additionally, pets were present in about half of the homes, mold was seen in about 40% of homes, and half of the homes had incomes greater than $100,000 annually.

The most frequently used products were hand dishwashing detergent, dishwasher detergent, multisurface cleaners, glass cleaners, and laundry detergent, the study authors learned.

The investigators found that 14% of children in the study were atopic, 9% had recurrent wheeze, and 6% had received an asthma diagnosis by age 3. Notably, 2% had recurrent wheeze with atopy by age 3, the investigators said.

The risks for these outcomes were higher in households that reported frequent use of liquid or solid air fresheners, spray air fresheners, plug-in deodorizers, dusting sprays, antimicrobial hand sanitizers, and oven cleaners compared to infrequent users, the investigators added.

“These findings add to our understanding of how early life exposures are associated with the development of allergic airway disease, and identify household cleaning behaviors as a potential area for intervention,” said lead study author Jaclyn Parks, graduate student in SFU's Faculty of Health Sciences, in a statement.

The researchers added that a child’s risk can be mitigated by reading labels on cleaning products and choosing the ones that are not sprayed or contain volatile organic compounds. This, coupled with an effort to live in a mold-free, low-allergen home, can help minimize a child’s exposure to these respiratory illness triggers.

“A proposed mechanism for our findings is that chemicals in cleaning products damage the respiratory epithelium by affecting inflammatory pathways of the innate immune system rather than allergic pathways,” the study authors wrote. In studies focused on adults, cleaning products were shown to cause asthma and wheeze as a result to exposure to these products. The damage can worsen with long-term exposure, noted the study authors.

The statement also noted that the American Lung Association recommends against using harmful cleaning products, but that the makers of these products in Canada and the United States are not required to list all of the ingredients.

“Some ‘green’ products may contain harmful substances, as these products are not regulated,” the authors said.

Reference

Parks J, McCandless L, Dharma C, et al. Association of use of cleaning products with respiratory health in a Canadian birth cohort [published online February 18, 2020]. CMAJ. doi: 10.1503/cmaj.190819.