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Maternal preconception occupational exposure to cleaning products and disinfectants and offspring asthma - 05/01/22

Doi : 10.1016/j.jaci.2021.08.025 
Gro Tjalvin, MD, PhD a, b, , Øistein Svanes, MD b, c, Jannicke Igland, PhD d, e, Randi Jacobsen Bertelsen, PhD c, f, Bryndís Benediktsdóttir, MD g, h, Shyamali Dharmage, MD, PhD i, Bertil Forsberg, PhD j, Mathias Holm, MD, PhD k, Christer Janson, MD, PhD l, Nils Oskar Jõgi, MD b, c, m, Ane Johannessen, PhD a, Andrei Malinovschi, MD, PhD n, Kathrine Pape, PhD o, p, Francisco Gomez Real, MD, PhD c, q, Torben Sigsgaard, MD, PhD p, Kjell Torén, MD, PhD k, Hilde Kristin Vindenes, MD b, c, Jan-Paul Zock, PhD r, s, t, Vivi Schlünssen, MD, PhD o, p, Cecilie Svanes, MD, PhD b, u
a Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway 
b Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway 
c Department of Clinical Science, University of Bergen, Bergen, Norway 
d Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway 
e Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway 
f Oral Health Center of Expertise in Western Norway, Bergen, Norway 
g Medical Faculty, University of Iceland, Reykjavík, Iceland 
h Department of Sleep, Landspitali University Hospital Reykjavík, Reykjavík, Iceland 
i Allergy and Lung Health Unit, University of Melbourne, Melbourne, Australia 
j Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden 
k Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden 
l Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden 
m Tartu University Lung Clinic, Tartu, Estonia 
n Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden 
o National Research Centre for the Working Environment, Aarhus, Denmark 
p Department of Public Health, Aarhus University, Environment, Work and Health, Danish Ramazzini Centre, Aarhus, Denmark 
q Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway 
r ISGlobal, Barcelona, Spain 
s Universitat Pompeu Fabra (UPF), Barcelona, Spain 
t CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain 
u Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway 

Corresponding author: Gro Tjalvin, MD, PhD, Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, N-5020 Bergen, Norway.Department of Global Public Health and Primary CareUniversity of BergenPO Box 7804BergenN-5020Norway

Abstract

Background

Emerging research suggests health effects in offspring after parental chemical exposures before conception. Many future mothers are exposed to potent chemicals at work, but potential offspring health effects are hardly investigated.

Objective

We sought to investigate childhood asthma in relation to mother’s occupational exposure to cleaning products and disinfectants before conception.

Methods

The multicenter Respiratory Health In Northern Europe/Respiratory Health In Northern Europe, Spain and Australia generation study investigated asthma and wheeze starting at age less than 10 years in 3318 mother-offspring pairs. From an asthma-specific Job-Exposure Matrix and mothers’ occupational history, we defined maternal occupational exposure to indoor cleaning agents (cleaning products/detergents and disinfectants) starting before conception, in the 2-year period around conception and pregnancy, or after birth. Never-employed mothers were excluded. Exposed groups include cleaners, health care workers, cooks, and so forth. Associations were analyzed using mixed-effects logistic regression and ordinary logistic regression with clustered robust SEs and adjustment for maternal education.

Results

Maternal occupational exposure to indoor cleaning starting preconception and continuing (n = 610) was associated with offspring’s childhood asthma: odds ratio 1.56 (95% CI, 1.05-2.31), childhood asthma with nasal allergies: 1.77 (1.13-2.77), and childhood wheeze and/or asthma: 1.71 (95% CI, 1.19-2.44). Exposure starting around conception and pregnancy (n = 77) was associated with increased childhood wheeze and/or asthma: 2.25 (95% CI, 1.03-4.91). Exposure starting after birth was not associated with asthma outcomes (1.13 [95% CI, 0.71-1.80], 1.15 [95% CI, 0.67-1.97], 1.08 [95% CI, 0.69-1.67]).

Conclusions

Mother’s occupational exposure to indoor cleaning agents starting before conception, or around conception and pregnancy, was associated with more childhood asthma and wheeze in offspring. Considering potential implications for vast numbers of women in childbearing age using cleaning agents, and their children, further research is imperative.

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Graphical abstract




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Key words : Occupational exposures, preconception exposures, Job-Exposure Matrix (JEM), disinfectants, cleaning products, mother, childhood asthma, generation study, RHINESSA

Abbreviations used : ISCO, JEM, OAsJEM, RHINE, RHINESSA


Plan


 The RHINESSA generation study received funding by the Research Council of Norway (grants nos. 214123 and 228174), the Bergen Medical Research Foundation, the Western Norwegian Regional Health Authorities (grant nos. 912011, 911892, and 911631), the Norwegian Labour Inspection, the Norwegian Asthma and Allergy Association, the Danish Wood Foundation (grant no. 444508795), the Danish Working Environment Authority (grant no. 20150067134), the Swedish Heart and Lung Foundation, the Swedish Asthma and Allergy Association, and the Estonian Research Council (grant no. PUT562). The Respiratory Health In Northern Europe study received funding by the Norwegian Research Council, the Norwegian Asthma and Allergy Association, the Danish Lung Association, the Swedish Heart and Lung Foundation, the Vårdal Foundation for Health Care Science and Allergy Research, the Swedish Association Against Asthma and Allergy, the Swedish Association Against Heart and Lung Disease, the Swedish Council for Working Life and Social Research, the Icelandic Research Council, and the Estonian Science Foundation. The funding agencies had no direct role in the conduct of the study, the collection, management, statistical analysis, and interpretation of the data, or preparation/approval of the manuscript.
 Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest.


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Vol 149 - N° 1

P. 422 - janvier 2022 Retour au numéro
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