Birmingham Regional NHS Occupational Lung Disease Service, Birmingham Chest Clinic, Queensway, Birmingham, UK.
Occupational and Environmental Medicine, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
Occup Med (Lond). 2018 Nov 16;68(8):530-536. doi: 10.1093/occmed/kqy113.
Cleaning agents are now a common cause of occupational asthma (OA) worldwide. Irritant airway and sensitization mechanisms are implicated for a variety of old and new agents.
To describe the exposures responsible for cleaning agent OA diagnosed within a UK specialist occupational lung disease service between 2000 and 2016.
The Birmingham NHS Occupational Lung Disease Service clinical database was searched for cases of OA caused by cleaning agents, and data were gathered on age, gender, atopic status, smoking history, symptom onset, diagnostic investigations (including Occupational Asthma SYStem analysis of workplace serial peak expiratory flow measurements and specific inhalational challenge), proposed mechanism, industry, occupation and causative agent.
Eighty patients with cleaning agent OA (77% female, 76% arising de novo) were identified. The median annual number of cases was 4 (interquartile range = 2-7). The commonest cleaning agents causing OA were chloramines (31%), glutaraldehyde (26%) and quaternary ammonium compounds (11%) and frequently implicated industries were healthcare (55%), education (18%) and leisure (8%).
Certain cleaning agents in common usage, such as chlorine-releasing agents, quaternary ammonium compounds and aldehydes, are associated with sensitization and asthma. Their use alters over time, and this is particularly evident in UK healthcare where cleaning and decontamination practice and policy have changed. Vigilance for OA in workplaces such as hospitals, nursing homes, leisure centres and swimming pools, where these cleaning agents are regularly used, is therefore essential.
清洁剂现已成为全球范围内导致职业性哮喘（OA）的常见原因。各种新旧试剂都涉及到刺激性气道和致敏机制。
描述在 2000 年至 2016 年期间，英国一家专业职业肺部疾病服务机构诊断出的清洁剂导致的 OA 暴露情况。
在伯明翰国民保健服务职业肺部疾病服务临床数据库中搜索由清洁剂引起的 OA 病例，并收集患者年龄、性别、特应性状态、吸烟史、症状发作、诊断性检查（包括职业性哮喘系统分析工作场所系列呼气峰流速测量和特定吸入性挑战）、拟议的发病机制、行业、职业和致病剂等数据。
共发现 80 例清洁剂性 OA 患者（77%为女性，76%为新发）。每年病例中位数为 4 例（四分位距=2-7）。最常见的导致 OA 的清洁剂是氯胺（31%）、戊二醛（26%）和季铵化合物（11%），常见的涉及行业有医疗保健（55%）、教育（18%）和休闲（8%）。
某些常见的清洁剂，如释氯剂、季铵化合物和醛类，与致敏和哮喘有关。它们的使用随着时间的推移而改变，在英国的医疗保健行业中尤为明显，那里的清洁和去污实践和政策已经发生了变化。因此，在经常使用这些清洁剂的工作场所（如医院、疗养院、休闲中心和游泳池）中，对 OA 的监测至关重要。
