Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, Villejuif, France.
CREST, Ensai, Campus de KerLan, Bruz, France.
J Allergy Clin Immunol Pract. 2021 Jun;9(6):2358-2365.e4. doi: 10.1016/j.jaip.2021.02.022. Epub 2021 Feb 23.
Asthma control is suboptimal in nearly half of adults with asthma. Household exposure to disinfectants and cleaning products (DCP) has been associated with adverse respiratory effects, but data on their association with asthma control are scant.
To investigate the association between household use of DCP and asthma control in a large cohort of French elderly women.
We used data from a case-control study on asthma (2011-2013) nested in the E3N cohort. Among 3023 women with current asthma, asthma control was defined by the Asthma Control Test (ACT). We used a standardized questionnaire to assess the frequency of cleaning tasks and DCP use. We also identified household cleaning patterns using a clustering approach. Associations between DCP and ACT were adjusted for age, smoking status, body mass index, and education.
Data on ACT and DCP use were available for 2223 women (70 ± 6 years old). Asthma was controlled (ACT = 25), partly controlled (ACT = 20-24), and poorly controlled (ACT ≤ 19) in 29%, 46%, and 25% of the participants, respectively. Weekly use of sprays and chemicals was associated with poorly controlled asthma (odds ratio [95% confidence interval]: 1 spray: 1.31 [0.94-1.84], ≥2 sprays: 1.65 [1.07-2.53], P trend: .01; 1 chemical: 1.24 [0.94-1.64], ≥2 chemicals: 1.47 [1.03-2.09], P trend: .02). Risk for poor asthma control increased with the patterns "very frequent use of products" (1.74 [1.13-2.70]) and "infrequent cleaning tasks and intermediate use of products" (1.62 [1.05-2.51]).
Regular use of DCP may contribute to poor asthma control in elderly women. Limiting their use may help improve asthma management.
近半数哮喘患者的哮喘控制情况并不理想。家庭暴露于消毒剂和清洁产品(DCP)与不良呼吸道影响有关,但有关其与哮喘控制关系的数据很少。
在一个大型法国老年女性队列中,调查家庭使用 DCP 与哮喘控制之间的关系。
我们使用了哮喘病例对照研究(2011-2013 年)的数据,该研究嵌套在 E3N 队列中。在 3023 名患有当前哮喘的女性中,哮喘控制通过哮喘控制测试(ACT)来定义。我们使用标准化问卷来评估清洁任务和 DCP 使用的频率。我们还使用聚类方法确定家庭清洁模式。DCP 和 ACT 之间的关联在调整了年龄、吸烟状况、体重指数和教育程度后进行了评估。
共有 2223 名女性(70±6 岁)提供了 ACT 和 DCP 使用数据。参与者中分别有 29%、46%和 25%的哮喘控制良好(ACT=25)、部分控制(ACT=20-24)和控制不佳(ACT≤19)。每周使用喷雾剂和化学品与控制不佳的哮喘相关(优势比[95%置信区间]:1 个喷雾剂:1.31[0.94-1.84],≥2 个喷雾剂:1.65[1.07-2.53],P 趋势:0.01;1 种化学品:1.24[0.94-1.64],≥2 种化学品:1.47[1.03-2.09],P 趋势:0.02)。风险随着“频繁使用产品”(1.74[1.13-2.70])和“清洁任务不频繁且产品使用中等”(1.62[1.05-2.51])的模式增加而增加。
定期使用 DCP 可能会导致老年女性哮喘控制不佳。限制其使用可能有助于改善哮喘管理。