ILO Home
Go to the home page
Site map | Contact us Français | Español

CISDOC database

Document ID (ISN)111703
CIS number 11-0375
ISSN - Serial title 0271-3586 - American Journal of Industrial Medicine
Year 2011
Convention or series no.
Author(s) Sastre J., Madero M.F., Fernández-Nieto M., Sastre B., del Pozo V., Potro M.G., Quirce S.
Title Airway response to chlorine inhalation (bleach) among cleaning workers with and without bronchial hyperresponsiveness
Bibliographic information 2011, Vol.54, p.293-299. Illus. 11 ref.
Abstract Symptoms of obstructive lung disease in domestic cleaning staff have been related to the use of bleach and other irritant cleaning products. This study included 13 cleaning employees with work-related asthma-like symptoms, three asthmatic controls and three atopic subjects without bronchial hyperresponsiveness (BHR) who had no exposure to cleaning products. The study protocol consisted of a methacholine test, sputum induction and fraction of exhaled nitric oxide measurement (FENO) both at baseline and 24 hr after a 1-hr inhalation challenge with either placebo or bleach at a concentration of 0.4 ppm of chlorine. The inhalation of the placebo caused no bronchial reactions. Mean maximum fall in FEV1 during challenge testing with bleach was significantly higher than the values obtained during the placebo challenge. Inhalation challenge with bleach elicited two isolated late asthmatic reactions and one dual asthmatic reaction. Of all the patients who underwent challenge testing with bleach, only one had a ≥2-fold decrease in methacholine PC20 24 hr after the challenge. No significant correlation was found between maximum fall in FEV1 and PC20 methacholine. Following challenge testing with bleach, no clinically significant changes in sputum cell counts or FENO were detected. These results suggest that bleach inhalation at a concentration of 0.4 ppm - a concentration below 8-hr permissible occupational exposure level - brings about a substantial decrease in FEV1 in subjects with and without BHR. Some subjects have a positive challenge response to bleach inhalation.
Descriptors (primary) chlorine; cleaning agents; allergic reactivity; respiratory diseases; asthma; domestic and related helpers, cleaners
Descriptors (secondary) methacholine; javel water; extrinsic allergic alveolitis; allergy tests; respiratory function tests; exposure evaluation
Document type D - Periodical articles
Subject(s) Commerce, services, offices
Occupational pathology
Toxic and dangerous substances
Broad subject area(s) Industries and occupations
Occupational medicine, epidemiology
Chemical safety
Browse category(ies) Cleaning work
Diseases of the respiratory system (except for pneumoconiosis & similar)
Halogens and their inorganic compounds