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Household Cleaning Product Use and Respiratory Health in Early Life: An Analysis from the Canadian Healthy Infant Longitudinal Development (CHILD) Study
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A2810 - Household Cleaning Product Use and Respiratory Health in Early Life: An Analysis from the Canadian Healthy Infant Longitudinal Development (CHILD) Study
Author Block: T. K. Takaro1, J. P. Parks1, M. R. Sears2, D. Lefebvre2, L. McCandless1, J. R. Brook3, J. Scott4, S. E. Turvey5, P. Mandhane6, A. B. Becker7, P. Subbarao8, A. L. Kozyrskyj6, CHILD Study Investigators; 1Simon Fraser University, Burnaby, BC, Canada, 2McMaster University, Hamilton, ON, Canada, 3University of Toronto, Burnaby, ON, Canada, 4University of Toronto, Toronto, ON, Canada, 5University of British Columbia, Vancouver, BC, Canada, 6University of Alberta, Edmonton, AB, Canada, 7University of Manitoba, Winnipeg, MB, Canada, 8Hospital for Sick Children, Toronto, ON, Canada.
Introduction: Asthma is a common chronic disease of childhood. The timing, level and mix of environmental exposures is of particular interest when determining risk for this condition, and for designing interventions to reduce risk. By identifying hazardous exposures and behaviors that confer asthma risk, preventive measures could be taken to reduce exposures in early life and modify risk. Birth cohorts enable examination of the developmental origins of illness in early life. This study uses data from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort to examine the frequency of use of 26 common household cleaning products at 3 months of age, and the relationships between product use and intermediate asthma endpoints of wheeze, atopy, wheeze with atopy, and diagnosed asthma at age 1 and 3 years.
Methods: CHILD is following 3495 children enrolled in the prenatal period between 2008 and 2012 from four major Canadian cities. Our sample consists of 1884 CHILD subjects with complete exposure and outcome data. Household cleaning products exposure was estimated using a cumulative Frequency of Use Score (FUS) created from questionnaire responses. Those in the highest quartile of FUS were compared to those in the lowest quartile, producing odds ratios for outcomes using multivariate logistic regression modeling.
Results: Following adjustment for potential confounders, a very high frequency of product use assessed at 3 months was associated with higher odds of any wheeze (OR 1.77; 1.04-3.08, p=0.04), recurrent wheeze (OR 2.90; 1.40-6.50, p=0.01), persistent wheeze (OR 2.96; 0.98-11.02, p=0.07), and asthma diagnosis (OR 2.24; 1.14-4.64, p=0.02) in 3-year-old children when compared to those living in a home with low product use. A high frequency of cleaning product use was also associated with a 5.4 times greater odds of having a child with recurrent wheeze and atopy at age 3 (OR 5.40; 1.37-35.92, p=0.03), but not atopy alone. Adjusted logistic regression models showed positive, yet inconsistent and less significant relationships between these health outcomes at one year and the frequent use of cleaning products.
Conclusions: We found that while household cleaning product use is associated with an increased risk for childhood wheeze and asthma, it did not increase the risk of atopy. These results suggest that effects on the airway early in life from frequent cleaning product use in the home are due to an innate, inflammatory response rather than an acquired allergic response.
Author Block: T. K. Takaro1, J. P. Parks1, M. R. Sears2, D. Lefebvre2, L. McCandless1, J. R. Brook3, J. Scott4, S. E. Turvey5, P. Mandhane6, A. B. Becker7, P. Subbarao8, A. L. Kozyrskyj6, CHILD Study Investigators; 1Simon Fraser University, Burnaby, BC, Canada, 2McMaster University, Hamilton, ON, Canada, 3University of Toronto, Burnaby, ON, Canada, 4University of Toronto, Toronto, ON, Canada, 5University of British Columbia, Vancouver, BC, Canada, 6University of Alberta, Edmonton, AB, Canada, 7University of Manitoba, Winnipeg, MB, Canada, 8Hospital for Sick Children, Toronto, ON, Canada.
Introduction: Asthma is a common chronic disease of childhood. The timing, level and mix of environmental exposures is of particular interest when determining risk for this condition, and for designing interventions to reduce risk. By identifying hazardous exposures and behaviors that confer asthma risk, preventive measures could be taken to reduce exposures in early life and modify risk. Birth cohorts enable examination of the developmental origins of illness in early life. This study uses data from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort to examine the frequency of use of 26 common household cleaning products at 3 months of age, and the relationships between product use and intermediate asthma endpoints of wheeze, atopy, wheeze with atopy, and diagnosed asthma at age 1 and 3 years.
Methods: CHILD is following 3495 children enrolled in the prenatal period between 2008 and 2012 from four major Canadian cities. Our sample consists of 1884 CHILD subjects with complete exposure and outcome data. Household cleaning products exposure was estimated using a cumulative Frequency of Use Score (FUS) created from questionnaire responses. Those in the highest quartile of FUS were compared to those in the lowest quartile, producing odds ratios for outcomes using multivariate logistic regression modeling.
Results: Following adjustment for potential confounders, a very high frequency of product use assessed at 3 months was associated with higher odds of any wheeze (OR 1.77; 1.04-3.08, p=0.04), recurrent wheeze (OR 2.90; 1.40-6.50, p=0.01), persistent wheeze (OR 2.96; 0.98-11.02, p=0.07), and asthma diagnosis (OR 2.24; 1.14-4.64, p=0.02) in 3-year-old children when compared to those living in a home with low product use. A high frequency of cleaning product use was also associated with a 5.4 times greater odds of having a child with recurrent wheeze and atopy at age 3 (OR 5.40; 1.37-35.92, p=0.03), but not atopy alone. Adjusted logistic regression models showed positive, yet inconsistent and less significant relationships between these health outcomes at one year and the frequent use of cleaning products.
Conclusions: We found that while household cleaning product use is associated with an increased risk for childhood wheeze and asthma, it did not increase the risk of atopy. These results suggest that effects on the airway early in life from frequent cleaning product use in the home are due to an innate, inflammatory response rather than an acquired allergic response.
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