This issue of the Occupational Lung Disease Bulletin provides a summary of a recently published article on the association between work-related asthma and cleaning products based on data from Massachusetts and the three other SENSOR states. Also in this Bulletin is a brief report on Commonwealth of Massachusetts efforts to promote the use of environmentally preferable cleaning products. Information from SENSOR was instrumental in adding consideration of asthma causing-agents to the criteria for selecting cleaning products. Case #1- Massachusetts - A female housekeeper sought medical care for episodes of exertional dyspnea and chest pain, occurring 2-3 times per week while walking, climbing stairs or carrying items. The products contained an amine, two quaternary ammonium compounds (n-alkyl dimethyl benzyl ammonium chloride and didecyl dimethyl ammonium chloride) and two phenolic compounds. Case #2 - New Jersey - 55-year-old female worked as a housekeeper in a hospital for eight years. She had a two-year history of wheezing, cough, shortness of breath, and chest tightness that were worse at work. She particularly noted symptoms when she used a floor cleaner that contained quaternary ammonium salts, ethyl alcohol, and sodium hydroxide. Case #3 - California A non-smoking male custodian worked in a large urban school district for 17 years. He used several products to remove the graffiti for four hours at a time, up to five days per week. He developed symptoms of wheezing, cough, and chest-tightness that increased when he was reassigned to do graffiti removal. Further research to investigate the potential for cleaning products and their specific ingredients to cause asthma is needed. In the interim, there is a need for increased attention to careful product selection, ventilation, improved warning labels and workplace training about the potential hazards and appropriate mixing and use of cleaning products.
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