Daycare use of disinfectants and cleaning products and wheeze among children: Cross-sectional analyses in the French CRESPI cohort

Franziska Bright; Emilie Pacheco Da Silva; Flore Amat; Pierre Bonnet; Anastasie Eworo Nchama; Etienne Sévin; Valérie Siroux; Corinne Mandin; Nicole Le Moual; Orianne Dumas

doi:10.1016/j.scitotenv.2024.178016

Daycare use of disinfectants and cleaning products and wheeze among children: Cross-sectional analyses in the French CRESPI cohort

Sci Total Environ. 2024 Dec 17:958:178016. doi: 10.1016/j.scitotenv.2024.178016. Online ahead of print.

Affiliations

¹ Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, 94807 Villejuif, France.
² Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, 94807 Villejuif, France; Service de Pneumologie et d'Allergologie Pédiatrique - CRCM, Hôpital Robert Debré, Université Paris Cité, Paris, France.
³ Centre Scientifique et Technique du Bâtiment (CSTB), Direction Santé Confort, 84, avenue Jean Jaurès, Marne-la-Vallée, France.
⁴ EPICONCEPT, Paris, France.
⁵ Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, Grenoble, France.
⁶ Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, 94807 Villejuif, France. Electronic address: orianne.dumas@inserm.fr.

PMID: 39693649
DOI: 10.1016/j.scitotenv.2024.178016

Abstract

Background: Evidence is mounting that domestic use of disinfectants and cleaning products (DCP), particularly in spray form, is associated with wheezing in children. Beyond the home environment, many children are also exposed to DCP in daycare. The links between daycare exposures to DCP and child respiratory health have never before been studied.

Objectives: Evaluate the associations between daycare DCP use and wheeze among children.

Methods: This cross-sectional study draws upon the data at inclusion for 536 children (mean age: 22.3 months; 47.4 % female) of the French CRESPI cohort (108 daycares in the Paris region, 2019-2022). Exposure to DCP was evaluated using a barcode-scanning smartphone application with an embedded questionnaire. An exposure score was calculated as the sum of frequencies of use of DCP for each daycare. Child wheezing outcomes (ever wheeze since birth, recurrent wheeze (≥3 times since birth), and wheeze ever treated with inhaled corticosteroids (ICS)) were evaluated by parental questionnaire. Associations between daycare DCP exposure and wheezing outcomes were analyzed with Generalized Estimating Equations to account for a possible center effect, and adjusted for child age, parental smoking status, parental educational attainment, and daycare size.

Results: The prevalence of ever wheeze was 32.1 %, that of recurrent wheeze 13.3 %, and that of wheeze ever treated with ICS 14.5 %. Above-median exposure scores (vs. ≤ median exposure scores) were associated with higher odds of wheeze ever treated with ICS (Odds Ratio = 1.72, 95 % Confidence Interval: 1.07-2.75) and ever wheeze (1.40, 0.98-2.00), but not with recurrent wheeze (1.35, 0.79-2.31). Relationships between specific DCP application modes and wheezing outcomes did not suggest a predominant role of specific modes.

Discussion: Given the observed association between daycare DCP use and wheeze in children, measures which limit child exposure to DCP in care settings should be considered.

Keywords: Child wheeze; Cleaning products; Daycare; Indoor environmental exposures; Respiratory health.