Jaclyn Parks1, Lawrence McCandless1, Christoffer Dharma1, Jeffrey Brook1, Stuart E Turvey1, Piush Mandhane1, Allan B Becker1, Anita L Kozyrskyj1, Meghan B Azad1, Theo J Moraes1, Diana L Lefebvre1, Malcolm R Sears1, Padmaja Subbarao1, James Scott1, Tim K Takaro2. 1. Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont. 2. Faculty of Health Sciences (Parks, McCandless, Takaro), Simon Fraser University, Vancouver, BC; Department of Medicine (Dharma, Lefebvre, Sears), McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Brook, Scott), University of Toronto, Toronto, Ont.; Department of Pediatrics (Turvey), University of British Columbia, Vancouver, BC; Department of Pediatrics (Mandhane, Kozyrskyj), University of Alberta, Edmonton, Alta.; Department of Pediatrics & Child Health (Becker, Azad), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Moraes, Subbarao), University of Toronto and Hospital for Sick Children, Toronto, Ont. ttakaro@sfu.ca.
Abstract
BACKGROUND: Comprehensive longitudinal studies are important for understanding the complex risk factors, pathways, exposures and interactions that lead to the development and persistence of asthma. We aimed to examine associations between use of household cleaning products in early life and childhood respiratory and allergic disease using data from the Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study. METHODS: We summed responses from parental questionnaires that indicated the frequency of use of 26 household cleaning products in the homes of 2022 children from this birth cohort when they were 3-4 months of age to create a cumulative Frequency of Use Score (FUS). We used multivariable logistic regression models to assess whether frequent compared with less frequent use was associated with recurrent wheeze, atopy or asthma diagnosis, as defined by the questionnaire and clinical assessments at age 3 years. Data were collected between 2008 and 2015. RESULTS: Children in homes with a higher frequency of use of cleaning products in infancy, as determined by an interquartile range increase, had higher odds of recurrent wheeze (adjusted odds ratio [OR] 1.35, 95% confidence interval [CI] 1.11-1.64), recurrent wheeze with atopy (adjusted OR 1.49, 95% CI 1.02-2.16) and asthma diagnosis (adjusted OR 1.37, 95% CI 1.09-1.70), but no increase in the odds of atopy at age 3 years (adjusted OR 1.14, 95% CI 0.96-1.35). Compared with the lowest tertile of FUS exposure, infants in the highest tertile had higher odds of acquiring asthma. Stratification of the results showed that females had higher ORs than males for all outcomes, although the p values for this sex difference did not reach statistical significance. INTERPRETATION: Frequent use of household cleaning products in early life was associated with an increased risk for childhood wheeze and asthma but not atopy at age 3 years. Our findings add to the understanding of how early life exposures to cleaning products may be associated with the development of allergic airway disease and help to identify household behaviours as a potential area for intervention.
BACKGROUND: Comprehensive longitudinal studies are important for understanding the complex risk factors, pathways, exposures and interactions that lead to the development and persistence of asthma. We aimed to examine associations between use of household cleaning products in early life and childhood respiratory and allergic disease using data from the Canadian Healthy InfantLongitudinal Development (CHILD) Cohort Study. METHODS: We summed responses from parental questionnaires that indicated the frequency of use of 26 household cleaning products in the homes of 2022 children from this birth cohort when they were 3-4 months of age to create a cumulative Frequency of Use Score (FUS). We used multivariable logistic regression models to assess whether frequent compared with less frequent use was associated with recurrent wheeze, atopy or asthma diagnosis, as defined by the questionnaire and clinical assessments at age 3 years. Data were collected between 2008 and 2015. RESULTS:Children in homes with a higher frequency of use of cleaning products in infancy, as determined by an interquartile range increase, had higher odds of recurrent wheeze (adjusted odds ratio [OR] 1.35, 95% confidence interval [CI] 1.11-1.64), recurrent wheeze with atopy (adjusted OR 1.49, 95% CI 1.02-2.16) and asthma diagnosis (adjusted OR 1.37, 95% CI 1.09-1.70), but no increase in the odds of atopy at age 3 years (adjusted OR 1.14, 95% CI 0.96-1.35). Compared with the lowest tertile of FUS exposure, infants in the highest tertile had higher odds of acquiring asthma. Stratification of the results showed that females had higher ORs than males for all outcomes, although the p values for this sex difference did not reach statistical significance. INTERPRETATION: Frequent use of household cleaning products in early life was associated with an increased risk for childhood wheeze and asthma but not atopy at age 3 years. Our findings add to the understanding of how early life exposures to cleaning products may be associated with the development of allergic airway disease and help to identify household behaviours as a potential area for intervention.
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