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INDOOR AIR QUALITY The use of cleaning and disinfecting products in the workplace has emerged as a significant source of exposure. asthma attacks. Individuals with asthma or other respiratory con- ditions should be cautious when using scented cleaning products. Formaldehyde is a commonly used disinfectant found in cleaning products such as dishwashing liquids and furniture pol- ishes. Prolonged exposure to formaldehyde can also lead to the development of asthma and other respiratory disorders. Chlorine is a strong disinfectant commonly found in house- hold bleach and toilet bowl cleaners. Inhalation of chlorine fumes can irritate the respiratory system, leading to coughing, wheez- ing, and chest tightness. Individuals with asthma are particularly susceptible to the effects of chlorine, and exposure to high con- centrations can cause severe asthma attacks. What Can Be Done? To mitigate the risk for cleaning and maintenance workers, it’s important to bring awareness to respiratory risks and implement a program that reduces exposure. When selecting products for cleaning, choose fragrance-free alternatives, select low-VOC products, and consider natural alternatives. Companies also can: ■ Provide workers with personal protective equipment while paying close attention to respiratory protection. ■ Ensure that properly ventilated workspaces are available. ■ Provide workers with training and awareness for safe han- dling and use of cleaning products. ■ Make safety data sheets available for all cleaning products. ■ Consider implementing regular respiratory screening and medical monitoring for all cleaning and maintenance workers. Companies and workers should always remember early de- tection and management are important for improved health out- comes. Implications for Public Health Asthma is one of the greatest contributors to the global burden of respiratory diseases. Nearly 4 million people die prematurely from respiratory diseases each year, while hundreds of millions more suffer from respiratory diseases (Ferkol & Schraufnagel, 2014). Reducing exposure risks is one way to avoid the development of respiratory illness and relieve the burden. The economic impact of asthma is astounding as the costs of medical care, absenteeism, and deaths figure at nearly $82 mil- lion a year for businesses in the United States. (Tiotui et al, 2020). Globally, 180,000 deaths are attributed to asthma each year (Fer- kol & Schraufnagel, 2014), but the greatest problem is morbidity and quality of life. It is estimated that about 40 million people in the United States suffffer from asthma (Nunes, Pereira, & Marais- Almeida, 2017). ThThe average cost of treating one patient annually is $3,266. Approximately 8.7 million workdays are missed annu- ally due to asthma (Toitui et al., 2020). From an economic standpoint, public health policies can have a significant impact on adult-onset occupational asthma by ad- dressing preventable risk factors such as exposure to indoor envi- ronmental air pollutants. In Conclusion Maintaining cleanliness in offices is essential, but it’s not without its risks to cleaning and maintenance workers. The increased risk of asthma in the workplace is a significant concern for workers across various industries. It is important to be aware of the potential risks associated with common cleaning products. Aerosol sprays, disinfectant wipes, window and glass cleaners, carpet cleaners, and fragranced cleaning products are among the common products that can in- crease the risk of occupational asthma. Implementing a program of choosing safer alternatives, improving ventilation, ensuring proper use of respiratory projection, providing training on the proper use of cleaning products, and instituting medical moni- toring can help minimize the risk and create a healthier work en- vironment for all workers. Employers, regulatory bodies, and workers should collaborate in implementing preventative measures. By prioritizing respira- tory health and raising awareness, the risk of workers developing occupational asthma can be mitigated. Christine Robinson, Ph.D., is an industrial hygienist and environmental scientist specializing in indoor air quality. Robinson is an adjunct professor for the College of Safety and Emergency Services at Columbia Southern University. REFERENCES • Ferkol, T., & Schraufnagel, D. (2014). The global burden of respiratory disease. Annals of the American Thoracic Society, 11(3), 404-406. doi:10.1513/AnnalsATS.201311-405PS • Mapp, C. E., Boschetto, P., Maestrelli, P., & Fabbri, L. M. (2005). Occupational asthma. American Journal of Respiratory and Critical Care Medicine, 172(3), 280–305. https://doi.org/10.1164/rccm.200311- 1575SO • Mudarri, D. H. (2016). Valuing the economic costs of allergic rhinitis, acute bronchitis, and asthma from exposure to indoor dampness and mold in the US. Journal of Environmental and Public Health, 2016, 1-12. doi:10.1155/2016/2386596 • Nunes, C., Pereira, A. M., & Morais-Almeida, M. (2017). Asthma costs and social impact. Asthma Research and Practice, 3(1). doi:1186/s40733-016- 0029-3 • Sejbaek, C. S., Flachs, E. M., Carøe, T. K., Meye, H. W., Frederiksen, M., Frydendall, K. B., Wolkoff, P., Clausen, P. A., Hougaard, K. S., & Schlünssen, V. (2022). Professional cleaning and risk of asthma - a Danish nationwide register-based study. Scandinavian Journal of Work, Environment & Health, 48(2), 127–136. https://doi.org/10.5271/sjweh.3997 • Tiotiu, A. I., Novakova, S., Labor, M., Emelyanov, A., Mihaicuta, S., Novakova, P., & Nedeva, D. (2020). Progress in Occupational Asthma. International journal of environmental research and public health, 17(12), 4553. https:// doi.org/10.3390/ijerph17124553 22 Occupational Health & Safety | OCTOBER 2023 www.ohsonline.com