Abstract Rationale Household cleaners are exposed to many cleaning products through their work, and there is a need to identify the respiratory implications of these exposures. We explored the use of oscillometry to identify early airway disorders in this population. Methods Household cleaners were recruited from the Latina community in New York City as part of a research initiative focused on this large occupational group. A questionnaire on respiratory symptoms and past medical history of respiratory disease was completed by the participants. Spirometry and oscillometry were performed in a subset of participants. Two-step cluster analysis was used to define small airways disease (SAD) based on abnormal R5-R20, X5, and AX oscillometry values. The association between work and demographic variables and SAD was assessed using logistic regression. Results There were 46 participants; mean age was 48.4 years old (standard deviation 8.3) with a mean 3.2 years worked as a household cleaner. Participants typically worked about 5.6 hours a day. Of the participants, 13% and 22% reported a history of asthma and allergies respectively. Over half noted coughing in the last 12 months with 52% reporting shortness of breath with exertion. Thirty-five participants underwent spirometry and oscillometry. All spirometric values were normal based on the lower limit of normal except one with questionable obstruction and one that was not interpretable due to poor quality; 5 met the criteria for SAD by oscillometry. SAD correctly classified 88.6% of participants by whether they developed new-onset asthma while working in housecleaning (p = 0.06); whereas no spirometric indices did. Hours worked for the principal employer was associated with SAD after controlling for age and body mass index (odds ratio = 2.4, p = 0.04). Conclusions Oscillometry is a potentially useful test in evaluating SAD in the absence of frankly abnormal spirometry in household cleaners, who have known exposures to many chemicals through their work. Future research should focus on oscillometry use as an early marker of SAD development, identifying specific chemicals that may be associated with early or worse oscillometry results, and a role in prevention of respiratory disease in highly exposed working populations. This abstract is funded by: NIOSH ERC Pilot Project
Thompson et al. (Fri,) studied this question.