Study: the bleach paradox

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Reference Casas L, Espinosa A, Borràs-Santos a, et al. Domestic use of bleaching agents and infections in children: a multicenter cross -sectional study. Occup Environ Med. 2015 April 2. [EPUB AHEAD OF Print] Study design Cross -sectional study participant as part of the Health Effects of Indoor Pollutants project: Integrating Microbial, Toxicological, and Epidemiological Approaches (Hitea), in this study 9.102, children aged 6 to 12 years from schools in Spain, the Netherlands and Finland. Parameters rated parents of the registered children a questionnaire in which they have the frequency of infections (influenza, tonsillitis, sinusitis, otitis, bronchitis and pneumonia) in the past 12 months ...
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Reference

Casas L, Espinosa A, Borràs-Santos a, et al. Domestic use of bleaching agents and infections in children: a multicenter cross -sectional study. Occup Environ med. 2015 April 2. [Epub Ahead of Print]

study design

cross -sectional study

participant

as part of the Health Effects of Indoor Pollutants project: Integrating Microbial, Toxicological, and Epidemiological Approaches (Hitea), 9.102 children aged 6 to 12 years from schools in Spain, the Netherlands and Finland.

parameter evaluated

parents of the registered children filled out a questionnaire in which they provided the frequency of infections (influenza, tonsillitis, sinusitis, otitis, bronchitis and pneumonia) in the past 12 months and reported whether bleaching agents were used to clean the house at least once a week.

primary result measurements

The conditions of the relative risk (RR) for childhood infections in relation to the use of bleaching agents at home were calculated for each country, and the RR conditions were combined for meta-analysis.

important knowledge

The use of bleaching agents vary very different from country to country (7 % of the respondents from Finland and 72 % of the respondents from Spain). In all three countries, the overall prevalence of infections in children that were exposed to bleaching agents was higher. Exposure compared to bleaching agents was associated in the Netherlands with a significantly increased influenzar risk (RR = 1.27; 95 % confidence interval [CI]: 1.06–1.54), tonsillitis and sinusitis in Finland (RR = 2.41; 95 % CI: 1.25–4.66 for tonsillitis; rr = 2.18; 95 % AI: 1.19–4.00 for sinusitis) and every infection in Spain (RR = 1.28; 95 % AI: 1.00–1.65). This is a 27 % increased risk of influenza in the Netherlands, a 141 % increased risk of almond inflammation and an increased risk of sinusitis in Finland and a 28 % increased risk of any infection in Spain. In a combined analysis of all 3 countries, exposure to bleaching agents was associated with an increased risk of influenza, tonsillitis and any infection.

practice implications

The current study with HITEA study participants finds a positive correlation between the use of bleaching agents in the household and the occurrence of infectious diseases in children. In other studies, this relationship is hardly examined, which more frequently examine the relationship between atopic illness and chlorine or bleach exposure. Beans in infants and toddlers, for example, were associated with the routine use of chemical cleaning agents (including bleach and cleaning sprays) in the house. In contrast, according to a cross -sectional study with a similar design as the study discussed here, the use of bleaching agents in the household was associated with a reduced risk for asthma, eczema and house dust mite allergies.
Exposure to bleaching agents can increase the risk of infectious diseases, since chlorine -bleached aerosolized fleeting chemicals released and make children more susceptible to respiratory diseases.
Part of the challenge when evaluating the relevance of these studies is their design. These are population -related studies that are helpful in order to improve our understanding of environmentally related risk factors for diseases, but can only show associations, no causal relationships. Results of population -related studies can be misleading if a variable that has not taken into account is the real cause of the observed effect. The study checked here takes into account gender, age, mold in the household, passive rough exposure and parental education, but does not take into account the use of other cleaning products in the household that could expose children to chemical irritants. We therefore have to be careful when we generalize the results.
If the use of bleaching agents in the household actually increases the risk of infectious diseases, the mechanism is uncertain. It is tempting to argue that the results of this study support the "hygiene hypothesis", the idea that the immune system of children is weakened by life in artificially sterile environments. However, the hygiene hypothesis explains that atopic diseases-no infectious diseases-are increasing if children of microbial exposure are robbed, do not develop natural immunity and do not build up healthy microbioma. 7 A more plausible explanation for why exposure to bleaching agents could increase the risk of infectious diseases Aerosolized fleeting chemicals stimulate airways and make children more susceptible to respiratory diseases.
patients use bleaching agents at home because it is a broadband disinfectant that is assumed that it is eliminated by disease -causing microorganisms - which makes the results of this study a paradox. For practical reasons, bleaching agents for routine household cleaning is simply unnecessary. An unbleached home does not have to be a dirty home. Non -toxic cleaning agents can be bought or manufactured at home with vinegar, soda, liquid soap, essential oils or other natural ingredients. We could wait for future studies to confirm the connection between the use of bleaching agents in the household and the risk of infectious diseases in children, or we could assume that, as this study suggests, the risks of bleaching agents for routine use in the household outweigh the advantages.

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