Asthmatic woman using an asthma inhaler during asthma attacks

Those with asthma are experiencing less asthma control related to an increase in using household disinfectants — known asthma triggers — because of COVID-19, according to a survey co-conducted by University of Illinois Chicago researchers.

Results of the survey, co-led by Kamal Eldeirawi, an associate professor at UIC’s College of Nursing, are published in the Journal of Allergy and Clinical Immunology: In Practice. 

“We became concerned with increased cleaning and disinfecting related to the COVID-19 pandemic, combined with people spending more time indoors may expose people with asthma to more environmental triggers for asthma symptoms,” Eldeirawi said. “This prompted our interest in studying the impact of disinfectants and asthma control among those living with asthma.”

Cleaning products are considered respiratory irritants that cause inflammation and bronchial hyperresponsiveness, Eldeirawi explained.  

In the online survey, conducted between May and September 2020, adults with asthma answered questions about handwashing and hand sanitizer use, household disinfectant use and frequency. They also were asked five questions about asthma symptoms, use of rescue medications, effect of asthma on daily functioning, and personal control over the past four weeks with responses on a 1-5 scale to determine participants’ asthma control score, which ranges from 5 to 25. A score of 19 or less was considered an indication of uncontrolled asthma.

Of the 795 respondents, the percent who reported household disinfectant use five or more times per week increased 138% for disinfectant wipes, 121% for disinfectant sprays, 155% for bleach and water solution, and 89% for other liquids since the COVID-19 pandemic began.

Researchers also observed significant associations of frequent disinfectant use since the pandemic with uncontrolled asthma. And, while the researchers did not collect data on increases in health care providers’ or ER visits for asthma, a large percentage of the respondents indicated having had an asthma attack, Eldeirawi said.

The study indicates people with asthma could be negatively affected by increases in disinfectant use and should discuss with their health care providers safer alternatives for cleaning, as well as managing symptoms. Cleaning product alternatives include vinegar, water and a drop of dish detergent, 70% alcohol, or hydrogen peroxide.

Eldeirawi said it is yet unknown what COVID-19’s impact is on those with asthma, but research is being conducted around the world. Eldeirawi and his research team will continue their research, this time asking survey respondents about their symptoms and mask use.

The research paper’s additional authors are Luz Huntington-Moskos of the University of Louisville, Dr. Sharmilee Nyenhuis of UIC, and Barbara Polivka of the University of Kansas.