Respiratory Health Clinical Trial
Official title:
Daycare Environmental Exposure to Cleaning Products and Respiratory Health in Young Children and Daycare Workers
CRESPI - RESPIratory health of Children in daycare
The CRESPI study, will be a cohort of 1500/2000 children attending daycare in Paris region,
and will be initiated in November 2019.
The aim of the project is to study the impact of environmental exposures to cleaning products
and disinfectants on respiratory health of infants and toddlers (< 3 years) in daycares
Two specific aims were defined:
1. evaluate environmental exposure to cleaning products by complementary and innovative
tools: air quality measurements in daycares, specific standardized questionnaire,
identification of compounds of the products via a database and a Smartphone application
to scan bar codes and inform on product use
2. evaluate the impact of early exposure in daycares and at home on respiratory health of
young children
Context
Exposure to cleaning products is an emergent risk factor for respiratory health of children.
In some studies, an association has been observed between the use of these products in
households and wheezing in young children (<18 months). However, the specific chemical
substances associated with health hazards remain poorly known. A few studies suggested
associations between some specific organic volatile compounds (aldehydes, aromatics) and
asthma but only one study has been conducted in young children (<3 years).
Detergents/disinfectants may contain sensitizers, irritants and endocrine disrupters.
Children who attend daycares may be particularly exposed: cleaning tasks are often performed
in their presence; moreover, babies and young children often put objects (eg, toys) in their
mouths and might be exposed through various routes (ingestion, inhalation, skin). The
importance of studying the health impact of early life environmental exposures has been
emphasized, especially in the context of the Developmental Origins of Health and Diseases
(DOHaD) research. However, few studies have focussed on environmental exposures in nurseries
in relation to children's respiratory health.
The originality of the CRESPI cohort lies in the fact that no epidemiological survey focussed
on: 1) the effect of early exposure to cleaning products in daycares on respiratory health in
first years of life; 2) the use of complementary and innovative tools to improve evaluation
of such exposures, via a Smartphone application and measurements of pertinent volatile (VOCs)
and semi-volatile (SVOCs) organic compounds. 3) the use of complementary and innovative tools
to improve evaluation of children respiratory health, via a Smartphone application
Methods
The project CRESPI (http://crespi.vjf.inserm.fr/) is to set up an epidemiological survey
among young children attending daycares. A sample of 400 daycares (30-40 children/daycare) in
Ile-de-France (Paris region) has been drawn from a national file. We hypothesise that the
acceptance rate of daycares will be of 25% and those of parents at least of 50% (see French
OQAI study 2011), with an expected population of 1500 to 2500 children.
Each daycare will be visited by trained interviewers to : i) precise the objectives of the
study to the parents/workers in the daycare and give all material to collect data
(questionnaire, smartphone); ii) collect dust samples (to measure SVOCs; triclosan, muscs
...) via an adapted vacuum cleaner and install measuring equipment to evaluate air quality
(VOCs; ammoniac, glycol ethers ...); iii) collect information on the building (surface,
ventilation …) and activities of workers including a calendar of cleaning tasks in rooms
(toilets, bedroom ...) and surface (toys, windows, toddler beds …).
A standardized questionnaire (http://crespi.vjf.inserm.fr/), as previously used in a
parent-child cohort (sepages.inserm.fr), collecting information on the use of products,
respiratory health and potential confounders will be completed by the parents. Respiratory
health of the children will also be evaluated by a group of experts (paediatricians) using
information available from medical records (children's health booklets).
This project will take full advantage of innovative tools, i.e. Smartphone applications, to
evaluate 1) exposures : workers and parents will scan bar-codes of products used, in the
nursery and at home, and respond to a short questionnaire about their use, and 2) respiratory
health of children, with monthly follow-up.
Statistical analyses of the data will evaluate the associations between exposures and
respiratory health of children, after adjustment for potential confounders.
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