Passive exposure to disinfectants and cleaning products in daycare settings and child wheeze in the French CRESPI cohort

<bold>Background:</bold> Evidence is mounting that passive exposure at home to disinfectants and cleaning products (DCP), particularly in spray form, is associated with increased risk of wheezing in children. The links between daycare exposures to DCP and child respiratory health have never been studied. <bold>Methods:</bold> This cross-sectional study includes 536 children (mean age: 22.3 months; 47.4% female) of the French CRESPI cohort (108 daycares, 2019-2022). Exposure to DCP was evaluated using a barcode-scanning smartphone application with an embedded questionnaire. An exposure score was calculated as the sum of frequencies of use of DCP for each daycare. Child wheezing outcomes (ever wheeze since birth, recurrent wheeze (≥ 3 times since birth), and ever wheeze with inhaled corticosteroid (ICS) use) were evaluated by parental questionnaire. Associations between daycare DCP exposure and wheezing outcomes were analyzed with Generalized Estimating Equations to account for a possible daycare effect, and adjusted for child age, parental smoking status, parental educational attainment, and daycare size. <bold>Results:</bold> The prevalence of ever wheeze was 32.1%, that of recurrent wheeze 13.3%, and that of ever wheeze with ICS use 14.5%. Above-median DCP exposure scores (vs. ≤ median scores) were associated with higher odds of ever wheeze with ICS use (Odds Ratio=1.72, 95% Confidence Interval: 1.07–2.75, p value=0.024) and ever wheeze (1.40, 0.98–2.00; p=0.068), but not with recurrent wheeze (1.35, 0.79-2.31; p=0.270). <bold>Discussion:</bold> Given the observed association between daycare DCP use and wheeze in children, measures which limit child exposure to DCP in care settings should be considered.