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Cleaning for Asthma-Safer Schools Reduces Asthma Risk, Saves Money

Categories: Respiratory Health


A 43-year-old high-school custodian started having breathing problems he associated with using a bathroom disinfectant and a floor stripper. When he was away from the chemicals for a few months, his breathing problems improved. The problems came back once he returned to work. He visited the emergency room several times, and healthcare providers repeatedly told him he had bronchitis. The custodian was finally diagnosed with asthma. About a year later, he left his job because of his work-related asthma.


A paradox exists for cleaning many of the nation’s schools. While ridding schools of contaminants and microbes to keep students and staff healthy, cleaning may expose them to harmful chemicals in cleaning products, sanitizers, and disinfectants. Some ingredients in conventional products such as floor strippers, disinfectant wipes, and bathroom cleaners, or chemicals used by themselves or mixed with water, like ammonia, and bleach, pose avoidable risks for the health of school occupants – custodians, teachers, administrators, and students.

In a school setting, workers and students share the same space. Improvements made for workers can also benefit the health of students. In the US, 6.8 million (9.3%) children and 18.7 million adults (8.0%) have asthma.[1] An estimated 40% of adults in California with current asthma report that their asthma was caused or aggravated by work.[2] People deserve to work and learn in the safest and healthiest school environment possible. Substitution with safer cleaning products and practices can help create such an environment.

Work-Related Asthma in California

The Work-Related Asthma Prevention Program (WRAPP) in the California Department of Public Health’s Occupational Health Branch tracks cases of work-related asthma and the chemical exposures associated with them in order to target prevention efforts. Asthma is considered work-related when caused (new-onset asthma) or worsened (work-aggravated asthma) by exposure to substances at work. WRAPP found that 12.5% of the work-related asthma cases in its surveillance database were related to cleaning products.[3] Of those cases, about 20% had occupations where cleaning tasks were part of their job, such as custodians. The other 80% were bystanders working in areas where cleaning was occurring or recently happened–their asthma symptoms were attributed to the cleaning products used nearby. Cases included many workers in schools.

Healthy Cleaning & Asthma-Safer Schools

Healthy Cleaning & Asthma-Safer Schools: A How-To Guide is a handbook from the California Department of Public Health that helps school districts transition to asthma-safer cleaning products and practices. The handbook explains to school administrators, facility managers, and other school advocates how to switch to asthma-safer cleaning in simple, manageable steps. It provides ready-to-use tools, resources, and forms to assist districts in making changes and promoting safer cleaning successes within the school community. A companion video features California custodians’ and administrators’ successes using the handbook’s strategies.

The handbook and video were created as part of the California Department of Public Health’s work-related asthma prevention efforts, following extensive pilot testing of the approach with volunteer school districts across California. Some cleaning products that are marketed as “natural” or “green” contain ingredients that can cause asthma. The handbook directs school districts to resources to help them find asthma-safer products and practices to help prevent asthma or asthma symptoms. These methods may also help to prevent other health effects—like cancer and endocrine disruption—and minimize environmental degradation.[4] School districts that have transitioned to safer products and technologies found that they saved funds on cleaning products and reduced absenteeism among staff and students.

Asthma-Safer Cleaning Needed in Many Work Environments

It’s safe to say that every indoor work environment requires some kind of cleaning that poses a potential exposure risk for cleaners and building occupants. The National Occupational Research Agenda (NORA) Services Sector Council has set goals for disseminating information to reduce respiratory disease not only for Education and Schools, but for other significant industry subsectors, as outlined in the National Services Agenda. These include Building Services, Hotels and Motels, Public Administration, and Restaurants and Food Services. The resources described above outline a process of transitioning to safer cleaning products that can be implemented in many kinds of workplaces.

We would like you to share your experiences with switching to safer cleaning products. What made it a successful effort? What advice do you have for others who want to try it?

Debbie Shrem, MPH; Justine Weinberg, MSEHS, CIH; Jennifer Flattery, MPH; Barbara Materna, PhD, CIH

Ms. Shrem works as a health educator, Ms. Weinberg as an industrial hygienist, and Ms. Flattery as an epidemiologist in the California Department of Public Health’s Occupational Health Branch. Dr. Materna is Chief of the Occupational Health Branch and Co-Chair of the NORA Services Sector Council. 



[1] Centers for Disease Control and Prevention. (2015). Faststats-Asthma. Retrieved from

[2] Milet M, Lutzker L, Flattery J. Asthma in California: A Surveillance Report. Richmond,

CA: California Department of Public Health, Environmental Health Investigations

Branch, May 2013 (p. 93).

[3] Milet M, Lutzker L, Flattery J. Asthma in California: A Surveillance Report. Richmond,

CA: California Department of Public Health, Environmental Health Investigations

Branch, May 2013 (p. 103).

[4] Green Seal. (2011). GS-37 Green Seal Standard for Cleaning Products for Industrial and Institutional use. Sixth Edition, September 1, 2011 (Pp. 7-13). Retrieved from

Public Comments

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  1. August 20, 2015 at 6:23 am ET  -   Lagu Komplit

    Thanks for information and I really love your blogs

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  2. January 30, 2016 at 7:50 am ET  -   tom clean

    thanks for the info, you guys have some great blogs, keep up the good work

    Link to this comment

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