Increasing non-cosmetic exposure and sensitization to isothiazolinones require action for prevention: Review.

Frequent use of methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and MI in cosmetic products has been the main cause of widespread sensitization and allergic contact dermatitis to these preservatives (biocides). Their use in non-cosmetic products is also an important source of sensitization. Less is known about sensitization rates and use of benzisothiazolinone (BIT), octylisothiazolinone (OIT), and dichlorooctylisothiazolinone (DCOIT), which have never been permitted in cosmetic products in Europe. BIT and OIT have occasionally been routinely patch-tested. These preservatives are often used together in chemical products and articles. In this study, we review the occurrence of contact allergy to MI, BIT, OIT, and DCOIT over time, based on concomitant patch testing in large studies, and case reports. We review EU legislations, and we discuss the role of industry, regulators, and dermatology in prevention of sensitization and protection of health. The frequency of contact allergy to MI, BIT, and OIT has increased. The frequency of contact allergy to DCOIT is not known because it has seldom been patch-tested. Label information on isothiazolinones in chemical products and articles, irrespective of concentration, is required for assessment of relevance, information to patients, and avoidance of exposure and allergic contact dermatitis.

A Retrospective Analysis of Risk Factors for Atopic Dermatitis Severity.

Background: Atopic dermatitis (AD) has the highest burden of any skin disease; however, the severity-associated factors remain unclear. Objective: To evaluate potential severity-associated factors of AD and to design and validate a severity prediction model to inform the management of AD patients. Methods: A cross-sectional study of 900 AD patients was conducted from December 2021 to October 2022 at our hospital. The primary outcome was disease severity, categorized as mild, moderate, or severe using the scoring atopic dermatitis index. Ordinal logistic regression and bootstrapped validation were used to derive and internally validate the model. Results: Increasing age, elevated eosinophil level, higher economic status, and urban residence were associated with severe AD. Breastfeeding, disinfectants and topical emollients use, and short duration of bathing were associated with mild AD. In the prediction model, predictors included age, eosinophil and economic status, residence, feeding, disinfectants and emollients use, and duration of bathing. Prediction models demonstrated good discrimination (bias-corrected concordance index [c-index] = 0.72) and good calibration. Conclusion: Risk factors for the severity of AD were identified that could aid the early prediction of AD progression. The predictive model included variables that are easily evaluated and could inform personalized prevention and therapy.

Risks of obstructive genitourinary birth defects in relation to trihalomethane and haloacetic acid exposures: expanding disinfection byproduct mixtures analyses using relative potency factors.

BACKGROUND: Some disinfection byproducts (DBPs) are teratogens based on toxicological evidence. Conventional use of predominant DBPs as proxies for complex mixtures may result in decreased ability to detect associations in epidemiological studies. OBJECTIVE: We assessed risks of obstructive genitourinary birth defects (OGDs) in relation to 12 DBP mixtures and 13 individual component DBPs. METHODS: We designed a nested registry-based case-control study (210 OGD cases; 2100 controls) in Massachusetts towns with complete quarterly 1999-2004 data on four trihalomethanes (THMs) and five haloacetic acids (HAAs). We estimated temporally-weighted average DBP exposures for the first trimester of pregnancy. We estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for OGD in relation to individual DBPs, unweighted mixtures, and weighted mixtures based on THM/HAA relative potency factors (RPF) from animal toxicology data for full-litter resorption, eye defects, and neural tube defects. RESULTS: We detected elevated aORs for OGDs for the highest of bromodichloromethane (aOR = 1.75; 95% CI: 1.15-2.65), dibromochloromethane (aOR = 1.71; 95% CI: 1.15-2.54), bromodichloroacetic acid (aOR = 1.56; 95%CI: 0.97-2.51), chlorodibromoacetic acid (aOR = 1.97, 95% CI: 1.23-3.15), and tribromoacetic acid (aOR = 1.90; 95%CI: 1.20-3.03). Across unweighted mixture sums, the highest aORs were for the sum of three brominated THMs (aOR = 1.74; 95% CI: 1.15-2.64), the sum of six brominated HAAs (aOR = 1.43; 95% CI: 0.89-2.31), and the sum of nine brominated DBPs (aOR = 1.80; 95% CI: 1.05-3.10). Comparing eight RPF-weighted to unweighted mixtures, the largest aOR differences were for two HAA metrics, which both were higher with RPF weighting; other metrics had reduced or minimally changed ORs in RPF-weighted models.

[Research progress on exposure to disinfectants and chronic obstructive pulmonary disease].

Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease. In recent years, the cumulative prevalence of COPD has been increasing. There are many etiologies and predisposing factors related to COPD, among which occupational risk factors play an important role. Recent studies have found an association between exposure to disinfectants and their products and airway inflammation, respiratory symptoms, and the development of COPD. During the period of COVID-19, disinfection has become an important link in the prevention and control of COVID-19, and the use rate of disinfectants has increased significantly. Therefore, this review summarizes the effects of disinfectants and their products on COPD, discusses the possible mechanisms, and puts forward suggestions for rational use of disinfectants according to the current situation and the development status of disinfectants.

Comparison of maternal and neonatal survival exposed to humidifier disinfectants during perinatal periods: a case-series study.

A humidifier disinfectant (HD) has been prohibited by the government due to its serious effects on the human body. Several studies on the relationship between HD and lung diseases have been performed independently on children and adults. However, there have been no reports on the effects of HD exposure on pregnant women and their foetuses. Therefore, the present study was conducted to investigate the effects of HD exposure on the foetuses of women who encountered HD during pregnancy. A total of 56 cases were recruited from 2017 to 2019 through the Korea Environmental Industry & Technology Institute, and data obtained from the medical records included maternal date of birth, maternal date of death, maternal start and end date of HD exposure, maternal date of symptom onset, neonatal birthday, neonatal birthweight, gestational age, and neonatal survival status within 28 days. All data were retrospectively investigated through medical records. Of the 47 mothers, 20 (42.6%) mothers survived, and 27 (57.4%) mothers died. In the group of survivors, there was a shorter period of total HD use, period of HD use before pregnancy and period of HD use to onset of symptoms. Shorter durations of HD use resulted in higher survival rate of mothers. HD use caused an increase in gestational age surviving foetuses, and foetal mortality increased when clinical symptoms developed before birth.

Exposures to humidifier disinfectant and various health conditions in Korean based on personal exposure assessment data of claimants for compensation.

BACKGROUND: Humidifier disinfectants (HDs) were commonly used household chemicals to prevent microbial growth in a humidifier water tank in South Korea. A growing body of evidence has indicated that its airborne exposure can induce severe lung injury. However, there has been low awareness of other health outcomes in HD users. This study aimed to evaluate health conditions appealed by claimants for compensation in relation with an increased exposure to HD. METHODS: From survey data of personal HD exposure assessment of claimants for compensation in Korea, we included a total of 4,179 subjects [cases in each dataset were defined by nine reported health conditions, i.e., pneumonia, asthma, cardiovascular disease, respiratory disease, otorhinolaryngologic disease, brain disease (including cerebrovascular disease), dermatological disease, lung cancer, and all cancers]. HD exposures was considered as the following exposure criteria: exposure duration, exposure proximity, exposure direction, chemical type, cumulative exposure time, indoor air concentration, and cumulative exposure level. Logistic regression models were used to evaluate the associations between HD exposure and health conditions. RESULTS: After adjusting for sociodemographic and health behavioral factors and other chemical exposures (households, environmental, and occupational exposures), an increase in cumulative HD exposure time was significantly associated with risks of all nine diseases (all p-trends < 0.05). An increase in HD exposure duration was associated with asthma, respiratory disease, otorhinolaryngologic disease, dermatological disease, all cancers, and lung cancer (p-trends < 0.05). Indoor HD concentration was associated with only pneumonia (p-trend = 0.015). CONCLUSIONS: Our findings suggest that cumulative exposures to airborne HD might potentially increase the risk of various reported health outcomes.

Unexpected Ocular Manifestations Due to Exposure to Highly Concentrated Peracetic Acid: A Case Report.

BACKGROUND Peracetic acid is among the disinfectants that irritate the upper respiratory tract, skin, and conjunctiva. It can cause symptoms of eye irritation, secondary to an inflammatory process that can lead to various manifestations. Irritation happens due to the high reduction potential of the acid, which causes the consequent release of reactive oxygen species. This fact serves to reinforce the importance of personal protective equipment when handling peracetic acid. CASE REPORT During an accident at work, a 21-year-old patient received a strong jet of disinfectant solution directly into both eyes. The composition of the disinfectant solution was 15% peracetic acid, 15-16% hydrogen peroxide, 22-23% acetic acid, and 16-17% horticultural sanitizers. Twenty-four hours after the incident, eye damage (punctate keratitis and low visual acuity) had occurred, and was treated by washing the eye with ice water and frequently applying lubricating eye drops. The next day, the patient returned with an improvement of irritative symptoms, but with a major complaint of low visual acuity in left eye, secondary to optic neuritis, detected by fundoscopy and confirmed by optical coherence tomography. In the following week, fluorescent angiography indicated the persistence of neuritis in the left eye. This was treated with prednisone, 40 mg/day, which brought about gradual improvement. Two months later, the patient returned with test results showing normal magnetic resonance imaging and negative serologies (for syphilis, HIV, and herpes virus), visual acuity 20/20 in both eyes, and normalization of angiography and optical coherence tomography parameters. CONCLUSIONS Until now, there have been no published studies demonstrating neuritis caused by direct contact of peracetic acid into the eyes. Therefore, this is the first report in the world literature of this manifestation of ocular exposure to peracetic acid. This is a chemical formulation that is widely useful and prevents the growth of various pathogens. Further investigation and studies on the subject should be encouraged to improve its management and use.

Efectos adversos asociados al uso de desinfectantes en trabajadores con neumopatía obstructiva crónica: revisión sistemática / Adverse effects associated with the use of disinfectants in workers with chronic obstructive pulmonary disease: a systematic review

Introducción: Existe evidencia del aumento progresivo de las enfermedades pulmonares crónicas en población trabajadora asociado al uso, cada vez más frecuente, de desinfectantes; pero se dispone de escasa información científica sobre sus efectos adversos en trabajadores con patología respiratoria de base. El objetivo de esta investi-gación fue conocer la evidencia científica existente sobre los efectos adversos derivados del uso de desinfectantes en trabajadores con neumopatía obstructiva crónica.Métodos: Análisis crítico de artículos mediante revisión sistemática en MEDLINE (vía PubMed), EMBASE, Cochrane Library, Scopus, Web of Science, LILACS y MEDES. La búsqueda realizada se hizo desde la primera fecha disponible hasta el 20 de diciembre de 2022. Se seleccionaron, por nivel de evidencia y criterios de inclusión y exclusión, un total de 10 artículos.Resultados: En los 10 estudios seleccionados, la exposición fue a los desinfectantes. Del total de artículos, se no-tificó la aparición de efectos adversos en 9 y un estudio no mostró relación del empeoramiento de su enfermedad respiratoria crónica con la exposición.Conclusiones: Los resultados mostraron una asociación no concluyente entre la exposición a desinfectantes y la aparición de diferentes daños para la salud en trabajadores con enfermedad pulmonar obstructiva crónica (EPOC) en diversos ámbitos laborales. Por lo tanto, son necesarios más estudios, diferenciando entre los distintos desinfec-tantes utilizados y según las características de cada puesto de trabajo (AU)

Introduction: There is evidence of a progressive increase in chronic lung diseases in the working population asso-ciated with the increasingly frequent use of disinfectants, but there is limited scientific information on their adverse effects on workers with underlying respiratory pathology. The objective of this research was to review and under-stand the existing scientific evidence on the adverse effects of disinfectant use in workers with chronic obstructive pulmonary disease.Methods: Critical analysis of articles through a systematic review in MEDLINE (via PubMed), EMBASE, Cochrane Li-brary, Scopus, Web of Science, LILACS, and MEDES. The search was conducted from the earliest available date until December 20, 2022. A total of 10 articles were selected based on the level of evidence and inclusion and exclusion criteria.Results: In the 10 selected studies, exposure was to disinfectants. Of the total articles, adverse effects were reported in 9, and one study showed no relationship between the worsening of their chronic respiratory disease and expo-sure.Conclusions: The results showed inconclusive association between exposure to disinfectants and the appearance of different health damages in workers with chronic obstructive pulmonary disease in different work settings. Therefore, it is necessary to conduct more studies that differentiate the different disinfectants used in isolation and according to the characteristics of each job position (AU)

Aislamiento de Acanthamoeba spp. en salas cerradas de un hospital de la provincia de Buenos Aires, Argentina / Isolation of Acanthamoeba spp. in closed rooms of a hospital in Buenos Aires province, Argentina

Resumen Las amebas de vida libre (AVL) son protozoos ubicuos con cuatro géneros patógenos para el ser humano: Acanthamoeba, Naegleria, Balamuthia, y Sappinia. Acanthamoeba puede actuar como reservorio de microorganismos (endosimbiontes), por lo cual, en medio hospitalario, implicaría un riesgo para la transmisión de bacterias, virus y hongos intranosocomiales. Se investigó la presencia de AVL, con énfasis en Acanthamoeba spp., en un hospital pediátrico de la provincia de Buenos Aires, Argentina. Se colectaron 22 muestras de lavamanos e incubadoras en salas de Neonatología y Terapia Intensiva, las que fueron cultivadas a 37 y 42 °C. Los aislados fueron identificados molecularmente. El 63,64% de las muestras presentaron Acanthamoeba spp. Esta investigación representa el primer estudio realizado en la Argentina sobre la detección de Acanthamoeba spp. en salas cerradas de un hospital. Su presencia es una señal de alarma y resulta un blanco útil para investigar posibles reservorios de microorganismos patógenos en ambientes hospitalarios.

Abstract Free-living amoebae (FLA) are ubiquitous protozoa with four pathogenic genera for humans: Acanthamoeba, Naegleria, Balamuthia, and Sappinia. Acanthamoeba can act as a reservoir of microorganisms (endosymbionts), for which reason, in a hospital environment, it would imply a risk for transmission of nosocomial bacteria, viruses and fungi. The presence of AVL, with emphasis on Acanthamoeba spp., was investigated in a pediatric hospital. Twenty-two samples were collected from sinks and incubators in Neonatology and Intensive Care rooms, which were cultured at 37 and 42 °C. The isolates found were molecularly identified. A total of 63.64% of the samples presented Acanthamoeba spp. This research represents the first study in Argentina on the detection of Acanthamoeba spp. in closed rooms of a hospital. Its presence is an alarm signal, and it is a useful target to investigate possible reservoirs of pathogenic microorganisms in hospital environments.

Resumo As amebas de vida livre (AVL) são protozoários ubíquos com quatro gêneros patogênicos para o ser humano: Acanthamoeba, Naegleria, Balamuthia, e Sappinia. Acanthamoeba pode atuar como um reservatório de microrganismos (endossimbiontes), e portanto, em um ambiente hospitalar, representaria um risco de transmissão de bactérias, vírus e fungos intra-nosocomiais. A presença de AVL, com em Acanthamoeba spp. em um hospital pediátrico da província de Buenos Aires, Argentina, foi investigada. Vinte e duas amostras foram coletadas em lavatórios e incubadoras em Salas de Neonatologia e Cuidados Intensivos, cultivadas a 37 e 42 °C. Os isolados foram identificadas molecularmente. Foram encontradas Acanthamoeba spp. em 63,64% das amostras. Esta investigação representa o primeiro estudo realizado na Argentina sobre a detecção de Acanthamoeba spp. em salas fechadas de um hospital. A sua presença é um sinal de alarme e um alvo para investigar possíveis reservatórios de microrganismos patogênicos em ambientes hospitalares.

Household disinfection practices by women living in Egypt during the 2020 COVID-19 lockdown and the association of information sources and suspected bleach toxicity.

INTRODUCTION: The spread of contradictory health information was a hallmark of the early COVID-19 pandemic. Because of a limited understanding of the disease, its mode of transmission, and its pathogenicity, the public turned to easily accessible and familiar sources of information. Some of these sources included wrong or incomplete information that could increase health risks and incidents of toxicity due to improper information about the usage of disinfectants. The objective of this study was to assess the relationship between sources of information about the COVID-19 pandemic, the related household cleaning and disinfection practices among adult women living in Egypt, and the associated adverse effects of bleach toxicity during a national lockdown. METHODS: Through a self-administered online survey, 452 adult women (18 years and older) living in Egypt were recruited from 13 cities between 4 June 2022 and 4 July 2022 to answer the questionnaire. The questionnaire included (41) questions in Arabic and collected data about respondents' household cleaning and disinfection practices to prevent the spread of the SARS-CoV-2 virus and protect their families during the lockdown that started in Egypt in March 2020. RESULTS: The study found that 88.1% (n = 398) of participants reported increased use of disinfectants during the lockdown. Women who chose social media as their primary source of information to learn about disinfection practices reported an increased frequency of respiratory symptoms associated with bleach toxicity (correlation coefficient = 0.10, p-value = 0.03), followed by women who depended on relatives and friends as the primary source of information (correlation coefficient = 0.10, p-value = 0.02). CONCLUSION: This study showed that social media is an easily accessible, efficient and fast communication tool that can act as a primary source for individuals seeking medical information compared to other media platforms (e.g., websites, T.V., satellite channels). However, better regulations and monitoring of its content may help limit the harms caused by the misinformation and disinformation spread by these popular platforms, particularly in times of uncertainty and upheaval.

Reduced Diffusing Capacity in Humidifier Disinfectant-Associated Asthma Versus Typical Asthma: A Retrospective Case Control Study.

BACKGROUND: Humidifier disinfectant-related lung injury (HDLI) is a severe form of toxic inhalational pulmonary parenchymal damage found in residents of South Korea previously exposed to specific guanidine-based compounds present in humidifier disinfectants (HD). HD-associated asthma (HDA), which is similar to irritant-induced asthma, has been recognized in victims with asthma-like symptoms and is probably caused by airway injury. In this study, diffusing capacity of the lung for carbon monoxide (DLCO) in individuals with HDA was compared to that in individuals with pre-existing asthma without HD exposure. METHODS: We retrospectively compared data, including DLCO values, of 70 patients with HDA with that of 79 patients having pre-existing asthma without any known exposure to HD (controls). Multiple linear regression analysis and logistic regression analysis were performed to confirm the association between HD exposure and DLCO after controlling for confounding factors. The correlation between DLCO and several indicators related to HD exposure was evaluated in patients with HDA. RESULT: The mean DLCO was significantly lower in the HDA group than in the control group (81.9% vs. 88.6%; P = 0.021). The mean DLCO of asthma patients with definite HD exposure was significantly lower than that of asthma patients with lesser exposure (P for trend = 0.002). In multivariable regression models, DLCO in the HDA group decreased by 5.8%, and patients with HDA were 2.1-fold more likely to have a lower DLCO than the controls. Pathway analysis showed that exposure to HD directly affected DLCO values and indirectly affected its measurement through a decrease in the forced vital capacity (FVC). Correlation analysis indicated a significant inverse correlation between DLCO% and cumulative HD exposure time. CONCLUSION: DLCO was lower in patients with HDA than in asthma patients without HD exposure, and decreased FVC partially mediated this effect. Therefore, monitoring the DLCO may be useful for early diagnosis of HDA in patients with asthma symptoms and history of HD exposure.

Use and management of disinfectants by dentists in San Luis Potosi, Mexico, during the covid-19 pandemic / Uso y manejo de desinfectantes por odontólogos de San Luis Potosí, México durante la pandemia covid-19

Introduction: Chlorine, ethyl alcohol, and quaternary ammonium are disinfectants with antiviral activity against SARS-Cov2. However, there are no previous reports of their use and handling for cleaning and disinfection in dental offices. Objetive: To determine the use and management of disinfectants in critical and non-critical areas used by dentists in San Luis Potosí, Mexico, during the COVID-19 pandemic. Material and Methods: A validated cross-sectional survey was applied online to 100 dentists in San Luis Potosí between February and June 2021. Participants were informed about the handling of personal data according to the standard DOF regulations (DOF 07-05-2010). Results: A total of 100 dentists were included in the study, 63% female and 37% male, with a mean age of 26 years. The most widely used disinfectants during the pandemic in critical areas were Lysol® and 0.1% sodium hypochlorite in non-critical areas. Eighty-five percent of dentists know the adverse effects of inappropriate use of disinfectants, 72% did not have any sign or symptom associated with the use of disinfectants. The most used protection barrier was gloves (97%). Sixty-seven per cent of dentists disposed of disinfectant waste down the drain. Conclusion: Sodium hypochlorite and quaternary ammonium compounds and/or ethanol are used to clean non-critical and critical areas in dental offices. However, appropriate measures for their management are not adopted. It is necessary to implement educational strategies to improve the use and management of disinfectants in dental practice.

Introducción: Cloro, alcohol etílico y amonio cuaternario son desinfectantes que muestran actividad antiviral contra el SARS-Cov2, sin embargo, no existen reportes previos de su uso y manejo para la limpieza y desinfección en clínicas dentales. Objetivo: Determinar el uso y manejo de los desinfectantes en áreas críticas y no críticas empleados por los odontólogos en San Luis Potosí durante la COVID-19. Material y Métodos: Encuesta transversal validada y aplicada on-line a 100 odontólogos de San Luis Potosí durante febrero-junio 2021. Se informó a los participantes sobre el manejo de datos personales de acuerdo a la norma (DOF 05-07-2010). Resultados: Se incluyeron un total de 100 odontólogos, 63% del sexo femenino y 37% del sexo masculino, con una edad promedio de 26 años. Los desinfectantes más utilizados durante la pandemia en las áreas críticas fueron el Lysol® y el hipoclorito de sodio al 0.1% en áreas no críticas. El 85% de los odontólogos conocen los efectos adversos del uso inadecuado de los desinfectantes, 72% no tuvieron algún signo o síntoma asociado al uso de desinfectantes. La barrera de protección más utilizada fueron los guantes (97%). El 67% de los odontólogos eliminó los desechos de desinfectantes por la coladera. Conclusión: Para la limpieza de las áreas no críticas y críticas en las clínicas dentales se utilizan el hipoclorito de Sodio y compuestos de amonio cuaternario y/o etanol, sin embargo, no se utilizan las medidas adecuadas para su manejo. Es necesario implementar estrategias educativas para mejorar el uso y manejo de desinfectantes en la práctica dental.

Acute respiratory distress after exposure to chlorine dioxide-based disinfectant.

A hospital cleaner developed acute respiratory distress after working with a chlorine dioxide-based disinfectant. The content of chlorine dioxide in the product is below the limit that would require the product to be labelled as hazardous to health, but we show with a simple estimation that the relevant threshold limit values for chlorine dioxide in the working atmosphere may be exceeded under normal use of the product. This may have implications for risk assessment of the use of such chlorine dioxide-based disinfectants and may warrant stricter regulations for labelling these products.

Injection Injury Caused by Disinfectant During COVID-19: A Case Report.

High-pressure injection injury of the hand is a rare but severe emergency, which requires full attention and timely treatment. However, the early symptoms may not be obvious. As the swelling and necrosis progress, the condition gradually worsens, and in severe cases, it may end with amputation. We report a particular case of a hand injection injury, which occurred to a worker who worked overtime to produce disinfectant during the Coronavirus Disease-19 (COVID-19) pandemic. Because of the chemical toxicity of the disinfectant and pressure's damage, although the emergency debridement was promptly performed, we still lost some fingers in the end. In the existing disinfection product manuals, we have not seen any tips on dealing with tissue injection injury. It may reduce workers' attention to injuries, leading to delays in emergency operations.

CE: Environments & Health: Chemicals in the Home That Can Exacerbate Asthma.

ABSTRACT: Although chemical exposures from cleaning and disinfectant products often go unnoticed or unrecognized, such exposures have been associated with asthma-related symptoms and exacerbations. The Environmental Working Group (EWG) website provides consumer information on a wide range of issues and products related to human health and the environment, including the use of cleaning and disinfectant products, 2,500 of which it has rated in terms of their effects on respiratory function and asthma. In discussing how the use of cleaning and disinfectant products and the frequency of their use may affect asthma control, the authors use the EWG ratings as well as data collected for a study they conducted on older adults with asthma.

Association between household cleaning product profiles evaluated by the Ménag'Score® index and asthma symptoms among women from the SEPAGES cohort.

OBJECTIVE: Considering household disinfectants and cleaning products (HDCP) as mixture of ingredients, rather than each ingredient individually, might help in characterizing their role in asthma. We investigated the association between HDCP and asthma, using the recently developed Ménag'Score®, a health risk assessment score based on exhaustive ingredient lists of HDCP. METHODS: The study is based on 103 female volunteers of the SEPAGES cohort (2014-2019), with repeated data (up to 3 collection times, 200 observations). HDCP use was assessed from a barcode-based smartphone application linked with an ingredient database. The Ménag'score® risks for health and environment were computed for each weekly used HDCP from their exhaustive ingredient data (from A: no known risk to E: highest risk). The association between the use of HDCP with a poor Ménag'score® (D or E; overall, health, environment scores) and asthma symptoms, was estimated by generalized estimating equations models adjusted for age, BMI and smoking status. RESULTS: Participants were on average 33 years old, 11% smoked and 20% had at least one asthma symptom. The Ménag'score® was computed for 540 HDCP scanned by participants. Weekly use of HDCP with a poor Ménag'score®-health (around 60% of the participants) was associated with a higher risk of asthma symptoms (OR 3.13, 95% CI [1.32-7.43]). No association was observed for the Ménag'score®-environment. CONCLUSION: The use of HDCP with a poor Ménag'score®-health was associated with asthma symptoms. The results support the use of the Ménag'score®-health to further evaluate the health risks of HDCP in observational studies and as a potential public health tool.