Respiratory Health Risks Linked to Chemical Cleaners and Biomass Fuel in Homes

Experts presented new insights on the impact of indoor air pollution from biomass combustion and household cleaning products, highlighting their contribution to respiratory health risks and opportunities for prevention during the European Respiratory Society (ERS) Congress 2025 in Amsterdam, Netherlands.

Biomass Pollution and COPD Risk

The session began with Nicolas Roche introducing Naresh Gupta, a professor from Guru Gobind Singh Indraprastha University in New Delhi, India. Gupta discussed the widespread use of biomass fuels—such as wood and dung—for cooking and heating, noting that 41% of India’s population continues to rely on these sources.

Gupta shared data from a meta-analysis presented indicating that use of solid biomass fuels increases the risk of chronic obstructive pulmonary disease (COPD) by a factor of 2.65 compared with non-biomass fuels.

He explained that traditional stoves often burn fuel inefficiently, producing particulate matter (PM 2.5 and PM 10), black carbon, and other gases that accumulate in poorly ventilated homes. Gupta outlined the associations between these exposures and conditions such as pneumonia, COPD, cardiovascular disease, and lung cancer.

Drawing from field studies in rural India, Gupta compared households using biomass fuels with those relying on liquefied petroleum gas (LPG). Biomass households showed higher concentrations of indoor particulate matter and black carbon, alongside higher reported rates of chronic cough, wheezing, and shortness of breath. Women, who are more likely to spend extended time in kitchens, appeared especially affected, though Gupta noted this remains an area requiring further research. The professor closed out the session with recommendations for improved ventilation, wider access to LPG, and more efficient stove designs, as they could reduce exposure and improve respiratory outcomes.

Health Impacts of Cleaning Products

Sarah De Matteis, PhD, professor of occupational and environmental medicine at the the University of Turin in Italy, addressed indoor exposures from cleaning products. She noted that disinfectant use rose sharply during the COVID-19 pandemic and remains high in both occupational and household settings.

De Matteis presented evidence linking cleaning product exposure to asthma, COPD, and other respiratory symptoms, with professional cleaners experiencing the highest risks. She described potential mechanisms, including irritant and allergic airway responses, but emphasized that incomplete labeling and frequent reformulations make it challenging to fully evaluate health impacts.

She highlighted prevention strategies such as substituting hazardous ingredients, using “green” products or simple alternatives like vinegar and bicarbonate, and ensuring adequate ventilation.

For providers, they may need to be aware of their patients that may be exposed to these agents, such as professional house cleaners. Additionally, administrators should be aware of the risks to their hospital cleaning staff, as disease control and disinfection are paramount in health facilities. The speaker also mentioned the risks of mixing bleach products with acid or ammonia-based products, which can create toxic gasses that can cause serious injury and possibly death.

De Matteis also underscored the importance of awareness and training for professional cleaners and suggested that respiratory effects from long-term exposure could be considered within occupational health frameworks. When asked about face mask use for protection, she noted that small chemical products can still penetrate traditional hospital masks, and more protection may be required.

De Matteis concluded, “The most important thing is ventilation and to use the cleaning products appropriately... At my hospital, when the [custodial staff] cleans, they want to do the job very quickly; they often put a lot of concentrated product on a surface without diluting it or mixing and matching. All these highly concentrated volatile agents are irritants. So it's obvious that they can harm our lungs, and so we have to improve exposure in the ambient environment and in the procedures, and better information access, training, and awareness are the best first steps. But as researchers, we will have to study the effect more.”

Questions and Broader Implications

During the discussion, an audience member asked about the potential long-term and intergenerational effects of exposure. Gupta noted that some studies suggest biomass smoke exposure during childhood may affect lung function, though data on maternal exposure during pregnancy remain limited.

He also noted a higher likelihood of biomass exposure causing health problems among female children, who may have been shadowing their mothers while they were cooking. Similarly, De Matteis referenced a study associating maternal cleaning product use with increased risk of childhood asthma, while emphasizing that more research is needed to understand adult outcomes.

The panel also considered awareness campaigns and interventions. Gupta mentioned government and NGO programs in India aimed at promoting LPG and improved cookstoves, though uptake has been uneven due to cost and cultural practices. De Matteis highlighted the role of education in encouraging safe cleaning practices and informed product choices.

In closing remarks, Gupta pointed to the potential benefits of reducing biomass smoke exposure through improved stove efficiency and wider LPG adoption. De Matteis emphasized the importance of increasing awareness of cleaning product–related respiratory risks and promoting safer alternatives where feasible.

The session concluded with a shared perspective: addressing indoor air pollution, whether from cooking fuels or cleaning agents, remains an important step toward reducing preventable respiratory disease worldwide.