Occupational exposures to dust, fumes, chemicals and gases are associated with increased prevalence of respiratory symptoms and impairment of lung function . Exposure to dust has long been associated with the prevalence of varying degrees of airway obstruction and respiratory symptoms in human . Substances found in the workplace cause the airways of the lungs to swell and narrow, leading to attacks of wheezing, shortness of breath, chest tightness, and coughing .
Dust and different chemicals impairs lung function and causes respiratory symptoms such as cough, wheezing, shortness of breath and chest pain. The incidence depends upon the chemical composition of dust, size of the particles, duration of exposure and individual susceptibility  and severity depends on several factors including the chemical nature, physical state of the inhaled substance, the size & concentration of the dust and chemical particles and the duration of exposure .
Cleaning services include a broad range of activities and are performed in different work environments, such as homes, offices, industries, schools, shops, aircrafts and hospitals. The risks that cleaners may be exposed to therefore depend on the tasks they perform. Moreover, cleaning worker often lack training, tools and information in order to perform their work in the best healthy and safe manner .
Cleaning agents contain both volatile and nonvolatile substances. The application of common cleaning products results in excessive exposure to potentially harmful volatile pollutants . Cleaning products have emerged as a significant respiratory hazard for cleaners. Most cleaning agents have an irritating effect on mucous membranes and the skin (e.g. Chlorine and Ammonia) and have a sensitizing potential (e.g. monoethanolamine and aldehydes). Thus, these products have been implicated in different respiratory conditions, including work-related asthma .
Ammonia is often included in glass cleaner and other hard-surface cleaner chemicals, and can irritate the skin, eyes, throat, and lungs. Ammonium quaternary compounds are a family of chemicals known for their disinfectant and detergent properties. They are found in cleaning products like disinfectant sprays and toilet cleaners, and have been identified as a known inducer of occupational asthma among cleaning workers .
Chlorine bleach or sodium hypochlorite is the most commonly used disinfecting and cleaning agent. It is now used in daily life for a variety of applications such as water and food disinfection and cleaning of surfaces in public and private buildings . However, chlorine bleach is unstable and highly reactive chemical. When mixed with other cleaning agents, chlorine bleach can release chlorine or tri-chloramine, two gases which are strong irritant to the eyes and the respiratory tract. Exposure to chlorine gas can cause coughing, shortness of breath, chest pain, nausea, or other symptoms [7, 8]. The acute inhalation in toxic concentrations of the respiratory irritants such as hypochlorite and chlorine gas results in a clinical entity described as reactive airways dysfunction syndrome .
Monoethanolamine (MEA) is a surfactant commonly found in detergents which enhances the cleaning power of it. MEA is used in cleaning products such as laundry detergents, and floor cleaners and has been identified as a known inducer of occupational asthma in cleaning workers .
Aldehydes are extensively used in medical facilities for disinfecting heat sensitive equipment such as fiber optic endoscopes. They can cause mucous irritation, respiratory symptoms, and immunoglobulin IgE–mediated hypersensitivity reactions, and are well-known causative agents of occupational asthma .
Even though great attention has been given to different occupations on health, pulmonary function complications of cleaners have been poorly characterized. The alterations of pulmonary function of professional hospital cleaners have not been significantly addressed previously in Ethiopia.
Hence, this study was planned to assess the prevalence of respiratory symptoms among cleaners working in a hospital setting and compare the results with a control group who are not exposed to cleaning products and dust at work. The study will further improve the rate of morbidity and mortality in patients with pulmonary function impairment by creating prior awareness and behavioral changes which will be used to minimize unnecessary health costs through promoting the use of personal protective devices.