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Indoor Cleaning Services

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General Profile

Cleaning consists of dusting, washing and polishing surfaces; washing walls; mopping, sweeping and polishing floors; as well as disposing of waste and waste water. It is done in offices, public and commercial buildings, homes and factories. It may be done in confined spaces with little ventilation and in spaces not designed with cleaning in mind. Cleaners may be independent or be employed by the enterprise which owns the facilities being cleaned, or they may work for private contractors. Those who clean may be called cleaners, housekeepers, chars, custodians or janitors, depending on the spaces cleaned and the details of the assigned tasks. For example, janitors and custodians may combine cleaning with maintenance and repair work.

Cleaners have usually worked relatively autonomously, compared to other employment categories of similar prestige. Inspection is done by supervisors, although the users of the cleaned spaces also comment on the cleaners’ work. Workers tend to order the tasks themselves and develop their own procedures (Messing, Haëntjens and Doniol-Shaw 1993). However, in commercial spaces in North America, cleaners’ routes have increasingly been determined using software programmed to take account of furniture, floor surfaces and crowding. The desired frequency of operations, area to be cleaned and time estimated for the type of area are used to calculate the total time required. Inspection may be done using a computer-programmed spot check procedure. Some of these procedures may severely underestimate the task as performed in shared space, especially if the inventory is not brought regularly up to date (Messing, Chatigny and Courville 1996).

In Canada, cleaning is the eighth most common profession of men and the tenth most common profession of women; women make up 46% of the profession (Armstrong and Armstrong 1994). In France in 1991, 229,000 cleaners worked for 9,000 cleaning companies; about a third were immigrants and 64% were women (Bretin 1994). In Denmark 85% of the 130,000 cleaners are women (Nielsen 1995). In some countries, tasks in factories and services have often been divided into “light” and “heavy”, assigned formally or informally to female and male workers respectively, who may be paid at different rates (Government of Quebec 1994). Women may dust and polish surfaces, clean bathrooms and empty wastebaskets while men sweep, mop and polish floors and carry waste to incinerators (Messing, Haëntjens and Doniol-Shaw 1993; Messing, Doniol-Shaw and Haëntjens 1993; Messing, Chatigny and Courville 1996). In other countries, men and women can be assigned to all cleaning tasks (Nielsen 1995; Hagner and Hagberg 1989). Cleaners are often relatively old compared to other workers (Bretin et al. 1992; Messing 1991; Nielsen 1995).

Risk Factors and Prevention Strategies

Cleaning may be done with hand-held tools such as brushes, brooms, rags and mops, or may be aided by machines. A variety of chemicals are used to dissolve dirt and to make surfaces appear clean and shiny. The difficulty of the task varies according to the type of surface (rough, smooth, pitted), the height and geometry of the objects cleaned, the degree of crowding of spaces and the vocations exercised in the spaces cleaned. In some places, the need for cleaning may be reduced or eliminated by design changes in the object cleaned (such as self-flushing toilets).

Musculoskeletal load

Cleaning, particularly cleaning furniture and bathrooms and emptying wastebaskets, involves rapid postural changes and many awkward and constrained postures (see table 1). Many objects must be cleaned, at a variety of heights; a typical sequence observed for dusting in a hospital room was: table (81 cm), television (196 cm), table (81 cm), telephone (81 cm), lamp (extends to 188 cm), table foot (11 cm), chair (46 cm), screen (81 cm), armchair (46 cm), window ledge (89 cm), wall sphygmomanometer (154 cm), chair legs (floor to 46 cm), oxygen fixture (137 cm) (Messing, Chatigny and Courville 1995).

Table 1. Postures observed during dusting in a hospital.

Activity

Duration

Extension (%)

Neutral (%)

Bending <45º (%)

Bending ≥45º (%)

Not observable
on video (%)

Clean nurse station

3 m, 26 s

—

13.6

86.4

—

—

Waste-basket (3)

1 m, 26 s

—

19.8

71.1

9.2

—

Bath (2)

5 m, 17 s

2.8

26.6

63.1

7.5

—

Bathroom corridor (2)

3 m, 53 s

6.6

18.6

71.0

3.8

0.3

Clean rooms

8 m, 45 s

3.7

29.8

60.1

2.9

3.5

Reception area

3 m, 13 s

—

24.7

74.4

—

0.9

Secretaries’ office

10 m, 20 s

3.6

32.0

59.7

0.3

4.4

Overall

36 m, 20 s

3.0

26.4

65.8

2.7

2.2

Source: Messing, Chatigny and Courville 1995.

Floor cleaning requires repeated movements (fundamental cycle time of 1 to 2 seconds in the Sogaard, Fallentin and Nielsen (1996) study) and a sustained moderate bending of the back. Constant pressure is exerted by the hands to push vacuum cleaners or buffers, tasks requiring forces near 10 kg (Messing, Chatigny and Courville 1996). Sogaard, Fallentin and Nielsen (1996) found mean back bending during floor mopping to be 28º and mean neck bending to be 51º. Hagner and Hagberg (1989) also noted static muscular loads especially at the shoulder joint. Nordin et al. (1986) found extensive forward trunk bending in a simulated janitorial task involving floor mopping. Cleaning floors and objects is usually done with repeated movements. Sogaard (1994) suggests that the sustained repetitive motions with infrequent pauses in activity may exhaust the relatively small numbers of muscle fibres involved and result in muscular disorders.

In order to clean, many objects must be moved. During 66 minutes cleaning and polishing floors, 0.7 objects had to be moved per minute, with weights up to 10 kg; during 23 minutes of dusting, 3.7 objects were moved per minute, with weights up to 2 kg (Messing, Chatigny and Courville 1995).

Winkel et al. (1983) and Hagner and Hagberg (1989) note that increasing specialization and standardization have reduced the number of opportunities to vary body movements and postures during cleaning work. It is therefore important to provide adequate break time. Formal or informal division of tasks according to sex may increase the likelihood of musculoskeletal problems by decreasing the variation in movements (Messing, Haëntjens and Doniol-Shaw 1993).

Cardiovascular load

The cardiovascular load can be quite heavy. Johansson and Ljunggren (1989) recorded the heart rate of female cleaners during office or toilet cleaning at 123 beats/minute, 65% of the maximum for their average age of 29.8 years (corresponding to about 35% of their estimated maximal oxygen uptake or VO2 max, close to that of construction workers). Swabbing or mopping resulted in similar heart rates of 122 to 127 beats/minute. Hagner and Hagberg (1989) found a high level of oxygen consumption (up to 40% of the VO2 max) among cleaners doing floor mopping under experimental conditions. Sogaard (1994) found that relative cardiovascular strain of female school cleaners measured in the workplace was 53% of the VO2 max.

To prevent musculoskeletal problems and decrease the cardiovascular load, workload should be appropriate and sufficient rest time should be allowed. Attention should be paid to ease of cleaning when spaces and procedures are being designed and when furnishings are purchased. Vacuuming requires less force if carpets are carefully laid so as not to wrinkle when the vacuum cleaner is passed. The use of adequate tools is important. For example, extendable brushes for dusting can reduce the necessity to reach or climb. Prolonged bending can be minimized if efficient chemicals and tools make it possible to clean quickly, and if cleaning is frequent enough so that dirt does not become hardened.

The common practice of reducing the rate of ventilation in buildings during the evening or night hours, when cleaning is done, reduces air quality for cleaning workers who work during these times and should be avoided. To prevent overwork in the case where cleaning is planned using purchased software, careful observation and verification should be done in order to make sure that times allotted are realistic and take into account multiple use of spaces cleaned. Inventories of rooms and objects cleaned should be updated frequently.

Procedures and apparatus for emptying wastebaskets into bins, and bins into incinerators, have been developed so that manual lifting can be avoided.

Chemicals

Chemicals can be classed as soaps, detergents, disinfectants, porcelain cleaners, scouring powders, wax removers and strippers, solvents, pesticides and drain cleaners. They may contain other ingredients such as fragrances and colouring agents. There may be surface skin contact or they may be inhaled or absorbed through the skin into the system. Damage to the skin, eyes, throat or lungs can result. The risk of exposure depends on the concentration of the chemical and how it is used. Sprays volatilize chemicals and increase exposure. Some chemicals are irritants at low concentration and corrosive at high concentration (acids, oxidizing agents or bases). Others are effective solvents or detergents which may damage the skin barrier and make it more vulnerable to other chemical agents. Still others contain metals (nickel, cobalt, chrome) or other substances which can act as allergens.

Cleaning agents are often sold at high concentrations and diluted on site for use. The common practice of using chemicals at a higher concentration than recommended, in the hope of cleaning more quickly or more efficiently, is a source of overexposure and should be remedied by proper education and by adjusting the workload. Mixing different chemicals can cause accidental intoxication or burns. Work with strong chemicals in poorly ventilated spaces can be a hazard for cleaners and should be avoided.

The Danish Product Register Data Base PROBAS contains information on 2,567 washing and cleaning agents. Of these, 70 are considered to be potentially harmful agents causing chronic or acute health damage, such as corrosives, carcinogens, reproductive toxicants, allergens and neurotoxic agents (Borglum and Hansen 1994). These agents are presented in table 2. A study of the PROBAS register found 33 contact allergens in cleaning agents (Flyvholm 1993).

Table 2. Dangerous chemicals used in cleaning.†

 Chemical

 Health damage codes

 Other hazards

Solvents

Butylglycol

N*

 

Isopropyl benzene

N

 

Naphtha, white spirit,

Stoddard solvent

N,R

 

Toluene

N,R

Flammable

Ethanol

R

Flammable

2-Ethoxyethanol

N,R

 

2-Methoxyethanol

R

 

1-Methyl-2-pyrrolido

R

 

Base oil, crude oil

N

 

Tetrachloroethylene

N,R

 

1,1,1-Trichloroethane

N

 

Xylene

N,R*

Flammable

Butyldiglycol

I

 

Acids and bases

Acetic acid

C

 

Ammonium hydroxide

I

Reacts with chlorine bleaches to liberate toxic gas

Potassium hydroxide

C

 

Sodium carbonate

I

 

Sodium hydroxide

C

 

Phosphoric acid

C

 

Sulphuric acid

C

 

Residual monomers and impurities

Formaldehyde

A,K*

 

Phenol

N*

 

Benzene

K,R,N

 

Acrylonitrile

A,K

 

Butylacrylate

A

 

Methylmethacrylate

A,R

 

Styrene

R

Flammable

1-Propanol

N

Flammable

Ethyl acrylate

A,K*

 

1,2-Ethylene diamine

A

 

Ethylene oxide

A,K,R

Flammable

Propylene oxide

K

Flammable

2-Methylaniline

K

 

2-Propyn-1-ol

N

 

Chelators

Sodium EDTA (ethylene diamine tetraacetic acid)

R

 

Sodium NTA (nitrilotriacetic acid)

K

 

Anti-rusts

2-Aminoethanol

N

 

Triethanolamine

A

 

Hexamethylene tetramine

A

 

2-Butyn-1,4-diol

C,T

 

Disodium metasilicate

C,I

 

2-(3H)-Benzothiazolethione

A

 

Disinfectants

Borax

R

 

Disodium tetraborate

R

 

Morpholine

N

 

Benzalkonium chloride

C

 

Sodium dichloroisocyanurate

I

Reacts with acid to liberate toxic gas

Sodium hypochlorite

C

Reacts with acid or ammonia to release toxic gases

Preserving agents

1,2-Bensisothiazol-3(2H)-one

A

 

5-Chlor-2-methyl-3-isothiazolone

A

 

2-Methyl-3-isothiazolone

A

 

2-Chloracetamide

A

 

p-Chlor-m-cresol

A

 

Hexahydro-1,3,5-tris-

(2-hydroxyethyl)1,3,5-triazine

A

 

1,5-Pentadiol

A

 

2-Bromo-2-nitro-1,3-propanediol

T

 

Fillers

Quartz

K

 

Silicon dioxide

K

 

Sodium hydrogen sulphate

C

 

Others

Subtilisin (Enzyme)

A

 

Sodium saccharine

K

 

Ammonium peroxodisulphate

(bleaching agent)

A

 

A = allergen; C = corrosive; I = irritant; K = carcinogen; N = neurotoxic agent; R = reproductive toxic agent; T = toxic if swallowed; * = danger dependent on concentration.

Determination of toxicity was done by the Danish Institute of Occupational Health. 

†Note that not all cleaning agents have been tested for all toxic properties, so that this list is not necessarily complete or comprehensive.

Source: Summarized from Borglum and Hansen 1994.

Cleaners who work in factories or hospitals may be exposed to chemicals (or biohazards) associated with the ongoing activities in the spaces they clean. If cleaners are not integrated into the training programmes and social network of the regular workforce, they may be less aware of these hazards than other workers. For example, one study showed that cleaners were the group most often exposed to harmful chemicals of all categories of hospital workers (Weaver et al. 1993).

There is some controversy about the use of gloves for cleaning work. Gloves play an important role in protecting the skin from hazardous agents if they fit correctly and are made of impermeable and resistant materials. But wearing gloves constantly can keep perspiration from evaporating. The resulting damp area is a favourable growth medium for infectious agents. Wearing gloves was associated with skin problems in a large sample of Danish cleaners (Nielsen 1996). It is therefore best to wear gloves the minimum time compatible with protection. The necessity for wearing gloves can often be obviated by using tools with long handles, or by other changes in methods. Wearing cotton gloves under rubber or plastic gloves may reduce humidity and protect against allergies to some glove materials (Foussereau et al. 1982). Some hand creams may contain irritants and should be avoided (Hansen 1983).

Several other practices diminish exposure to chemicals. When cleaning solutions are stored or prepared, there should be good ventilation, and procedures should permit preparation without any danger of touching or breathing the chemicals. The temptation to work with undiluted chemicals will diminish if workers have adequate time and implements. Also, cleaners may use undiluted chemicals or chemicals that have allergenic fragrances in order to signal to others that they have done their job. This can be done by other means, such as clear inspection procedures and communication links with other workers and with clients of cleaning services.

Useful information on prevention of exposure to chemicals can be found in a handbook published by the City of New York (Michaels, undated).

Other health risks

Cleaners often work evening or night shifts, so as not to interfere with the other activities being carried out in the same spaces. They may therefore suffer the usual effects of shift work on biorhythms. In addition, they may risk violence if they work alone in isolated areas.

Cleaners, particularly those who work outside regular building hours and/or who are not part of the regular personnel, may be ignored and excluded from the social network in their workplaces (Messing in press). They may not be given access to the appropriate facilities for breaks and meals. Aside from the psychological effects of exclusion, cleaners may be deprived of information on hazards routinely given to other workers, despite legal requirements in many jurisdictions to provide this information. Also, despite the importance of surface textures and design for their work, they and their supervisors may not be consulted when relevant purchasing and planning decisions are made. This is especially true if cleaning is contracted out. It is therefore important that a special effort be made to include cleaners in occupational health and safety promotion activities in the workplace. Information on characteristics of chemicals, on work procedures and on safety should be discussed with cleaners and clearly posted in the workplace.

Health Effects and Disease Patterns

Cleaners as a profession have poorer health than others (Nielsen 1995; ASSTSAS 1993; Sogaard 1994). Comparing cleaners with other workers, an analysis of the Quebec Health Survey found, after controlling for age, that women cleaners had the highest prevalence of chronic back problems and cardiopathies of all categories of women workers and that male cleaners had the highest prevalence of musculoskeletal problems and cardiopathies (Gervais 1993). Pregnant cleaners have an increased likelihood of miscarriage (McDonald et al. 1986), giving birth prematurely (McDonald et al. 1988) or bearing children with low birth weight (McDonald et al. 1987).

Some large population-based epidemiological studies have found high cancer rates among cleaners. Rates of some brain tumours among US White men have been found to be especially high for cleaning service workers (Demers, Vaughan and Schommer 1991). Among women, invasive cervical cancer is almost five times more common among cleaners than other women (Savitz, Andrews and Brinton 1995). These results are attributed to chemical exposures, particularly solvents.

Musculoskeletal problems are often encountered. In Denmark, Nielsen (1995) found that those who left cleaning had a reduced frequency of musculoskeletal symptoms compared to those who stayed in the profession. Cleaning was one of the five trades reporting the most shoulder/neck pain, tendovaginitis and low back pain (Sogaard, Fallentin and Nielsen 1996). A population-based epidemiological study found female cleaners to be particularly likely to have osteoarthritis of the knee, compared to other Swedish workers (Vingard et al. 1991). Cleaners in Quebec hospitals suffer almost twice as many occupational accidents and illnesses as the average Quebec health care worker: 23.8 compared to 13.9 per 100 full-time equivalent workers per year (ASSTSAS 1993). Most lesions involved the trunk or upper limbs (ASSTSAS 1993). Comparing male with female cleaners, a survey of cleaners in the Paris region in France found that men had more back pain and women had more joint pain (Opatowski et al. 1995). These differences are probably attributable to specificities in the tasks assigned to women and men cleaners (Messing, Haëntjens and Doniol-Shaw 1993; Messing, Doniol-Shaw and Haëntjens 1993; Messing, Chatigny and Courville 1996).

Cleaners have a high level of skin problems, including dermatitis and eczema (Gawkrodger, Lloyd and Hunter 1986; Singgih et al. 1986). Point prevalences of skin diseases of 15 to 18%and a duration of employment prevalence of 39%have been found among large samples of hospital cleaners (Hansen 1983; Delaporte et al. 1990). Cleaners who spend more time with wet hands have more skin problems (Nielsen 1996). Cleaners may also be injured or infected by broken glass, needles or other sharp objects while handling waste (ASSTSAS 1993).

Recently, occupational health specialists have noted symptoms of stress related to work among hospital cleaners, for which they suggest re-examination of the work process (Toivanen, Helin and Hänninen 1993). Low prestige of the profession may be a cause of distress for cleaners (Messing, in press).

Accidents, infection and environmental contamination may be prevented by clear and well-publicized guidelines for disposal of dangerous waste in factories, hospitals, offices and public buildings. Since constraints placed on other workers may prevent them from paying full attention to prevention of hazards for cleaners, consultations between cleaners and other workers should be arranged, in order to decide on the appropriate size and placement of wastebaskets, waste separation and labelling. Cleaners should be included whenever waste disposal practices are being planned or reviewed so that realistic methods can be proposed.

 

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Contents

Personal and Community Services References

Agency for Toxic Substances and Disease Registry (ATSDR). 1995. Toxicological Profile for Tetrachloroethylene (Update-draft for Public Comment). Atlanta, GA: US ATSDR.

Albert, RE, AR Sellakumar, S Laskin, K Kuschner, N Nelson, and CA Snyder. 1982. Gaseous formaldehyde and hydrogen chloride induction of nasal cancer in the rat. JNCI 68: 597-603.

Anderson, B. 1993. Britain’s Secret Slaves: An Investigation into the Plight of Overseas Domestic Workers. Human Right Series No. 5, Anti-slavery International and Kalayaan: Justice for Overseas Domestic Workers.

Armstrong, P and H Armstrong. 1994. The Double Ghetto, 3rd edition. Toronto: McClelland and Stewart.

Association pour la santé et la sécurité au travail, secteur affaires sociales (ASSTSAS). 1993. Entretien sanitaire. Montreal: ASSTSAS.

Baxter, PJ, AM Brazier, and SEJ Young. 1988. Is smallpox a hazard in church crypts? Br J Ind Med 45: 359-360.

Blainey, AD, S Ollier, D Cundell, RE Smith, and RJ Davies. 1986. Occupational asthma in hairdressing salons. Thorax 41:42-50.

Blair, A, R Saracci, PA Stewart, RB Hayes, and C Shy. 1990a. Epidemiologic evidence on the relationship between formaldehyde exposure and cancer. Scand J Work, Environ and Health 16:381-391.

Blair, A, P Stewart, PE Tolbert, D Grauman, FX Moran, J Faught, and J Rayner. 1990b. Cancer and other causes of death among laundry and dry cleaning workers. Br J Ind Med 47:162-168.

Blair, A, PA Stewart, M O’Berg, W Gaffey, J Walrath, J Ward, R Bales, S Kaplan, and D Cubit. 1986. Mortality among industrial workers exposed to formaldehyde. JNCI 76: 1071-1084.

Borglum, B and AM Hansen. 1994. A Survey of Washing and Cleaning Agents (in Danish, abstract in English). AMI Report 44. Copenhagen, Denmark: Danish Institute of Occupational Health.

Bretin, H. 1994. Santé des ouvriers du nettoyage à Montréal et à Paris: La face cachée du travail dans la ville. Kremlin-Bicêtre, France: INSERM Unité 292.

Bretin, H, N Frigul, I Metenier, L Aussel, and A Thébaud-Mony. 1992. Des femmes chomeuses en mauvaise santé. Kremlin-Bicêtre, France: INSERM Unité 292.

Cherry, NM, MH Beck, and V Owen-Smith. 1994. Surveillance of Occupational Skin Disease in the United Kingdom: The OCC-Derm Project. US NIOSH Publication No. 94-112. Proceedings of the 9th International Symposium on Epidemiology in Occupational Health, 23-25 September 1992, Cincinnati, OH: US NIOSH.

Coleman, R. 1995. Reducing the levels of formaldehyde exposure in gross anatomy laboratories. Anat Rec 243: 531-533.

Delaporte, M-F, M Estryn-Behar, G Brucker, E Peigne, and A Pelletier. 1990. Pathologie dermatologique et exercice professionnel en milieu hospitalier. Arch mal prof 51(2):83-88.

Demers, PA, TL Vaughan, and RR Schommer. 1991. Occupation, socioeconomic status and brain tumor mortality: A death certificate-based case-control study. JOM 33(9):1001-1006.

Dooms-Goossens, A. 1986. A computerized retrieval system of contact allergenic substances. Seminars in Dermatology 5(3):249-254.

Duh, RW and NR Asal. 1984. Mortality among laundry and dry cleaning workers in Oklahoma. Am J Public Health 74:1278-1280.

Earnest, GS. 1996. Evaluation and control of perchloroethylene exposures during dry cleaning. Appl Occup Environ Hyg 11(2):125-132.

Earnest, GS and AB Spencer. 1996. Lessons from Europe: Reducing Occupational Exposure and Environmental Emissions to Perchloroethylene in Commercial Dry Cleaning (ECTB No. 201-07). Cincinnati, OH: US NIOSH.

Environmental Protection Agency (EPA). 1991a. Dry-cleaning Facilities—Background Information for Proposed Standards (EPA Publication No. 50/3-91-020a). Research Triangle Park, NC: Office of Air Quality Planning and Standards, Environmental Protection Agency.

—. 1991b. National emission standards for hazardous air pollutants for source categories: Perchloroethylene emissions from dry cleaning facilities, proposed rule and notice of public hearing. Federal Reg 56(236):64382-64402.

Feron, VJ, JP Bruyntjes, RA Woutersen, HR Immel, and LM Appelman. 1988. Nasal tumors in rats after short-term exposure to a cytotoxic concentration of formaldehyde. Canc Lett 39: 101-111.

Flyvholm, M-A. 1993. Contact allergens in registered cleaning agents for industrial and household use. Br J Ind Med 50:1043-1050.

Foussereau, J, C Benezra, HI Maibach, and N Hjorth. 1982. House personnel. In Occupational Contact Dermatitis, Clinical and Chemical Aspects. Philadelphia: W. B. Saunders Company.

Gamboa, PM, CG de la Cuesta, BE Garcia, JG Castillo, and A Oehling. 1989. Late asthmatic reaction in a hairdresser, due to inhalation of ammonium persulfate salts. Allergologia et immunopathologia 17:109-111.

Gawkrodger, DJ, MH Lloyd, and JAA Hunter. 1986 Occupational skin disease in hospital cleaning and kitchen workers. Contact Dermatitis 15:132-135.

Gershon, RRM and C Karkashion. 1996. The risk of TB in funeral service workers: Preliminary results. Presented at the American Public Health Association meetings, November, New York City.

Gershon, RRM, D Vlahox, H Farzadegan, and A Miriam. 1995. Occupational risk of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus infections among funeral service practitioners in Maryland. 1995. Infec Contr Hosp Epid 16: 194-197.

Gervais, M. 1993. Bilan de santé des travailleurs québécois. Montréal: Institut de recherche en santé et en sécurité du travail du Quebec.

Government of Quebec. 1994. Décret sur le personnel d’entretien d’édifices publics de la région de Montréal. Québec: Éditeur officiel.

Gulati, L. 1993. Women Migrant Workers in Asia: A Review. New Delhi. ILO Asian Regional Team for Employment Protection.

Hagner, I-M and M Hagberg. 1989. Evaluation of two floor-mopping work methods by measurement of load. Ergonomics 32 (4): 401-408.

Hansen, KS. 1983. Occupational dermatoses in hospital cleaning women. Contact Dermatitis 9:343-351.

Harford, TC and SD Brooks. 1992. Cirrhosis mortality and occupation. J Stud Alcohol 53(5):463-468.

Hayes, RB, A Blair, PA Stewart, RF Herrick, and H Mahar. 1990. Mortality of U.S. embalmers and funeral directors. Am J Ind Med 18: 641-652.

Hayes, RB, JW Raatgever, A de Bruyn, and M Gerin. 1986. Cancer of the nasal cavity and paranasal sinuses and formaldehyde exposure. Int J Canc 37: 487-492.

Healing, TD, PN Hoffman, and SEJ Young. 1995. The infection hazards of human cadavers. Communicable Dis Rev 5: R61-R68.

Hohenstein Institute. 1995. Requirements for the Use of Hydrocarbon Solvents in the Dry Cleaning Industry. Boennigheim, Germany: Hohenstein Institute.

Horte, LG and K Toren. 1993. Smoking adjusted mortality due to asthma in a population of Swedish working women. Br J Ind Med 50(6):575-576.

International Agency for Research on Cancer (IARC). 1995a. Dry cleaning, some chlorinated solvents and other industrial chemicals (Dry cleaning). In IARC Monographs on the Evaluation of Carcinogenic Risk to Humans. Vol. 63. Lyon: IARC.

—. 1995b. Dry cleaning, some chlorinated solvents and other industrial chemicals (Tetrachloroethylene). In IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Lyon: IARC.

—. 1995c. Wood dust and formaldehyde. In IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Lyon: IARC.

International Fabricare Institute. 1990. Focus on Dry Cleaning: Distillation. Silver Spring, MD: International Fabricare Institute.

International Labour Organization (ILO). 1989. Conditions of Work Digest: Home Work. Vol. 8, No. 2. Geneva: ILO.

Johannsson, S-E and G Ljunggren. 1989. Perceived exertion during a self-imposed pace of work for a group of cleaners. Applied Ergonomics 20 (4):307-312.

John, EM, DA Savitz, and CM Shy. 1994. Spontaneous abortion among cosmetologists. Epidemiology 5:147-155.

Katz, RM and D Jowett. 1981. Female laundry and dry cleaning workers in Wisconsin: A mortality analysis. Am J Public Health 71:305-307.

Kerns, WD, KL Pavkov, DJ Donofrio, EJ Gralla, and JA Swenberg. 1982. Carcinogenicity of formaldehyde in rats and mice after long-term inhalation exposure. Canc Res 43: 4382-4392.

Koenig, KL. 1994. Hair dye use and breast cancer: A case-control study among screening participants. Am J Epi 133:985-995.

Levine, RJ, DA Andjelkovich, and LK Shaw. 1984. The mortality of Ontario undertakers and a review of formaldehyde-related mortality studies. J Occ Med 26: 740-746.

Lin, RS and II Kessler. 1981. A multifactorial model for pancreatic cancer in man: Epidemiologic evidence. JAMA 245:147-152.

McCarroll, JE, RJ Ursano, CS Fullerton, and A Lundy. 1993. Traumatic stress of a wartime mortuary, anticipation of exposure to mass death. J Nerv Ment Dis 181: 545-551.

—. 1995. Anticipatory stress of handling human remains from the Persian Gulf War. J Nerv Ment Dis 183: 698-703.

McDonald, AD, B Armstong, N Cherry, C Delorme, AD Nolin, JC McDonald, and D Robert. 1986. Spontaneous abortion and occupation. J Occ Med 28:1232-1238.

McDonald, AD, JC McDonald, B Armstong, N Cherry, C Delorme, AD Nolin, and D Robert. 1987. Occupation and pregnancy outcome. Br J Ind Med 44:521-526.

McDonald, AD, JC McDonald, B Armstong, N Cherry, AD Nolin, and D Robert. 1988. Prematurity and work in pregnancy. Br J Ind Med 45:56-62.

McDougal, L, PR Band, JJ Spinelli, WJ Threlfall, and RP Gallagher. 1992. Mortality patterns in female domestic workers. Am J Ind Med 21(4):595-599.

Messing, K. 1991. Occupational Health Concerns of Canadian Women/La santé et la sécurité des travailleuses canadiennes. Ottawa: Human Resources Canada.

—. In press. Hospital trash: Cleaners speak of their role in disease prevention. Med Anthropol Quar.

Messing, K, C Chatigny, and J Courville. 1995. Travail prescrit, travail réel, travail perçu: l’entretien sanitaire «lourd» et «léger» en milieu hospitalier. Annals of the Société d’ergonomie de langue française: 578-585.

—. 1996. L’invisibilité du travail et la division léger/lourd dans l’entretien sanitaire: Impact sur la santé et la sécurité du travail. Objectif Prévention. 19(2):13-16.

Messing, K, G Doniol-Shaw, and C Haëntjens. 1993. Sugar and spice: Health effects of the sexual division of labour among train cleaners. Int J Health Services 23 (1):133-146.

Messing, K, C Haëntjens, and G Doniol-Shaw. 1993. L’invisible nécessaire: l’activité de nettoyage des toilettes sur les trains de voyageurs en gare. Le travail humain 55:353-370.

Michaels, David. Undated. Right-to-know Handbook for Custodial Assistants. New York: City of New York Mayor’s Office of Operations, Citywide Office of Occupational Safety and Health and District Council 37 Education Fund.

National Fire Protection Association (NFPA). 1991. Fire Protection Handbook. Quincy, MA: NFPA.

National Institute for Occupational Safety and Health (NIOSH). 1975. Health and Safety Guide for Laundries and Dry Cleaners. NIOSH Publication No. 273-831. Cincinnati, OH: US NIOSH.

—. 1977. Occupational Diseases: A Guide to Their Recognition. NIOSH Publication No. 77-181. Cincinnati, OH: US NIOSH.

Nielsen, J. 1995. Occupational Health of Cleaners (in Danish, summary in English). Ph.D. thesis. Copenhagen, Denmark: Arbejdsmiljjoinstituttet.

—. 1996. The occurrence and course of skin symptoms on the hands among female cleaners. Contact Dermatitis 34: 284-291.

Nordin, M, G Hultman, R Philipsson, S Ortelius, and GBJ Andersson. 1986. Dynamic measurements of trunk movements during work tasks. In The Ergonomics of Working Postures, edited by N Corlett, J Wilson and I Manenica. Philadelphia: Taylor & Francis.

Nwanyanwu, OC, TH Tubasuri, and G Harris. 1989. Exposure to and precautions for blood and body fluids among workers in the funeral home franchises of Fort Worth, Texas. Am J Infect Control 17: 208-212.

Occupational Safety and Health Administration (OSHA). 1993. Occupational Safety and Health Administration, database, regulations, documents and technical information. OSHA-CD-ROM (OSHA A93-2). Unpublished database.

Olsen, JH and S Asnaes. 1986. Formaldehyde and the risk of squamous cell carcinoma of the sinonasal cavities. Br J Ind Med 43: 769-774.

Opatowski, S, P Varaillac, C Richoux, N Sandret, L Peres, D Riffiod, and Y Iwatsubo. 1995. Enquête sur les ouvriers nettoyeurs d’Ile-de-France. Archives des maladies professionnelles 56 (3):219-220.

Pearce, N. 1992. Increasing incidence of Non-Hodgkin’s lymphoma: Occupational and environmental factors. Canc Res 52 (Supplement): 5496s-5500s.

Pepys, J. 1986. Occupational allergic lung disease caused by organic agents. J Allergy Clin Immunol 78(5) Part 2: 1,058-1,062.

Rice, B and J Weinberg. 1994. Dressed to Kill: The Dangers of Dry Cleaning and the Case for Chlorine-free Alternatives. A Greenpeace/Pollution Probe Report. Toronto. Pollution Probe, Sunset Chemicals Project for the Great Lakes.

Roush, GC, J Walrath, LT Stayner, SA Kaplan, JT Flannery, and A Blair. 1987. Nasopharyngeal cancer, sinonasal cancer and occupations related to formaldehyde: A case-control study. JNCI 79: 1221-1225.

Royal Society of Chemistry (RSC). 1986. Organochlorine Solvents: Health Risks to Workers (EUR10531EN). Luxembourg: Royal Society of Chemistry, Commission of the European Communities.

Ruder, AM, EM Ward, and DP Brown. 1994. Cancer mortality in female and male dry cleaning workers. J Occup Med 36:867-874.

Savitz, DA, KW Andrews, and LA Brinton. 1995. Occupation and cervical cancer. J Occup and Envir Med 37(3):357-361.

Schwartz, HJ, JL Arnold, and KP Strohl. 1990. Occupational allergic rhinitis in the hair care industry. Reactions to permanent wave solutions. J Occ Med 32:473-475.

Scolari, FG and B Gardenghi. 1966. Problems of preselection, prevention, and recovery in occupational dermatology. Giornale Italiano di Dermatologia 107 (5):1259-1270.

Seligman, PJ, SC Newman, CL Timbrook, and WE Halperin. 1987. Sexual assault of women at work. Am J Ind Med 12 (4):445-450.

Singgih, SIR, H Latinga, JP Nater, TE Woest, and JA Kruyt-Gaspersz. 1986. Occupational hand dermatoses in hospital cleaning personnel. Contact Dermatitis 14: 14-19.

Sly. 1994. Epidemic of small-pox in Quebec, supposed to depend upon the opening of an intramural cemetery 214 years old. Can J Publ Hlth (May-June): 149.

Sogaard, K. 1994. Biomechanics and Motor Control during Repetitive Work: A Biomechanical and Electromyographical Study of Floor Cleaning. Ph.D. thesis. Copenhagen, Denmark: Department of Physiology, National Institute of Occupational Health.

Sogaard, K, N Fallentin, and J Nielsen. 1996. Workload during floor cleaning. The effect of cleaning methods and work technique. Eur J App Physiol.

Sovet, U. 1958. Poisoning caused by powder used in the cleaning of silver. Presse Medicale 10 (9):69-70.

Spencer, AB, CF Estil, JB McCammon, RL Mickelsen, and OE Johnston. 1996. Control of ethyl methacrylate exposures during the application of artificial fingernails. Amer Ind Hyg Assoc J 58: 214-218.

Starr, JC, J Yunginger, and GW Brahser. 1982. Immediate type I asthmatic response to henna following occupational exposure in hairdressers. Annals of Allergy 48:98-99.

Stayner, LT, L Elliott, L Blade, R Keenlyside, and W Halperin. 1988. A retrospective cohort mortality study of workers exposed to formaldehyde in the garment industry. Am J Ind Med 13: 667-681.

Steineck, G, N Plato, SE Norell, and C Hogstedt. 1990. Urothelial cancer and some industry-related chemicals: An evaluation of the epidemiologic literature. Am J Ind Med 17:371-391.

Tanaka, S, AB Smith, W Halperin, and R Jensen. 1982. Carpet-layer’s knee. New England J Med 307(20):1276-1277.

Tobe, M, T Kaneko, Y Uchida, E Kamata, Y Ogawa, Y Ikeda, and M Saito. 1985. Studies on Inhalation Toxicity of Formaldehyde. Report of the National Sanitary and Medical Laboratory Service. Tokyo: Toxicity Department of the Organism Safety Research Centre.

Toivanen, H, P Helin, and O Hänninen. 1993. Impact of regular relaxation training and psychosocial working factors on neck-shoulder tension and absenteeism in hospital cleaners. J Occup Med 35(11): 1123-1130.

Turnbull, N, J Dornan, B Fletcher, and S Wilson. 1992. Prevalence of spinal pain among the staff of a district health authority. Occup Med 42(3):143-148.

Ursano, RJ, CS Fullerton, TC Kao, and VR Bhartiya. 1995. Longitudinal assessment of posttraumatic stress disorder and depression after exposure to traumatic death. J Nerv and Ment Dis 183: 36-42.

van der Walle, HB and VM Brunsveld. 1994. Dermatitis in hairdressers. Contact Dermatitis 30:217-221.

Vasquez, C. 1995. Wet Cleaning Equipment. Chicago: Center for Neighborhood Technology.

Vaughan, TL, C Strader, S Davis, and JR Daling. 1986. Formaldehyde and cancers of the pharynx, sinus and nasal cavity. Occupational exposures. Int J Canc 38: 677-683.

Villaplana J, C Romaguera, and F Grimalt. 1991. Contact dermatitis from resorcinol in a hair dye. Contact Dermatitis 24:151-152.

Vingard, E, L Alfredsson, I Goldie, and C Hogstedt. 1991. Occupation and osteoarthrosis of the hip and knee: A register-based cohort study. Int J Epidemiol 20 (4):1025-1031.

Walrath, J and JF Fraumeni. 1983. Mortality patterns among embalmers. Int J Canc 31:407-411.

Weaver, V, MA McDiarmid, JA Guidera, FE Humphrey, and JA Schaefer. 1993. Occupational chemical exposures in an academic medical center. J Occup Med 35(7):701-706.

Wentz, M. 1995. The evolution of environmentally responsible fabricare technologies. American Drycleaner 62(7):52-62.

Winkel, J, B Ekblom, M Hagberg, and B Jonsson. 1983. The working environment of cleaners. Evaluation of physical strain in mopping and swabbing as a basis for job redesign. In Ergonomics of Workstation Design, edited by TO Kialseth. Toronto: Butterworth.

Wolff, HL and JJAB Croon. 1968. The survival of small pox virus (Variola Mivor) in natural circumstances. Bull World Health Organ 38: 492-493.

Zahm, SH, DD Weisenburger, PA Babbitt, RC Saal, JB Vaught, and A Blair. 1992. Use of hair coloring products and the risk of lymphoma, multiple myeloma, and chronic lymphocytic leukemia. Am J Public Health 82:990-997.