Arif A A, Delclos G L, Serra C
The University of North Carolina at Charlotte, Department of Public Health Sciences, College of Health and Human Services, 9201 University City Blvd, CHHS Building 429, Charlotte, NC 28223, USA.
Occup Environ Med. 2009 Apr;66(4):274-8. doi: 10.1136/oem.2008.042382. Epub 2009 Jan 22.
To identify occupational exposure risk factors associated with the development of new-onset asthma in nurses.
A cross-sectional survey was administered to a sample of licensed Texas nurses (response rate 70%) and compared to three other healthcare professional groups. Nursing professionals were defined based on self-reported longest held job. Outcome variables were physician-diagnosed new-onset asthma after entry into the healthcare profession and symptoms associated with bronchial hyper-responsiveness (BHR). Occupational exposures were ascertained through a job-exposure matrix, grouped into four categories: cleaning-related tasks, use of powdered latex gloves, administration of aerosolised medications, and tasks involving adhesive compounds, glues and/or solvents.
After adjustment for age, sex, ethnicity, atopy, smoking, body mass index and seniority, reported asthma was significantly greater among nursing professionals involved in medical instrument cleaning (OR = 1.67, 95% CI 1.06 to 2.62) and exposure to general cleaning products and disinfectants (OR = 1.72, 95% CI 1.00 to 2.94). Use of powdered latex gloves during 1992-2000 was associated with 1.6 times (95% CI 1.01 to 2.50) the odds of reported asthma. In univariate analysis, exposure to adhesives, glues and/or solvents was associated with a twofold increase in the odds of reported asthma, but not after adjustment for covariates. Similarly, the odds of BHR-related symptoms were significantly greater among nursing professionals exposed to general cleaning products and disinfectants (OR = 1.57, 95% CI 1.11 to 2.21) and adhesives, glues and/or solvents used in patient care (OR = 1.51, 95% CI 1.08 to 2.12).
Among nursing professionals, workplace exposures to cleaning products and disinfectants increase the risk of new-onset asthma.
确定与护士新发哮喘发病相关的职业暴露风险因素。
对得克萨斯州持牌护士样本进行横断面调查(应答率70%),并与其他三个医疗专业群体进行比较。护理专业人员根据自我报告的最长在职工作进行定义。结局变量为进入医疗行业后经医生诊断的新发哮喘以及与支气管高反应性(BHR)相关的症状。通过工作暴露矩阵确定职业暴露情况,分为四类:清洁相关任务、使用粉末状乳胶手套、雾化药物给药以及涉及粘合剂、胶水和/或溶剂的任务。
在对年龄、性别、种族、特应性、吸烟、体重指数和资历进行调整后,参与医疗器械清洁的护理专业人员中报告的哮喘显著更多(OR = 1.67,95%CI 1.06至2.62),以及接触一般清洁产品和消毒剂的人员中报告的哮喘显著更多(OR = 1.72,95%CI 1.00至2.94)。1992 - 2000年期间使用粉末状乳胶手套与报告哮喘的几率增加1.6倍(95%CI 1.01至2.50)相关。在单因素分析中,接触粘合剂、胶水和/或溶剂与报告哮喘的几率增加两倍相关,但在对协变量进行调整后则不然。同样,接触一般清洁产品和消毒剂的护理专业人员中与BHR相关症状的几率显著更高(OR = 1.57,95%CI 1.11至2.21),以及在患者护理中使用粘合剂、胶水和/或溶剂的护理专业人员中与BHR相关症状的几率显著更高(OR = 1.51,95%CI 1.08至2.12)。
在护理专业人员中,工作场所接触清洁产品和消毒剂会增加新发哮喘的风险。