Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK.
Occup Med (Lond). 2013 Oct;63(7):513-6. doi: 10.1093/occmed/kqt093. Epub 2013 Aug 9.
There is a disproportionately high number of cases of work-related asthma occurring in health care occupations due to agents such as glutaraldehyde, latex and cleaning products.
To understand the causes and measure trends over time of occupational asthma (OA) in health care workers (HCWs).
We reviewed OA notifications from the Midland Thoracic Society's Surveillance Scheme of Occupational Asthma (SHIELD) database in the West Midlands, UK, from 1991 to 2011 and gathered data on occupation, causative agent and annual number of notifications.
There were 182 cases of OA in HCWs (median annual notifications = 7; interquartile range [IQR] = 5-11), representing 5-19% of annual SHIELD notifications. The modal annual notification was 20 (in 1996); notifications have declined since then, in line with total SHIELD notifications. The majority of cases (136; 75%) occurred in nursing, operating theatre, endoscopy and radiology staff. The most frequently implicated agents were glutaraldehyde (n = 69), latex (n = 47) and cleaning products (n = 27), accounting for 79% of the 182 cases. Cleaning product-related OA was an emerging cause with 22 cases after 2001 and only 5 cases between 1991 and 2000.
Control measures within the UK National Health Service have seen a decline in OA in HCWs due to latex and glutaraldehyde, though OA remains a problem amongst HCWs exposed to cleaning products. Continuing efforts are required to limit the number of cases in this employment sector.
由于戊二醛、乳胶和清洁产品等物质，医护人员职业性哮喘的发病比例过高。
了解医护人员职业性哮喘（OA）的病因，并分析其时间趋势。
我们回顾了英国西米德兰兹郡胸腔协会职业性哮喘监测系统（SHIELD）数据库中 1991 年至 2011 年期间的 OA 通报情况，并收集了职业、致病因子和每年通报数量的数据。
共有 182 例医护人员 OA（中位数年通报数=7；四分位距 [IQR]=5-11），占 SHIELD 年通报总数的 5-19%。每年通报数最多的是 1996 年（20 例），此后呈下降趋势，与 SHIELD 年通报总数的变化一致。大多数病例（136 例，75%）发生在护理、手术室、内镜和放射科工作人员中。最常涉及的物质是戊二醛（n=69）、乳胶（n=47）和清洁产品（n=27），占 182 例的 79%。自 2001 年以来，清洁产品相关 OA 成为一个新的致病因素，共 22 例，而 1991 年至 2000 年仅 5 例。
英国国民保健署采取的控制措施使医护人员乳胶和戊二醛相关 OA 有所减少，但接触清洁产品的医护人员仍存在 OA 问题。需要继续努力，减少这一就业人群中的病例数量。
