Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Irinis 95, Limassol 3041, Cyprus.
Scand J Work Environ Health. 2019 Sep 1;45(5):505-513. doi: 10.5271/sjweh.3804. Epub 2019 Mar 14.
Objectives A cross-sectional study was designed in two hospitals of Cyprus to: (i) examine the possible association between exposure to disinfectants/trihalomethanes (THM) with point of care glycosylated hemoglobin (HbA1c) levels among active nurses, and (ii) identify the main determinants of pre-diabetes metabolic risk among active nurses in Cyprus. Methods In total, 179 nurses from two public hospitals in Cyprus were recruited excluding pregnant or nurses working <5 years (participation rate ~25.6%). End-of-shift urine samples were used to measure exposures to THM, and questionnaire items were used to construct improved exposure classification matrices, ie, the job exposure matrix (JEM) and the job-task exposure matrix (JTEM). Results Results showed associations between JEM- and JTEM-derived metrics of exposure and HbA1c for few disinfectants (eg, peracetic acid), but no consistent trends were derived. In multivariable models, adjusted for age, BMI, sex, smoking status and alcohol consumption, the number of night shifts per month, and (ln)chloroform (a THM compound) were associated with HbA1c levels [β 0.11 (95% confidence interval (CI) 0.05-0.17) and 0.05 (95% CI 0.00-0.11), respectively]. Conclusion A significant association between the number of monthly night shifts and HbA1c was observed, but no consistent associations were found between three exposure metrics of eleven different disinfectants, or urinary THM and point of care HbA1c levels in active nurses. Replication of the study findings in larger prospective sample is warranted. This is a novel occupational health dataset shedding light on the possible metabolic effects of exposures to disinfectants/by-products that have not been studied before.
在塞浦路斯的两家医院进行横断面研究，以：（i）检查在活跃护士中，接触消毒剂/三卤甲烷（THM）与即时糖化血红蛋白（HbA1c）水平之间可能存在的关联，以及（ii）确定塞浦路斯活跃护士中糖尿病前期代谢风险的主要决定因素。方法：共招募了来自塞浦路斯两家公立医院的 179 名护士，排除了怀孕或工作<5 年的护士（参与率约为 25.6%）。使用轮班结束时的尿液样本来测量 THM 的暴露量，并使用问卷项目来构建改进的暴露分类矩阵，即工作暴露矩阵（JEM）和工作任务暴露矩阵（JTEM）。结果：结果显示，JEM 和 JTEM 衍生的暴露指标与少数消毒剂（例如过氧乙酸）的 HbA1c 之间存在关联，但没有得出一致的趋势。在多变量模型中，调整了年龄、BMI、性别、吸烟状况和饮酒量、每月夜班次数以及（ln）三氯甲烷（THM 化合物）后，与 HbA1c 水平相关[β0.11（95%置信区间（CI）0.05-0.17）和 0.05（95% CI 0.00-0.11）]。结论：观察到每月夜班次数与 HbA1c 之间存在显著关联，但在 11 种不同消毒剂的三种暴露指标之间，或在活跃护士的尿液 THM 和即时 HbA1c 水平之间，未发现一致的关联。需要在更大的前瞻性样本中复制研究结果。这是一个新颖的职业健康数据集，揭示了以前未研究过的接触消毒剂/副产物可能对代谢产生的影响。
