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德克萨斯州注册护士助理的职业性哮喘。

Work-Related Asthma Among Certified Nurse Aides in Texas.

机构信息

Department of Epidemiology, University of Arkansas for Medical Sciences.

Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth).

出版信息

Workplace Health Saf. 2020 Oct;68(10):491-500. doi: 10.1177/2165079920914322. Epub 2020 May 4.

Abstract

Although nurses are well described as being at risk of work-related asthma, certified nurse aides (CNAs) are understudied. Using a statewide registry in Texas, we measured prevalence and risk factors for work-related asthma and bronchial hyperresponsiveness (BHR) symptoms among CNAs. : For this cross-sectional study, a questionnaire was mailed to a random sample of CNAs ( = 2,114) identified through the Texas Department of Aging and Disability Services registry, working in health care during 2016-2017, to collect data on job history, asthma symptoms, and sociodemographics. Two outcomes were defined: (a) new-onset asthma (NOA) after entry into the health care field and (b) BHR-related symptoms. Job exposures to cleaning compounds and tasks were assigned using an externally coded CNA-specific job-exposure matrix. Logistic regression modeling was used to measure associations between cleaning exposures and the two asthma outcomes. : The final sample consisted of 413 CNAs (response rate 21.6%). The prevalence of NOA and BHR symptoms were 3.6% and 26.9%, respectively. In adjusted models, elevated odds for BHR symptoms were observed for patient care cleaning (odds ratio [OR] = 1.71, 95% confidence interval [CI] = [0.45, 6.51]), instrument cleaning (OR = 1.33, 95% CI = [0.66, 2.68]), building-surface cleaning (OR = 1.39, 95% CI = [0.35, 5.60]), exposure to glutaraldehyde/orthophthalaldehyde (OR = 1.33, 95% CI = [0.66, 2.68]), and latex glove use during 1992-2000 (OR = 1.62, 95% CI = [0.84, 3.12]). There were too few NOA cases to warrant meaningful regression analysis. : Although not statistically significant, we observed elevated odds of BHR symptoms among nurse aides, associated with cleaning exposures, suggesting this is an at-risk group of health care professionals for work-related respiratory disease, meriting further study.

摘要

虽然护士被描述为有患与工作相关哮喘的风险,但注册护士助理(CNA)的相关研究却很少。我们使用德克萨斯州的全州注册系统,测量了在该州从事医疗保健工作的注册护士助理(CNA)中与工作相关的哮喘和支气管高反应性(BHR)症状的患病率和危险因素。

在这项横断面研究中,我们向通过德克萨斯州老龄化和残疾服务部注册登记、在 2016 年至 2017 年期间从事医疗保健工作的随机抽样的注册护士助理(CNA)(n=2114)邮寄了一份问卷,以收集有关工作经历、哮喘症状和社会人口统计学数据的信息。定义了两个结果:(a)进入医疗保健领域后新出现的哮喘(NOA),和(b)BHR 相关症状。使用外部编码的 CNA 特定的职业暴露矩阵来分配清洁化合物和任务的职业暴露。使用逻辑回归模型来测量清洁暴露与两种哮喘结果之间的关联。

最终的样本包括 413 名注册护士助理(响应率为 21.6%)。NOA 和 BHR 症状的患病率分别为 3.6%和 26.9%。在调整后的模型中,观察到与 BHR 症状相关的升高的比值比(OR)为患者护理清洁(OR=1.71,95%置信区间[CI] = [0.45,6.51])、仪器清洁(OR=1.33,95% CI = [0.66,2.68])、建筑物表面清洁(OR=1.39,95% CI = [0.35,5.60])、接触戊二醛/邻苯二醛(OR=1.33,95% CI = [0.66,2.68])和在 1992-2000 年期间使用乳胶手套(OR=1.62,95% CI = [0.84,3.12])。NOA 病例太少,无法进行有意义的回归分析。

虽然没有统计学意义,但我们观察到注册护士助理的 BHR 症状的比值比升高,与清洁暴露有关,这表明他们是与工作相关的呼吸道疾病的高危医疗保健专业人员群体,值得进一步研究。

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