Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
Business School (Economics), Newcastle University, 5 Barrack Rd., Newcastle upon Tyne NE1 4SE, UK.
Int J Environ Res Public Health. 2022 Dec 1;19(23):16092. doi: 10.3390/ijerph192316092.
Nurses face the risk of new onset occupational asthma (OA) due to exposures to cleaning and disinfection (C&D) agents used to prevent infections in healthcare facilities. The objective of this study was to measure nurses' preferences when presented with simultaneous OA and respiratory viral infection (e.g., COVID-19) risks related to increased/decreased C&D activities.
Nurses working in healthcare for ≥1 year and without physician-diagnosed asthma were recruited for an online anonymous survey, including four risk-risk tradeoff scenarios between OA and respiratory infection with subsequent recovery (Infect and Recovery) or subsequent death (Infect and Death). Nurses were presented with baseline risks at hypothetical "Hospital 1", and were asked to choose Hospital 2 (increased OA risk to maintain infection risk), Hospital 3 (increased infection risk to maintain OA risk), or indicate that they were equally happy.
Over 70% of nurses were willing to increase infection risk to maintain baseline OA risk if they were confident they would recover from the infection. However, even when the risk of infection leading to death was much lower than OA, most nurses were not willing to accept a larger (but still small) risk of death to avoid doubling their OA risk. Age, work experience, and ever having contracted or knowing anyone who has contracted a respiratory viral infection at work influenced choices.
We demonstrate the novel application of a risk-risk tradeoff framework to address an occupational health issue. However, more data are needed to test the generalizability of the risk preferences found in this specific risk-risk tradeoff context.
护士在医疗机构中接触清洁和消毒 (C&D) 制剂以预防感染，面临新出现的职业性哮喘 (OA) 的风险。本研究旨在测量护士在同时面临 OA 和呼吸道病毒感染（如 COVID-19）风险时的偏好，这些风险与增加/减少 C&D 活动有关。
我们招募了在医疗机构工作≥1 年且未被医生诊断为哮喘的护士，进行了一项在线匿名调查，包括四个 OA 和呼吸道感染之间的风险-风险权衡场景，随后有恢复（感染和恢复）或死亡（感染和死亡）。护士在假设的“医院 1”中接触到基线风险，并被要求选择医院 2（增加 OA 风险以维持感染风险）、医院 3（增加感染风险以维持 OA 风险），或表示他们同样满意。
超过 70%的护士愿意增加感染风险以维持基线 OA 风险，如果他们有信心能从感染中恢复。然而，即使感染导致死亡的风险远低于 OA，大多数护士也不愿意接受更大（但仍然较小）的死亡风险，以避免将他们的 OA 风险增加一倍。年龄、工作经验以及是否曾在工作中感染或认识到有人感染呼吸道病毒感染，影响了他们的选择。
我们展示了风险-风险权衡框架在解决职业健康问题方面的新应用。然而，需要更多的数据来测试在这种特定风险-风险权衡背景下发现的风险偏好的普遍性。
