Gimeno Ruiz de Porras David, Patel Jenil, Conway Sadie, Pompeii Lisa, Mitchell Laura E, Carson Arch, Whitehead Lawrence W, Han Inkyu, Zock Jan-Paul, Henneberger Paul K, Patel Riddhi, De Los Reyes Joy, Delclos George L
Department of Environmental and Occupational Health, UT School of Public Health San Antonio, The University of Texas Health Science Center at San Antonio (UT Health San Antonio), San Antonio, TX, USA.
Center for Research in Occupational Health, Universitat Pompeu Fabra, Barcelona, Spain.
Workplace Health Saf. 2025 Feb;73(2):53-62. doi: 10.1177/21650799241284085. Epub 2024 Oct 23.
Adult-onset asthma, notably prevalent among healthcare professionals, especially nurses, is often attributed to occupational factors such as exposure to cleaning agents. Studies consistently underscore the substantial role of such exposure in work-related asthma among hospital staff. We aimed to (a) identify and characterize current practices in cleaning and aerosolized medication administration; (b) assess changes in practices since a similar 2003 study of Texas healthcare workers; and (c) identify factors contributing to diverse exposures within healthcare job categories. We conducted focus groups with 38 participants in 6 healthcare settings, analyzing current practices, changes since 2003, and factors contributing to exposure diversity. We used a three-step approach for data analysis, including sociodemographic characterization, a scissor-and-sort technique for exposure description, and qualitative content analysis. Participants were primarily healthcare providers (76%) and housekeepers/cleaners (11%) who reported exposure to aerosolized medications, cleaning products, adhesives, and solvents. Participants reported transitioning from cleaning practices to new formulas with reduced odors and shifting from spray cleansers to wipes. Personal protective equipment (PPE) used during cleaning tasks varied, with training differing among job categories. Aerosolized medication administration varied among facilities, with reported medication types and protocol changes over time. The results emphasized the significance of maintaining uniform protection, disseminating knowledge, and consistently adhering to PPE protocols in the healthcare environment. Addressing the identified gaps in comprehension and potential sources of exposure variability requires additional focus on occupational health and safety initiatives.
成人迟发型哮喘在医护人员中尤为普遍，尤其是护士，通常归因于职业因素，如接触清洁剂。研究一直强调这种接触在医院工作人员与工作相关的哮喘中所起的重要作用。我们旨在：（a）识别并描述清洁和雾化药物给药的当前做法；（b）评估自2003年对得克萨斯州医护人员进行的类似研究以来做法的变化；（c）确定导致医护工作类别中不同接触情况的因素。我们在6个医疗环境中对38名参与者进行了焦点小组讨论，分析当前做法、2003年以来的变化以及导致接触多样性的因素。我们采用了三步数据分析方法，包括社会人口特征描述、用于接触描述的剪拼技术以及定性内容分析。参与者主要是医护人员（76%）和管家/清洁工（11%），他们报告接触过雾化药物、清洁产品、粘合剂和溶剂。参与者报告说，清洁做法已从使用有气味的清洁剂转变为使用气味较小的新配方清洁剂，并且从喷雾清洁剂转变为擦拭巾。清洁任务中使用的个人防护装备（PPE）各不相同，不同工作类别的培训也有所不同。雾化药物给药在不同机构中也有所不同，报告的药物类型和方案随时间而变化。结果强调了在医疗环境中保持统一防护、传播知识以及始终遵守PPE协议的重要性。解决已发现的理解差距和接触变异性的潜在来源需要更多地关注职业健康和安全倡议。
