Risk of asthma symptoms among workers in health care settings

Abstract

Prevalence of asthma is quite high in health care settings due to exposure to a wide variety of substances, including cleaning products, latex, medicines, ammonia and solvents. In this cross-sectional study, participants completed a validated questionnaire about their occupation, asthma diagnosis, variability of asthma symptoms at and away from work, and exposure to individual substances in the workplace. Work-related asthma symptoms (WRAS) were defined based on a set of criteria. Principal component analysis (PCA) was conducted to classify different substances into exposure patterns. Multivariable logistic regression analysis was used to evaluate the association between self-reported exposures to substances and asthma outcomes among health care workers. PCA revealed two factors: factor 1 (metal dust, metal fumes, solvents, cleaning agents, ammonia, glues) and factor 2 (disinfectants, latex, medicines). Exposure to factor 1 agents was associated with increased risk of WRAS (crude odds ratio (OR) 5.52, 95% confidence intervals (CI) 2.72-11.19), while exposure to factor 2 agents was associated with non-significant lower risk of WRAS (crude OR 0.58, 95% CI 0.3-1.14). Adjusting by confounders such as parent's allergy and history of asthma, or smoking, did not appreciably change the ORs. Some agents were associated with increased risk of WRAS, while the lack of association with the exposure to other set of chemicals may be attributed to a number of factors, including healthy worker effect.

Work‐related allergy and asthma associated with cleaning agents in health workers in Southern African tertiary hospitals

“…Furthermore, in this current study, lifetime prevalence of work‐related ocular–nasal (23%) and asthma symptoms (12%) was higher than that reported in South African dental HWs (14% and 4%, respectively) 34 . Moreover, in this current study, the prevalence of work‐related asthma symptoms (WRAS) in the past 12 months (7%) was higher than that reported in a US study of HWs (3.3%) and on the upper end of the range compared to the Saudi Arabian study of HWs (5.7%), both using a similar definition of WRAS 48,49 . Although the authors did not comment on the adequacy of workplace control measures in the two studies, 48,49 the inadequate controls observed in the current study (manuscript under review; unreferenced) could partly explain the relatively higher prevalence of WRAS.…”

“…34 Moreover, in this current study, the prevalence of work-related asthma symptoms (WRAS) in the past 12 months (7%) was higher than that reported in a US study of HWs (3.3%) and on the upper end of the range compared to the Saudi Arabian study of HWs (5.7%), both using a similar definition of WRAS. 48,49 Although the authors did not comment on the adequacy of workplace control measures in the two studies, 48,49 the inadequate controls observed in the current study (manuscript under review; unreferenced) could partly explain the relatively higher prevalence of WRAS. Furthermore, 16 (2%) workers with WRAS in the current study had to change their jobs due to these symptoms, underscoring the negative consequences associated with continued exposure for work-related asthma.…”