Occupational exposures and asthma among nursing professionals

Objectives: To identify occupational exposure risk factors associated with the development of new-onset asthma in nurses. Methods: A cross-sectional survey was administered to a sample of licensed Texas nurses (response rate 70%) and compared to three other healthcare professional groups. Nursing professionals were defined based on self-reported longest held job. Outcome variables were physician-diagnosed new-onset asthma after entry into the healthcare profession and symptoms associated with bronchial hyper-responsiveness (BHR). Occupational exposures were ascertained through a job-exposure matrix, grouped into four categories: cleaning-related tasks, use of powdered latex gloves, administration of aerosolised medications, and tasks involving adhesive compounds, glues and/or solvents. Results: After adjustment for age, sex, ethnicity, atopy, smoking, body mass index and seniority, reported asthma was significantly greater among nursing professionals involved in medical instrument cleaning (OR=1.67, 95% CI 1.06 to 2.62) and exposure to general cleaning products and disinfectants (OR=1.72, 95% CI 1.00 to 2.94). Use of powdered latex gloves during 1992-2000 was associated with 1.6 times (95% CI 1.01 to 2.50) the odds of reported asthma. In univariate analysis, exposure to adhesives, glues and/or solvents was associated with a twofold increase in the odds of reported asthma, but not after adjustment for covariates. Similarly, the odds of BHR-related symptoms were significantly greater among nursing professionals exposed to general cleaning products and disinfectants (OR=1.57, 95% CI 1.11 to 2.21) and adhesives, glues and/or solvents used in patient care (OR=1.51, 95% CI 1.08 to 2.12). Conclusion: Among nursing professionals, workplace exposures to cleaning products and disinfectants increase the risk of new-onset asthma.