ORIGINAL ARTICLE

Occupational risk factors for asthma among nurses and related healthcare professionals in an international study

Maria C Mirabelli¹, Jan-Paul Zock¹, Estel Plana¹, Josep Maria Antó^1,2, Geza Benke³, Paul D Blanc⁴, Anna Dahlman-Höglund⁵, Deborah L Jarvis⁶, Hans Kromhout⁷, Linnéa Lillienberg⁵, Dan Norbäck⁸, Mario Olivieri⁹, Katja Radon¹⁰, Jordi Sunyer^1,2, Kjell Torén¹¹, Marc van Sprundel¹², Simona Villani¹³, Manolis Kogevinas¹⁴

¹ Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research, Barcelona, Spain
² Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
³ Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia
⁴ Department of Medicine, University of California San Francisco, California, USA
⁵ Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
⁶ Respiratory Epidemiology and Public Health Group, National Heart and Lung Insititute, Imperial College, London, UK
⁷ Institute for Risk Assessment Sciences, Environmental Epidemiology Division, Utrecht University, Utrecht, the Netherlands
⁸ Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University and University Hospital, Sweden
⁹ Unit of Occupational Medicine, University of Verona, Italy
¹⁰ Unit for Occupational and Environmental Epidemiology & NetTeaching, Institute for Occupational and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany
¹¹ Department of Allergology, Sahlgrenska University Hospital, Göteborg, Sweden
¹² Department Epidemiology and Social Medicine, University of Antwerp, Belgium
¹³ Section of Medical Statistics and Epidemiology, Department of Health Sciences, University of Pavia, Italy
¹⁴ Department of Social Medicine, Medical School, University of Crete, Heraklion, Greece

Correspondence to:
Dr M C Mirabelli
Centre for Research in Environmental Epidemiology, Instituto Municipal de Investigación Médica, c/Dr Aiguader, 88, 08003 Barcelona, Spain; mmirabelli{at}imim.es

Objective: The authors examined the relations between self-reported work tasks, use of cleaning products and latex glove use with new-onset asthma among nurses and other healthcare workers in the European Community Respiratory Health Survey (ECRHS II).

Methods: In a random population sample of adults from 22 European sites, 332 participants reported working in nursing and other related healthcare jobs during the nine-year ECRHS II follow-up period and responded to a supplemental questionnaire about their principal work settings, occupational tasks, products used at work and respiratory symptoms. Poisson regression models with robust error variances were used to compare the risk of new-onset asthma among healthcare workers with each exposure to that of respondents who reported professional or administrative occupations during the entire follow-up period (n = 2481).

Results: Twenty (6%) healthcare workers and 131 (5%) members of the referent population reported new-onset asthma. Compared to the referent group, the authors observed increased risks among hospital technicians (RR 4.63; 95% CI 1.87 to 11.5) and among those using ammonia and/or bleach at work (RR 2.16; 95% CI 1.03 to 4.53).

Conclusions: In the ECRHS II cohort, hospital technicians and other healthcare workers experience increased risks of new-onset current asthma, possibly due to specific products used at work.

Abbreviations: ECRHS, European Community Respiratory Health Survey; ISCO, International Standard Classification of Occupations

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