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

Maria C Mirabelli ^1*, Jan-Paul Zock ¹, Estel Plana ¹, Josep Maria Antó ¹, Geza Benke ², Paul D Blanc ³, Anna Dahlman-Höglund ⁴, Deborah L Jarvis ⁵, Hans Kromhout ⁶, Linnéa Lillienberg ⁴, Dan Norbäck ⁷, Mario Olivieri ⁸, Katja Radon ⁹, Jordi Sunyer ¹, Kjell Torén ¹⁰, Marc van Sprundel ¹¹, Simona Villani ¹² and Manolis Kogevinas ¹

¹ Centre for Research in Environmental Epidemiology, Institut Municipal d'Investigació Mèdica, Spain
² Department of Epidemiology and Preventive Medicine, Monash University, Australia
³ Department of Medicine, University of California San Francisco, United States
⁴ Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Sweden
⁵ National Heart and Lung Insititute, Imperial College, United Kingdom
⁶ Institute for Risk Assessment Sciences, Environmental Epidemiology Division, Utrecht University, Netherlands
⁷ Occupational and Environmental Medicine, Uppsala University and University Hospital, Sweden
⁸ Unit of Occupational Medicine, University of Verona, Italy
⁹ Institute for Occupational and Environmental Medicine, Ludwig-Maximilians-University, Germany
¹⁰ Department of Allergology, Sahlgrenska University Hospital, Sweden
¹¹ Department Epidemiology and Social Medicine, University of Antwerp, Belgium
¹² Department of Health Sciences, University of Pavia, Italy

^* To whom correspondence should be addressed. E-mail: mmirabelli{at}imim.es.

Accepted 16 February 2007

Abstract

Objective: We examined the relationships of self-reported work tasks, use of cleaning products and latex glove use with new-onset asthma among nurses and other health care 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 health care jobs during the 9-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. We used Poisson regression models with robust error variances to compare the risk of new-onset asthma among health care 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%) health care workers and 131 (5%) members of the referent population reported new-onset asthma. Compared to the referent group, we observed elevated risks among hospital technicians (relative risk (RR): 4.63; 95% confidence interval (95%CI):1.87, 11.5) and among those using ammonia and/or bleach at work (RR: 2.16; 95%CI: 1.03, 4.53). Conclusions: In the ECHRS II cohort, hospital technicians and other health care workers experience elevated risks of new-onset current asthma, possibly due to specific products used at work.

Keywords: asthma, epidemiology, latex, nurses, occupation

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