Objectives: To identify occupational exposure risk factors associated with development of new-onset asthma after entering the nursing profession.
Methods: A statewide cross-sectional survey was administered to a representative sample of Texas nurses with active licenses, and compared to three other healthcare professional groups (physicians, respiratory therapists, and occupational therapists). Response rate among nurses was 70%. Nursing professionals were defined based on self-reported longest held job as a registered nurse , nurse practitioner, licensed vocational nurse, or nurse aide. Outcome variables were physician-diagnosed new-onset asthma after entry into the health care profession (reported asthma) and symptoms associated with bronchial hyperresponsiveness (BHR). Occupational exposures were ascertained through an externally developed job-exposure matrix, grouped into four categories: cleaning-related tasks, use of powdered latex gloves, administration of aerosolized 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=7.2, 95%CI=1.4-37.2) and exposure to general cleaning products and disinfectants (OR=1.8, 95%CI=1.1-3.1). Use of powdered latex gloves between the years 1992 to 2000 was associated with 1.6 times (95%CI=1.0-2.6) the odds of reported asthma, but not thereafter. In the univariate analysis, exposure to adhesives, glues and/or solvents was associated with a two-fold 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=1.5, 95%CI=1.1-2.1) and adhesives, glues and/or solvents (OR=1.6, 95%CI=1.1-2.2).
Conclusion: Among nursing professionals, workplace exposures to cleaning products and disinfectants increase the risk of new-onset asthma.
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