RT Journal Article
SR Electronic
T1 Association of hand and arm disinfection with asthma control in US nurses
JF Occupational and Environmental Medicine
JO Occup Environ Med
FD BMJ Publishing Group Ltd
SP 378
OP 381
DO 10.1136/oemed-2017-104740
VO 75
IS 5
A1 Orianne Dumas
A1 Raphäelle Varraso
A1 Krislyn M Boggs
A1 Alexis Descatha
A1 Paul K Henneberger
A1 Catherine Quinot
A1 Frank E Speizer
A1 Jan-Paul Zock
A1 Nicole Le Moual
A1 Carlos A Camargo Jr
YR 2018
UL http://oem.bmj.com/content/75/5/378.abstract
AB Objectives To investigate the association between occupational exposure to disinfectants/antiseptics used for hand hygiene and asthma control in nurses.Methods In 2014, we invited female nurses with asthma drawn from the Nurses’ Health Study II to complete two supplemental questionnaires on their occupation and asthma (cross-sectional study, response rate: 80%). Among 4055 nurses (mean age: 59 years) with physician-diagnosed asthma and asthma medication use in the past year, we examined asthma control, as defined by the Asthma Control Test (ACT). Nurses were asked about the daily frequency of hand hygiene tasks: ‘wash/scrub hands with disinfectants/hand sanitizers’ (hand hygiene) and ‘wash/scrub arms with disinfecting products’ (surrogate of surgical hand/arm antisepsis). Analyses were adjusted for age, race, ethnicity, smoking status and body mass index.Results Nurses with partly controlled asthma (ACT: 20–24, 50%) and poorly controlled asthma (ACT ≤19, 18%) were compared with nurses with controlled asthma (ACT=25, 32%). In separate models, both hand and arm hygiene were associated with poorly controlled asthma. After mutual adjustment, only arm hygiene was associated with poorly controlled asthma: OR (95% CI) for <1 time/day, 1.38 (1.06 to 1.80); ≥1 time/day, 1.96 (1.52 to 2.51), versus never. We observed a consistent dose–response relationship between frequency of arm hygiene tasks (never to >10 times/day) and poor asthma control. Associations persisted after further adjustment for surfaces/instruments disinfection tasks.Conclusions Frequency of hand/arm hygiene tasks in nurses was associated with poor asthma control. The results suggest an adverse effect of products used for surgical hand/arm antisepsis. This potential new occupational risk factor for asthma warrants further study.