Respiratory symptoms and airway inflammation associated with specific chemical agents and tasks used in fixed surface cleaning and disinfection and in specimen preparation in tertiary hospital health workers
| n (%) | Asthma symptom score† | Asthma symptom score (≥2 vs 0–1) | Wrons | WRAS | FeNO, ppb‡ (n=654) | FeNO≥50 ppb (n=654) | |
| Prevalence (%) (n=697) | 91 (13) | 109 (16) | 48 (7) | 41 (6) | |||
| Fixed surfaces cleaning and disinfection | 572 (82) | 1.23 (0.80 to 1.90) | 1.41 (0.68 to 2.91) | 0.92 (0.53 to 1.60) | 1.01 (0.44 to 2.32) | 1.04 (0.92 to 1.19) | 0.88 (0.35 to 2.20) |
| Agents | |||||||
| Ammonia | |||||||
| Yes versus no | 73 (11) | 0.77 (0.48 to 1.24) | 0.90 (0.44 to 1.84) | 1.07 (0.51 to 2.24) | 0.17 (0.02 to 1.33) | 0.89 (0.76 to 1.04) | 1.02 (0.35 to 2.95) |
| 0 min/week | 624 (95) | 1 | 1 | 1 | 1 | 1 | 1 |
| 1–99 min/week | 24 (4) | 1.27 (0.64 to 2.51) | 2.27 (0.89 to 5.84) | 1.63 (0.56 to 4.71) | NC | 1.00 (0.78 to 1.29) | 0.52 (0.06 to 4.18) |
| ≥100 min/week | 9 (1) | NC | NC | NC | NC | NC | NC |
| Bleach | |||||||
| Yes versus no | 474 (68) | 1.09 (0.79 to 1.50) | 0.99 (0.59 to 1.64) | 0.97 (0.62 to 1.53) | 1.11 (0.57 to 2.18) | 1.03 (0.93 to 1.14) | 1.12 (0.53 to 2.36) |
| 0 min/week | 223 (40) | 1 | 1 | 1 | 1 | 1 | 1 |
| 1–99 min/week | 154 (27) | 1.46 (1.00 to 2.13)* | 1.43 (0.78 to 2.61) | 0.79 (0.43 to 1.45) | 0.67 (0.26 to 1.77) | 1.08 (0.95 to 1.24) | 1.42 (0.58 to 3.45) |
| ≥100 min/week | 189 (33) | 1.03 (0.70 to 1.51) | 0.92 (0.49 to 1.72) | 1.28 (0.76 to 2.16) | 1.46 (0.69 to 3.10) | 1.07 (0.94 to 1.21) | 1.46 (0.63 to 3.40) |
| Tasks | |||||||
| Use more sprays versus more wipes | 18 (3) | 2.81 (1.41 to 5.59)** | 5.01 (1.80 to 13.91)** | 0.63 (0.14 to 2.89) | 1.87 (0.39 to 9.11) | 0.88 (0.66 to 1.18) | 0.54 (0.07 to 4.47) |
| Specimen preparation products | 157 (23) | 1.27 (0.91 to 1.78) | 1.13 (0.66 to 1.92) | 1.55 (0.96 to 2.51) | 1.38 (0.70 to 2.75) | 1.15 (1.03 to 1.29)* | 1.19 (0.55 to 2.58) |
| Formalin 10% in normal saline | |||||||
| Yes versus no | 148 (21) | 1.27 (0.91 to 1.78) | 1.09 (0.64 to 1.88) | 1.47 (0.90 to 2.41) | 1.29 (0.64 to 2.60) | 1.16 (1.03 to 1.30)* | 1.09 (0.49 to 2.43) |
| 0 min/week | 549 (82) | 1 | 1 | 1 | 1 | 1 | 1 |
| 1–99 min/week | 110 (17) | 1.49 (1.03 to 2.16)* | 1.19 (0.65 to 2.16) | 1.65 (0.98 to 2.81) | 1.29 (0.59 to 2.81) | 1.17 (1.03 to 1.34)* | 1.27 (0.55 to 2.94) |
| ≥100 min/week | 5 (1) | NC | NC | NC | NC | NC | NC |
| Alcohol-based cytological fixative spray | |||||||
| Yes versus no | 25 (4) | 1.09 (0.54 to 2.20) | 1.45 (0.54 to 3.89) | 2.72 (1.05 to 7.07)* | 2.25 (0.60 to 8.46) | 1.20 (0.94 to 1.53) | 2.05 (0.53 to 7.84) |
| 0 min/week | 672 (98) | 1 | 1 | 1 | 1 | 1 | 1 |
| 1–99 min/week | 17 (2) | 1.24 (0.53 to 2.90) | 1.42 (0.43 to 4.66) | 3.06 (1.00 to 9.33)* | 2.22 (0.45 to 10.94) | 1.36 (1.01 to 1.83)* | 3.27 (0.80 to 13.36) |
| ≥100 min/week | 0 (0) | NC | NC | NC | NC | NC | NC |
Data are presented as OR (95% CI), unless otherwise indicated.
Adjusted for atopy, gender, smoking, age, study site and allergic sensitisation to natural rubber latex.
Bold values denote statistical significance at p<0.05 level.
*p<0.05, **p<0.01.
†Mean ratio (95% CI).
‡Geometric mean ratio (95% CI).
FeNO, fractional exhaled nitric oxide; NC, not calculable; WRAS, work-related asthma symptoms; WRONS, work-related ocular-nasal symptoms.