Exposures in healthcare associated with respiratory symptoms in workers with asthma

Healthcare is a large and vital industry in the United States, and it is important to identify and address potential causes of exacerbation of symptoms among workers with asthma. In a study of adults with asthma who were enrolled in a health maintenance organization in the northeastern United States, participants completed a questionnaire that inquired about work history, exposures at work, and respiratory symptoms in the past 12 months. Sixty-three participants were employed in healthcare, of whom 41% (n=26) reported at least 6 of 9 lower respiratory symptoms typical of asthma. These symptoms were more common for participants with a history of smoking (52%), onset of asthma as a child (56%), and for occupational exposure to dust, smoke, gas, or chemical fumes (56%). In analyses on specific workplace exposures, more symptoms were associated with dust and gas from building renovations (77%) and with cleaners, disinfectants, and sterilizing agents (50%), but not with musty or moldy odor, water damage, enzymes and pharmaceuticals, animals, or latex. When we fit a regression model and controlled for smoking and childhood onset of asthma, we observed an elevated prevalence ratio (PR) for building renovations with PR= 2.35 (95% CI 1.40, 3.95; p=0.001) and for cleaners, disinfectants, and sterilizing agents with PR= 2.06 (95% CI 0.99, 4.26; p=0.052). These findings suggest that relatively common irritant exposures in healthcare are risk factors for exacerbation of symptoms in workers with asthma.