Abstract

RATIONALE
Recent U.S. data suggest an increased risk of work-related asthma among healthcare workers, yet only a few specific determinants have been elucidated.

OBJECTIVES
To evaluate associations of asthma prevalence with occupational exposures in a cross-sectional survey of healthcare professionals.

METHODS
A detailed questionnaire was mailed to a random sample (n=5600) of all Texas physicians, nurses, respiratory therapists and occupational therapists with active licenses in 2003. Information on asthma symptoms and nonoccupational asthma risk factors obtained from the questionnaire was linked to occupational exposures derived through an industry specific job-exposure matrix.

MEASUREMENTS
Two a priori defined outcomes: a) physician-diagnosed asthma with onset after entry into healthcare ('reported asthma'),and b) 'bronchial hyperresponsiveness-related symptoms',defined through an 8-item symptom-based predictor.

MAIN RESULTS
Overall response rate was 66%. The final study population consisted of 862 physicians, 941 nurses, 968 occupational therapists and 879 respiratory therapists (n=3650). Reported asthma was associated with medical instrument cleaning (OR,2.22;95%CI,1.34-3.67), general cleaning (OR,2.02;95%CI,1.20-3.40), use of powdered latex gloves between the years 1992 and 2000 (OR,2.17;95%CI,1.27-3.73) and administration of aerosolized medications (OR,1.72;95%CI,1.05-2.83). The risk associated with latex glove use was not apparent after the year 2000. Bronchial hyperresponsiveness-related symptoms were associated with general cleaning (OR,1.63;95%CI,1.21-2.19), aerosolized medication administration (OR,1.40;95%CI,1.06-1.84), use of adhesives on patients (OR,1.65;95%CI, 1.22-2.24) and exposure to a chemical spill (OR,2.02;95%CI,1.28-3.21).

CONCLUSIONS
The contribution of occupational exposures to asthma in healthcare professionals is not trivial, meriting both implementation of appropriate controls and further study.

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