Occupational Asthma Reference
Le Moual N, Varraso R, Zock JP, Henneberger P, Speizer FE, Kauffmann F, Camargo CA Jr.,
Are operating room nurses at higher risk of severe persistent asthma? The Nurses' Health Study.,
J Occup Environ Med,
Keywords: USA, healthcare, nurse, operaring theatre, epidemiology
To assess the associations between operating room (OR) nursing, a category of health care workers at high risk of exposure to various inhaled agents, and asthma severity/control among women with asthma.
The level of severity/control in nurses with prevalent doctor-diagnosed asthma in 1998/2000 was compared, using nominal logistic regression, in OR nursing (n = 69) and administrative nursing (n = 546) from the US Nurses' Health Study for whom detailed information on asthma and nursing employment status was available.
We observed a significant association between OR nursing, compared with administrative nursing, and severe persistent asthma (adjusted odds ratio, 2.48; 95% confidence interval, 1.06 to 5.77).
Our findings suggest that nurses working in the OR are at a higher risk of severe persistent asthma. Further studies with detailed estimates of occupational exposures, especially to disinfectant/cleaning agents, are warranted.
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Asthma from exposures in operating theatres are well described (latex, acrylates, cleaning agents, anaesthetic gasses, aldehydes, hand gels, chlorhexidine, air conditioning systems etc). The risks are sufficient to warrent respiratory surveillance of exposed workers. The finding of severe asthma in this group suggests that occupational health surveillance needs improving for these workers
This is one of the first studies showing that operating nurses are at higher risk of severe persistent asthma. Although the causative agents are unknown, several suspected agents do exist in the working environment of operating nurses. In spite of this, no study has previously evaluated the possible association between work as an operating nurse and asthma/severity.
The study uses the US Nurses’ Health Study Questionnaire to gather detailed information regarding asthma and nursing employment status given on questionnaires. The study comprises 69 operating nurses and 546 administrative nurses, displaying an odds ratio (OR) of 2.50 (95% confidence interval [CI] 1.07-8.75) for operating nurses to have severe persistent asthma compared with the administrative nurses.
Previous studies have shown that specific disinfectants/cleaning agents that are used by hospital workers have been reported to be strongly associated with current asthma for other occupational groups. Also, the authors highlight that operating nurses are one of the highest exposed occupational groups to disinfectants, cleaning agents in the hospital.
The study has also examined the relationship between different degrees of asthmatic problems (severity). The authors do find a significant relationship between work as operating nurse and severe persistent asthma (OR=2.72, 95% CI 1.21-6.12), but not in relation to mild or moderate types of asthma.
The study investigates an important group with many occupational risk factors. It is an interesting start, but further studies with more detailed estimates of exposures are needed to better evaluate the risk factors for operating room nurses. The chemical exposure among these nurses is a mixture of different substances. The wide confidence intervals found in the study also indicated the need of performing a larger study on the topic
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