RISK OF ASTHMA SYMPTOMS AMONG WORKERS IN HEALTH CARE SETTINGS

摘要

Prevalence of asthma is quite high in health care settings due to exposure to a wide variety of substances, including cleaning products, latex, medicines, ammonia and solvents. In this cross-sectional study, participants completed a validated questionnaire about their occupation, asthma diagnosis, variability of asthma symptoms at and away from work, and exposure to individual substances in the workplace. Work-related asthma symptoms (WRAS) were defined based on a set of criteria. Principal component analysis (PCA) was conducted to classify different substances into exposure patterns. Multivariable logistic regression analysis was used to evaluate the association between self-reported exposures to substances and asthma outcomes among health care workers. PCA revealed two factors: factor 1 (metal dust, metal fumes, solvents, cleaning agents, ammonia, glues) and factor 2 (disinfectants, latex, medicines). Exposure to factor 1 agents was associated with increased risk of WRAS (crude odds ratio (OR) 5.52, 95% confidence intervals (CI) 2.72-11.19), while exposure to factor 2 agents was associated with non-significant lower risk of WRAS (crude OR 0.58, 95% CI 0.3-1.14). Adjusting by confounders such as parent's allergy and history of asthma, or smoking, did not appreciably change the ORs. Some agents were associated with increased risk of WRAS, while the lack of association with the exposure to other set of chemicals may be attributed to a number of factors, including healthy worker effect.