title: Work-related asthma among health care workers: surveillance data from California, Massachusetts, Michigan, and New Jersey, 1993-1997.
abstract: BACKGROUND
  Asthma morbidity has increased, posing a public health burden. Work-related asthma (WRA) accounts for a significant proportion of adult asthma that causes serious personal and economic consequences.
  
  
  METHODS
  Cases were identified using physician reports and hospital discharge data, as part of four state-based surveillance systems. We used structured interviews to confirm cases and identify occupations and exposures associated with WRA.
  
  
  RESULTS
  Health care workers (HCWs) accounted for 16% (n = 305) of the 1,879 confirmed WRA cases, but only 8% of the states' workforce. Cases primarily were employed in hospitals and were nurses. The most commonly reported exposures were cleaning products, latex, and poor air quality.
  
  
  CONCLUSIONS
  Health care workers are at risk for work-related asthma. Health care providers need to recognize this risk of WRA, as early diagnosis will decrease the morbidity associated with WRA. Careful product purchasing and facility maintenance by health care institutions will decrease the risk.
authors.affiliation: Occupational Health Surveillance Program, Massachusetts Department of Public Health, Boston, Massachusetts 02108, USA. Elise.Pechter@state.ma.us
authors.forename: Elise
authors.initials: E
authors.lastname: Pechter
authors.forename: Letitia K
authors.initials: LK
authors.lastname: Davis
authors.forename: Catharine
authors.initials: C
authors.lastname: Tumpowsky
authors.forename: Jennifer
authors.initials: J
authors.lastname: Flattery
authors.forename: Robert
authors.initials: R
authors.lastname: Harrison
authors.forename: Florence
authors.initials: F
authors.lastname: Reinisch
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Reilly
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Rosenman
authors.forename: Donald P
authors.initials: DP
authors.lastname: Schill
authors.forename: David
authors.initials: D
authors.lastname: Valiante
authors.forename: Margaret
authors.initials: M
authors.lastname: Filios
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects; D001249:Asthma / Q000453:epidemiology*; D002140:California / Q000453:epidemiology; D016009:Chi-Square Distribution; D003902:Detergents / Q000009:adverse effects; D005260:Female; D005557:Formaldehyde / Q000009:adverse effects; D005976:Glutaral / Q000009:adverse effects; D006282:Health Personnel; D006801:Humans; D007840:Latex / Q000009:adverse effects; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D009515:New Jersey / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000706:statistics & numerical data*
chemical_list: D000395:Air Pollutants, Occupational; D003902:Detergents; D007840:Latex; D005557:Formaldehyde; D005976:Glutaral