title: Occupational risk factors and asthma among health care professionals.
abstract: BACKGROUND
  Recent U.S. data suggest an increased risk of work-related asthma among health care workers, yet only a few specific determinants have been elucidated.
  
  
  OBJECTIVE
  To evaluate associations of asthma prevalence with occupational exposures in a cross-sectional survey of health care professionals.
  
  
  METHODS
  A detailed questionnaire was mailed to a random sample (n=5,600) 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.
  
  
  METHODS
  There were two a priori defined outcomes: (1) physician-diagnosed asthma with onset after entry into health care ("reported asthma") and (2) "bronchial hyperresponsiveness-related symptoms," defined through an 8-item symptom-based predictor.
  
  
  RESULTS
  Overall response rate was 66%. The final study population consisted of 862 physicians, 941 nurses, 968 occupational therapists, and 879 respiratory therapists (n=3,650). Reported asthma was associated with medical instrument cleaning (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.34-3.67), general cleaning (OR, 2.02; 95% CI, 1.20-3.40), use of powdered latex gloves between 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 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 health care professionals is not trivial, meriting both implementation of appropriate controls and further study.
authors.affiliation: The University of Texas-Houston School of Public Health, 1200 Herman Pressler Street, Suite RAS W1018, Houston, TX 77030, USA. george.delclos@uth.tmc.edu
authors.forename: George L
authors.initials: GL
authors.lastname: Delclos
authors.forename: David
authors.initials: D
authors.lastname: Gimeno
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Arif
authors.forename: Keith D
authors.initials: KD
authors.lastname: Burau
authors.forename: Arch
authors.initials: A
authors.lastname: Carson
authors.forename: Christine
authors.initials: C
authors.lastname: Lusk
authors.forename: Thomas
authors.initials: T
authors.lastname: Stock
authors.forename: Elaine
authors.initials: E
authors.lastname: Symanski
authors.forename: Lawrence W
authors.initials: LW
authors.lastname: Whitehead
authors.forename: Jan-Paul
authors.initials: JP
authors.lastname: Zock
authors.forename: Fernando G
authors.initials: FG
authors.lastname: Benavides
authors.forename: Josep M
authors.initials: JM
authors.lastname: Antó
mesh_terms: D001249:Asthma / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D015995:Prevalence; D012307:Risk Factors