Occupational risk factors and exposure-response relationships for airway disease among health workers exposed to cleaning agents in tertiary hospitals.
Occupational risk factors and exposure-response relationships for airway disease among health workers exposed to cleaning agents in tertiary hospitals.
复制标题
三级医院接触清洁剂的卫生工作者气道疾病的职业危险因素及暴露-反应关系。
DOI：
10.1136/oemed-2022-108763
复制
发表时间：
2023
影响因子：
4.9
通讯作者：
Jeebhay,MohamedFareed
中科院分区：
文献类型：
--
作者：
Mwanga,HusseinH;Baatjies,Roslynn;Jeebhay,MohamedFareed
目的调查南非和坦桑尼亚两所三级医院卫生工作者呼吸道疾病的职业危险因素和暴露-反应关系。方法在这项横断面研究中，697名参与者完成了问卷访谈，654人接受了呼出一氧化氮(FeNO)检测。哮喘症状评分(ASS)是根据过去12个月内5个哮喘相关症状问题的答案总和计算出来的。对于暴露-反应分析，与清洁剂相关的自我报告暴露变量被归类为三个水平(不使用清洁产品；每周使用清洁产品最多99 分钟，使用清洁产品每周≥100 分钟)。结果与哮喘相关的结果(ASS和FeNO)与医疗器械清洗剂(邻苯二甲醛和酶清洗剂)和任务(器械预清洁和更换消毒液)以及患者护理活动(手术前消毒和消毒伤口)呈正相关。与工作相关的眼鼻症状与医疗器械清洗剂(邻苯二甲醛、戊二醛、酶清洗剂、酒精和漂白剂)(OR范围：2.37~4.56)和任务(OR范围：2.92~4.44)之间存在显著的剂量-反应关系。ASS与固定表面清洗喷雾剂的使用密切相关(平均比值为2.81；95% 可信区间为1.41~5.59)。结论医疗器械专用消毒剂，如邻苯二甲醛和酶清洗剂、患者护理活动和喷雾剂的使用是卫生服务人员呼吸道疾病的重要职业危险因素。
ObjectivesThis study investigated occupational risk factors and exposure–response relationships for airway disease among health workers (HWs) exposed to cleaning agents in two tertiary hospitals in South Africa and Tanzania.MethodsIn this cross-sectional study, 697 participants completed questionnaire interviews while 654 underwent fractional exhaled nitric oxide (FeNO) testing. Asthma Symptom Score (ASS) was computed based on the sum of answers to five questions on asthma-related symptoms in the past 12 months. For exposure–response analyses, cleaning agent-related self-reported exposure variables were categorised into three levels (cleaning product not used; use of a cleaning product for up to 99 min per week and use of a cleaning product for ≥100 min per week).ResultsAsthma-related outcomes (ASS and FeNO) demonstrated positive associations with medical instrument cleaning agents (orthophthalaldehyde and enzymatic cleaners) and tasks (instruments precleaning and changing sterilisation solutions) as well as patient care activities (disinfection prior to procedures and disinfecting wounds). A particularly pronounced dose–response relationship was observed between work-related ocular-nasal symptoms and medical instrument cleaning agents (orthophthalaldehyde, glutaraldehyde, enzymatic cleaners, alcohols and bleach) (OR range: 2.37–4.56) and tasks (OR range: 2.92–4.44). A strong association was also observed between ASS and use of sprays for fixed surface cleaning (mean ratio 2.81; 95% CI 1.41 to 5.59).ConclusionsSpecific agents for medical instrument disinfection for example, orthophthalaldehyde and enzymatic cleaners, patient care activities and use of sprays are important occupational risk factors for airway disease among HWs.