Asthma in Texas Healthcare Workers II

描述(申请人提供)：在美国，哮喘患病率增长了近15%，据估计，15%至25%的成人病例是由工作相关因素引起或加重的。与工作相关的哮喘(WRA)包括因工作场所吸入暴露而加重或诱发的哮喘。某些职业群体患WRA的风险增加；其中包括保健工作者(HCW)。2003年，我们对具有代表性的5600名德克萨斯州妇女进行了第一次大规模的WRA研究。我们发现，在医护人员中，职业暴露对哮喘的贡献并不是微不足道的，尤其是在护士中，而且进入医疗行业后，在涉及仪器清洁和消毒、室内建筑表面使用的一般清洁产品、使用粉末乳胶手套以及喷雾剂药物管理的任务中，哮喘的风险显著增加。在调查进行以来的10年里，某些医疗保健做法发生了变化，如清洁和消毒或雾化药物的使用，某些产品的使用也发生了变化。这些和卫生保健环境实践中的其他变化，加上卫生工作者对哮喘的认识的提高，可能已经对这一领域的世界卫生组织产生了影响。大约10年后，重复全州范围的调查，从相同的目标人群中提取具有代表性的样本，但更新和改进暴露和结果的测量方法，将使我们能够记录可以为预防政策和旨在减轻卫生工作者WRA负担的干预措施设计提供信息的间隔变化。我们的具体目标是：我们的具体目标是：目标1：估计医疗保健环境中哮喘危险因素和WRA的患病率，并将这些比率与2003年调查中获得的比率进行比较；目标2：在德克萨斯州卫生工作者中衡量职业暴露与WRA之间的联系，并将其与2003年的结果进行比较；目标3：衡量医疗工作者哮喘的社会经济影响的各种指标，比较患有WRA的人、与工作无关的哮喘和非哮喘病患者。

DESCRIPTION (provided by applicant): In the U.S., asthma prevalence has grown by almost 15% and it is estimated that 15% to 25% of adult cases are caused or aggravated by work-related factors. Work-related asthma (WRA) includes asthma that is exacerbated or induced de novo by inhalation exposures in the workplace. Certain occupational groups are at an increased risk of developing WRA; among these are healthcare workers (HCWs). In 2003, we conducted the first large study of WRA in a representative sample of 5600 Texas HCWs. We found that the contribution of occupational exposure to asthma in healthcare workers was not trivial, especially among nurses, and that risk of asthma after entry into a healthcare profession was significantly increased for tasks involving instrument cleaning and disinfection, general cleaning products used on indoor building surfaces, use of powdered latex gloves, and the administration of aerosolized medications. In the 10 years that have elapsed since the survey was conducted, certain healthcare practices, such as cleaning and disinfection or administration of aerosolized medications, have changed, as has the use of certain products. It likely that these and other changes in healthcare setting practices, coupled with increased awareness of asthma in HCWs, have had an effect on WRA in this sector. Repeating the statewide survey, approximately 10 years later, drawing representative samples from the same target population but with updated and improved measures of exposure and outcomes, will allow us to document interval changes that can inform preventive policies and the design of interventions aimed at reducing the burden of WRA in HCWs. Our specific aims are to: Our specific aims are to: Aim 1: Estimate the prevalence rate of asthma risk factors and WRA in healthcare settings and compare these to rates obtained in the 2003 survey; Aim 2: Measure associations between occupational exposures and WRA among Texas HCWs and compare them to those obtained in 2003; Aim 3: Measure various indicators of socioeconomic impact of asthma in healthcare workers, comparing them among persons with WRA, non-work-related asthma and nonasthmatics.