Work tasks and occupations as risk factors for asthma in a sample of urban healthcare workers

Background: Prior studies have reported increased asthma risk in healthcare workers. The objective of this study was to evaluate the association of asthma-related outcomes with work tasks and occupations in a sample of urban healthcare workers in the United States. Methods: We invited workers from nine occupations–environmental service workers (ESWs, or housekeepers) and various nursing and technical occupations–to complete a questionnaire. The four work tasks evaluated were clean fixed surfaces (CLEAN), sterilize medical equipment (STERILIZE), administer aerosolized medications (AEROMED), and use chemicals on patients. The asthma outcomes included current asthma (CurAsthma), asthma exacerbation, and a symptom algorithm for bronchial hyper-responsiveness (BHR status). Regression models of outcomes had covariates for exposure and confounders, and weights to adjust for potential participation bias. Results: The 2,030 participants were 76% female, 62% African American, and a mean age of 48 years. The task CLEAN stood out because it had an elevated odds ratio (OR) for several outcomes, including CurAsthma, OR=1.84 (95% confidence interval (CI) 1.26-2.68), moderate exacerbation, OR=3.07 (95% CI 1.25-7.59), and BHR status, OR=1.38 (95% CI 1.08-1.77). The task AEROMED was associated with CurAsthma and moderate exacerbation, and STERILIZE with BHR status. Among occupations, ESWs and registered nurses were associated with CurAsthma, and licensed practical nurses with moderate exacerbation. Conclusion: This study adds to the growing body of evidence for the association of asthma and related symptoms with cleaning and other activities in healthcare, and helps to inform strategies for prevention.