Occupational Exposure Patterns to Disinfectants and Cleaning Products and Its Association With Asthma Among French Healthcare Workers

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine Pub Date : 2025-04-23 DOI:10.1002/ajim.23725

Bakari Ibrahim, Nicole Le Moual, Guillaume Sit, Marcel Goldberg, Bénédicte Leynaert, Céline Ribet, Nicolas Roche, Raphaëlle Varraso, Marie Zins, Rachel Nadif, Laurent Orsi, Orianne Dumas

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引用次数: 0

Abstract

Background

Disinfectants and cleaning products (DCPs) are important asthma risk factors among healthcare workers. However, healthcare work involves heterogenous cleaning tasks and co-exposure to many chemicals. These multidimensional aspects have rarely been considered. We aimed to identify patterns of occupational exposure to DCPs and study their associations with asthma.

Methods

CONSTANCES is a French population-based cohort of ≈220,000 adults. Current asthma and asthma symptom score were defined by questionnaire at inclusion (2012–2021). Healthcare workers completed a supplementary questionnaire on their current/last held occupation, workplace, and cleaning activities that were used in unsupervised learning algorithms to identify occupational exposure patterns. Logistic and negative binomial regression models, adjusted for potential confounders, were used to assess associations with asthma outcomes.

Results

In 5512 healthcare workers, four occupational exposure clusters were identified: Cluster1 (C1, 42%, reference), mainly characterized by low exposed nurses and physicians; C2 (7%), medical laboratory staff moderately exposed to common DCPs (chlorine/bleach, alcohol); C3 (41%), nursing assistants and nurses highly exposed to a few DCPs (mainly quaternary ammonium compounds); and C4 (10%), nurses and nursing assistants highly exposed to multiple DCPs (e.g., glutaraldehyde, hydrogen peroxide, and acids). Among women (n = 3734), C2 (mean score ratio [95% CI]: 1.31 [1.02; 1.68]) and C3 (1.18 [1.03; 1.36]) were associated with higher asthma symptom score, and an association was suggested between C3 and current asthma (odds ratio 1.22 [0.99; 1.51]).

Conclusion

In a large population of healthcare workers, four DCP exposure patterns were identified, reflecting the heterogeneity of healthcare jobs. Two patterns, including one characterized by laboratory workers, were associated with greater asthma symptoms in women.

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法国卫生保健工作者对消毒剂和清洁产品的职业暴露模式及其与哮喘的关系

背景消毒剂和清洁产品（dcp）是卫生保健工作者中重要的哮喘危险因素。然而，医疗保健工作涉及不同的清洁任务和共同暴露于许多化学品。这些多维方面很少被考虑。我们的目的是确定职业暴露于dcp的模式，并研究它们与哮喘的关系。contes是一项以法国人口为基础的约22万成年人队列研究。纳入时（2012-2021）通过问卷确定当前哮喘和哮喘症状评分。医护人员完成了一份关于他们当前/上次从事的职业、工作场所和清洁活动的补充问卷，这些问卷用于无监督学习算法来识别职业暴露模式。采用逻辑回归模型和负二项回归模型，对潜在混杂因素进行校正，以评估与哮喘结局的关联。结果5512名医护人员共分为4个职业暴露聚类：第1类（C1, 42%，参考），以低暴露护士和医生为主；C2(7%)，中等暴露于常见dcp（氯/漂白剂、酒精）的医务实验室工作人员；C3(41%)，护理员和护士高度暴露于少数dcp（主要是季铵类化合物）；和C4(10%)，护士和护理助理高度暴露于多种dcp（如戊二醛、过氧化氢和酸）。女性（n = 3734）， C2(平均评分比[95% CI]: 1.31 [1.02；1.68])和C3 (1.18 [1.03；1.36])与较高的哮喘症状评分相关，C3与当前哮喘存在关联(优势比1.22 [0.99；1.51])。结论在大量的卫生保健工作者中，确定了四种DCP暴露模式，反映了卫生保健工作的异质性。两种模式，包括一种以实验室工作人员为特征的模式，与女性更严重的哮喘症状有关。

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来源期刊

American journal of industrial medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.90

自引率

5.70%

发文量

108

审稿时长

4-8 weeks

期刊介绍： American Journal of Industrial Medicine considers for publication reports of original research, review articles, instructive case reports, and analyses of policy in the fields of occupational and environmental health and safety. The Journal also accepts commentaries, book reviews and letters of comment and criticism. The goals of the journal are to advance and disseminate knowledge, promote research and foster the prevention of disease and injury. Specific topics of interest include: occupational disease; environmental disease; pesticides; cancer; occupational epidemiology; environmental epidemiology; disease surveillance systems; ergonomics; dust diseases; lead poisoning; neurotoxicology; endocrine disruptors.