Veille documentaire MTPH

Médecine du travail du personnel hospitalier

Asthma among workers in healthcare settings: role of disinfection with quaternary ammonium compounds

Auteur M Gonzalez
Auteur J Jégu
Auteur M-Ch Kopferschmitt
Auteur C Donnay
Auteur G Hedelin
Auteur F Matzinger
Auteur M Velten
Auteur L Guilloux
Auteur A Cantineau
Auteur F de Blay
Publication Clinical and experimental allergy: journal of the British Society for Allergy and Clinical Immunology
Date Oct 15, 2013
Résumé INTRODUCTION: An increased incidence of asthma has been reported among healthcare workers. The role of quaternary ammonium compounds (QACs), commonly used in cleaning/disinfection products, has not been clearly defined. The aim of this study was to analyze associations between asthma and occupational exposure to disinfectants, especially QACs. METHODS: The study was performed on a stratified random sample of the various healthcare departments of 7 healthcare settings. The study included: questionnaire, physical examination and specific IgE assays. Occupational exposure assessment was performed by means of a work questionnaire, workplace studies and a review of products ingredients. Data were analyzed by logistic regression. RESULTS: response rate was 77%; 543 workers (89% female) participated; 37.1% were registered nurses (RNs), 16.4% auxiliary nurses (ANs), 17.3% cleaners; 32.8% were atopic. 335 participants were exposed to QACs. Nursing professionals reported a significantly higher risk of reported physician-diagnosed asthma and, for RNs, of nasal symptoms at work than administrative staff working in healthcare sector. This risk was particularly marked during disinfection tasks and when exposure to QACs. Exposure to QACs increased significantly the risk of reported physician diagnosed asthma and nasal symptoms at work (adjusted OR = 7.5 and 3.2 respectively). No significant association was found with other exposures such as latex glove use, chlorinated products / bleach or glutaraldehyde. CONCLUSION: RNs and ANs presented a higher risk of reported asthma than administrative staff. The highest risk was associated with tasks involving dilution of disinfection products by manual mixing, suggesting possible exposure to repeated peaks of concentrated products known to be strong respiratory irritants. Workplace interventions should be conducted in order to more clearly determine QAC exposure and improve disinfection procedures

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