Occupational use of high level disinfectants and time to pregnancy among nurses

Details

• Personal Author:
  Chavarro JE ; Gaskins AJ ; Laden F ; Lawson, Christina C. ; Missmer SA ; Rich-Edwards JW
• Description:
  OBJECTIVE: To examine the relationship between occupational use of high level disinfectants among nurses and time to pregnancy (TTP). DESIGN: Prospective cohort study. MATERIALS AND METHODS: Our study included 2,581 women trying to become pregnant or with a recent planned pregnancy in the Nurses' Health Study 3 cohort (2010-present). Every 3 to 6 months women report the duration of their pregnancy attempt. Women were considered at risk of pregnancy for the duration of their pregnancy attempt until they became pregnant, stopped trying to become pregnant, or were lost to follow-up. Occupational exposure to agents used to disinfect medical instruments, devices, or supplies was self-reported on the baseline questionnaire. Multivariable Cox proportional hazards models for discrete survival time were used to estimate the fecundability odds ratios (FOR) and 95% confidence intervals (CI) adjusting for age, race, BMI, smoking, and marital status. RESULTS: Nurses who reported current exposure to high level disinfectants had a 22% reduction in fecundity (longer TTP) compared to nurses who were never exposed (FOR=0.78 [95% CI 0.67, 0.90]). A longer TTP was associated with current use of glutaraldehyde (FOR=0.77 [95% CI 0.62, 0.96]) but not with ortho-phthalaldehyde (FOR=1.02 [95% CI 0.66, 1.56]), peracetic acid (FOR=1.27 [95% CI 0.82, 1.97]), or hydrogen peroxide (FOR=0.74 [95% CI 0.54, 1.02]). Consistent use of R3 types of protective equipment was rare (6.7%) but significantly protected exposed women against longer TTPs. When specific types of equipment were examined, only consistent use of a water resistant gown or respiratory protection (not including surgical mask) significantly protected exposed women against longer TTPs. Use of a disinfection system with dedicated ventilation, eye protection, or protective gloves appeared to be beneficial however they did not reach statistical significance. CONCLUSION: Occupational use of high level disinfectants, particularly glutaraldehyde, is associated with reduced fertility among women. Nurses using high level disinfectants should be advised to use the recommended protective equipment as these might mitigate the fertility impairments associated with high level disinfectant use. [Description provided by NIOSH]
• Subjects:
  Chemistry Disinfectants Health Personnel Hypersensitivity Occupational Health Personal Protective Equipment Pregnancy Risk Assessment Risk Factors Safety Surveys And Questionnaires Urogenital System Women

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• Keywords:
  Chemical-composition Chemical-hypersensitivity Chemical-properties Exposure-levels Fertility Hazards Humans Medical-personnel Models Nurses Protective-equipment Questionnaires Risk-factors Statistical-analysis

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• ISSN:
  0015-0282
• Document Type:
  Text
• Funding:
  Contract
• Genre:
  Abstract or Summary
• Place as Subject:
  Massachusetts ; Ohio ; OSHA Region 1 ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DSHEFS - Division of Surveillance, Hazard Evaluations, and Field Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  102
• Issue:
  3
• NIOSHTIC Number:
  nn:20045300
• Citation:
  Fertil Steril 2014 Oct; 102(3):E107
• CAS Registry Number:
  Glutaraldehyde (CAS RN 111-30-8) ; Hydrogen peroxide (CAS RN 7722-84-1)
• Federal Fiscal Year:
  2015
• NORA Priority Area:
  Healthcare and Social Assistance
• Peer Reviewed:
  False
• Source Full Name:
  Fertility and Sterility
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:37d844b304c663631b58776d9978a9b97ec6f94684657a4d7649532ca800e0f46755a9a1c35b595bdba63bc8b2c79122f067de398724089df9d1cdbc63830a09
• Download URL:
  https://stacks.cdc.gov/view/cdc/200764/cdc_200764_DS1.pdf
• File Type:
  [PDF - 46.61 KB ]