Development of a job-task-exposure matrix to assess occupational exposure to disinfectants among US nurses

Details

• Personal Author:
  Camargo CA Jr. ; Dumas O ; Goldberg M ; Henneberger, Paul K. ; Le Moual N ; Quinot C ; Speizer FE ; Varraso R ; Wiley AS ; Zock JP
• Description:
  Objectives: Occupational exposure to disinfectants is associated with work-related asthma, especially in healthcare workers. However, little is known about the specific products involved. To evaluate disinfectant exposures, we designed job-exposure (JEM) and job-task-exposure (JTEM) matrices, which are thought to be less prone to differential misclassification bias than self-reported exposure. We then compared the three assessment methods: self-reported exposure, JEM and JTEM. Methods: Disinfectant use was assessed by an occupational questionnaire in 9073 US female registered nurses without asthma, aged 49.68 years, drawn from the Nurses' Health Study II. A JEM was created based on self-reported frequency of use (1.3, 4.7 days/week) of 7 disinfectants and sprays in 8 nursing jobs. We then created a JTEM combining jobs and disinfection tasks to further reduce misclassification. Exposure was evaluated in 3 classes (low, medium, high) using product-specific cut-offs (e.g., <30%, 30-49.9%, >/=50%, respectively, for alcohol); the cut-offs were defined from the distribution of self-reported exposure per job/task. Results: The most frequently reported disinfectants were alcohol (weekly use: 39%), bleach (22%) and sprays (20%). More nurses were classified as highly exposed by JTEM (alcohol 41%, sprays 41%, bleach 34%) than by JEM (21%, 30%, 26%, respectively). Agreement between JEM and JTEM was fair-to-moderate (kappa 0.3 - 0.5) for most disinfectants. JEM and JTEM exposure estimates were heterogeneous in most nursing jobs, except in emergency room and education/administration. Conclusions: The JTEM may provide more accurate estimates than the JEM, especially for nursing jobs with heterogeneous tasks. Use of the JTEM is likely to reduce exposure misclassification. [Description provided by NIOSH]
• Subjects:
  Alcoholic Beverages Asthma Asthma, Occupational Disinfectants Health Personnel Lung Diseases Occupational Exposure Occupational Health Respiratory Tract Diseases Safety Surveys And Questionnaires Women

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• Keywords:
  Alcohol Analytical-models Bronchial-asthma Chemical Agents Employee-exposure Health-care-personnel Health-surveys Household Bleach JEM Job-analysis Job Exposure Matrix Lung-disorders Mathematical-models Nurses Occupational Asthma Pulmonary-system-disorders Questionnaires Respiratory-system-disorders Sprays Task Performance

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• ISSN:
  1351-0711
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; OSHA Region 1 ; OSHA Region 3 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  130-137
• Volume:
  74
• Issue:
  2
• NIOSHTIC Number:
  nn:20048563
• Citation:
  Occup Environ Med 2017 Feb; 74(2):130-137
• Contact Point Address:
  Catherine Quinot, Inserm UMRS 1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, 16, avenue Paul Vaillant Couturier, Villejuif cedex 94807, France
• Email:
  catherine.quinot@inserm.fr
• Federal Fiscal Year:
  2017
• NORA Priority Area:
  Healthcare and Social Assistance
• Performing Organization:
  Brigham and Women's Hospital, Boston, Massachusetts
• Peer Reviewed:
  True
• Start Date:
  20130901
• Source Full Name:
  Occupational and Environmental Medicine
• End Date:
  20170831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:efec2e2c642aaa9c497fab99608403279af66a947c89c9b6ceaaaca698acf77d1c165934e5bc3bcbccfe9672c91e6fe31688aa430550b90791a0528af744b299
• Download URL:
  https://stacks.cdc.gov/view/cdc/203288/cdc_203288_DS1.pdf
• File Type:
  [PDF - 585.71 KB ]