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
  More +
• Keywords:
  • Nurses
  • Bronchial-asthma
  • Disinfectants
  • Job Exposure Matrix
  • JEM
  • Task performance
  • Respiratory-system-disorders
  • Pulmonary-system-disorders
  • Lung-disorders
  • Women
  More +
• 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
• Download URL:
  https://stacks.cdc.gov/view/cdc/203288/cdc_203288_DS1.pdf
• File Type:
  [PDF - 585.71 KB]
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:efec2e2c642aaa9c497fab99608403279af66a947c89c9b6ceaaaca698acf77d1c165934e5bc3bcbccfe9672c91e6fe31688aa430550b90791a0528af744b299