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Association of hand and arm disinfection with asthma control in US nurses

机译：手臂消毒与美国护士中的哮喘控制联系

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To investigate the association between occupational exposure to disinfectants/antiseptics used for hand hygiene and asthma control in nurses.In 2014, we invited female nurses with asthma drawn from the Nurses’ Health Study II to complete two supplemental questionnaires on their occupation and asthma (cross-sectional study, response rate: 80%). Among 4055 nurses (mean age: 59 years) with physician-diagnosed asthma and asthma medication use in the past year, we examined asthma control, as defined by the Asthma Control Test (ACT). Nurses were asked about the daily frequency of hand hygiene tasks: ‘wash/scrub hands with disinfectants/hand sanitizers’ (hand hygiene) and ‘wash/scrub arms with disinfecting products’ (surrogate of surgical hand/arm antisepsis). Analyses were adjusted for age, race, ethnicity, smoking status and body mass index.Nurses with partly controlled asthma (ACT: 20–24, 50%) and poorly controlled asthma (ACT ≤19, 18%) were compared with nurses with controlled asthma (ACT=25, 32%). In separate models, both hand and arm hygiene were associated with poorly controlled asthma. After mutual adjustment, only arm hygiene was associated with poorly controlled asthma: OR (95%?CI) for 1?time/day, 1.38 (1.06 to 1.80); ≥1?time/day, 1.96 (1.52 to 2.51), versus never. We observed a consistent dose–response relationship between frequency of arm hygiene tasks (never to 10?times/day) and poor asthma control. Associations persisted after further adjustment for surfaces/instruments disinfection tasks.Frequency of hand/arm hygiene tasks in nurses was associated with poor asthma control. The results suggest an adverse effect of products used for surgical hand/arm antisepsis. This potential new occupational risk factor for asthma warrants further study.
机译：为了探讨职业暴露与护士用途卫生和哮喘控制的消毒剂/抗菌剂之间的关联。在2014年，我们邀请了从护士的卫生研究中汲取的哮喘的女性护士II，以完成两种职业和哮喘的补充问卷（十字架） - 审查研究，响应率：80％）。在过去的一年内具有医生诊断的哮喘和哮喘用药的4055名护士（意思年龄：59岁）中，我们检查了哮喘控制，如哮喘控制试验所定义的哮喘控制（ACT）。询问护士卫生任务的日常频率：'用消毒剂/手动消毒剂的洗涤/擦洗手/手工卫生）和用消毒产品的洗涤/磨砂臂'（手术手/臂反泻的替代品）。与受控的护士进行比较哮喘（ACT = 25,32％）。在单独的型号中，两只手和臂卫生都与哮喘较低的哮喘有关。互调整后，只有臂卫生伴有哮喘较差的哮喘：或（95％ΔCI）的＆ 1？时间/日，1.38（1.06至1.80）; ≥1？时间/日，1.96（1.52到2.51），而不是。我们观察到Arm卫生任务频率之间的一致剂量 - 响应关系（从未＆ 10？时间/日）和哮喘控制差。在进一步调整表面/仪器消毒任务后持续存在的关联。护士中的手/手臂卫生任务与哮喘控制差有关。结果表明用于外科手/臂防腐的产品的不利影响。这一潜在的哮喘的职业危险因素可进一步研究。

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