Article Dans Une Revue American Journal of Industrial Medicine Année : 2025

Occupational Exposure Patterns to Disinfectants and Cleaning Products and Its Association With Asthma Among French Healthcare Workers

Résumé

Background: Disinfectants and cleaning products (DCPs) are important asthma risk factors among healthcare workers. However, healthcare work involves heterogenous cleaning tasks and co-exposure to many chemicals. These multidimensional aspects have rarely been considered. We aimed to identify patterns of occupational exposure to DCPs and study their associations with asthma. Methods: CONSTANCES is a French population-based cohort of ≈220,000 adults. Current asthma and asthma symptom score were defined by questionnaire at inclusion (2012-2021). Healthcare workers completed a supplementary questionnaire on their current/last held occupation, workplace, and cleaning activities that were used in unsupervised learning algorithms to identify occupational exposure patterns. Logistic and negative binomial regression models, adjusted for potential confounders, were used to assess associations with asthma outcomes. Results: In 5512 healthcare workers, four occupational exposure clusters were identified: Cluster1 (C1, 42%, reference), mainly characterized by low exposed nurses and physicians; C2 (7%), medical laboratory staff moderately exposed to common DCPs (chlorine/bleach, alcohol); C3 (41%), nursing assistants and nurses highly exposed to a few DCPs (mainly quaternary ammonium compounds); and C4 (10%), nurses and nursing assistants highly exposed to multiple DCPs (e.g., glutaraldehyde, hydrogen peroxide, and acids). Among women (n = 3734), C2 (mean score ratio [95% CI]: 1.31 [1.02; 1.68]) and C3 (1.18 [1.03; 1.36]) were associated with higher asthma symptom score, and an association was suggested between C3 and current asthma (odds ratio 1.22 [0.99; 1.51]).

Conclusion:

In a large population of healthcare workers, four DCP exposure patterns were identified, reflecting the heterogeneity of healthcare jobs. Two patterns, including one characterized by laboratory workers, were associated with greater asthma symptoms in women.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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hal-05051215 , version 1 (29-04-2025)

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Bakari Ibrahim, Nicole Le Moual, Guillaume Sit, Marcel Goldberg, Bénédicte Leynaert, et al.. Occupational Exposure Patterns to Disinfectants and Cleaning Products and Its Association With Asthma Among French Healthcare Workers. American Journal of Industrial Medicine, 2025, ⟨10.1002/ajim.23725⟩. ⟨hal-05051215⟩
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