Is Exposure to Disinfectants at Work Associated With COPD Among Female Nurses?

In a cohort study of 73,262 U.S. female nurses participating in the Nurses’ Health Study II who were followed up from 2009 to 2015, occupational exposure to cleaning products and disinfectants was significantly associated with a 25 percent to 38 percent increased risk of developing chronic obstructive pulmonary disease independent of asthma and smoking.

Among the 73 262 women included in the analyses, mean (SD) age at baseline was 54.7 (4.6) years and 70 311 (96.0%) were white, 1235 (1.7%) black, and 1716 (2.3%) other; and 1345 (1.8%) Hispanic, and 71 917 (98.2%) non-Hispanic. Based on 368 145 person-years of follow-up, 582 nurses reported incident physician-diagnosed COPD. Weekly use of disinfectants to clean surfaces only (16 786 [22.9%] of participants exposed) and to clean medical instruments (13 899 [19.0%] exposed) was associated with COPD incidence, with adjusted hazard ratios of 1.38 (95% CI, 1.13-1.68) for cleaning surfaces only and 1.31 (95% CI, 1.07-1.61) for cleaning medical instruments after adjustment for age, smoking (pack-years), race, ethnicity, and body mass index. High-level exposure, evaluated by the JTEM, to several specific disinfectants (ie, glutaraldehyde, bleach, hydrogen peroxide, alcohol, and quaternary ammonium compounds) was significantly associated with COPD incidence, with adjusted hazard ratios ranging from 1.25 (95% CI, 1.04-1.51) to 1.36 (95% CI, 1.13-1.64). Associations were not modified by smoking or asthma status (P for interaction > .15).

The authors say their study’s findings suggest that regular use of chemical disinfectants among nurses may be a risk factor for developing chronic obstructive pulmonary disease.

Reference: Dumas O, et al. Occupational Exposure to Disinfectants With Incidence of Chronic Obstructive Pulmonary Disease Among U.S. Female Nurses. October 18, 2019

Source: JAMA Network Open

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