Asthma Symptoms in Health Care Workers

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Asthma Symptoms in Health Care Workers

• Lessons from Clinical and Surveillance Reports
• Edward Lee Petsonk, M.D.
• Senior Medical Officer
• National Institute for Occupational Safety and
  Health

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Asthma Symptoms in Health Care Workers
New asthma
Worsening of prior asthma
Improved asthma control
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Asthma Symptoms in Health Care Workers
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Asthma Symptoms in Health Care Workers

• Agents associated with new onset asthma
• Health care jobs with reported cases
• Preventive strategies

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Asthma in Health Care Workers - Reported Asthma
Inducers

• Cleaning/sterilizing agents
• Benzylkonium chloride
• Ethylene Oxide
• Formaldehyde
• Glutaraldehyde
• Hexachlorophene

• Resins (casts)
• Diisocyanates
• Pharmaceuticals
• INH and metabolites
• Psyllium
• Natural Rubber Latex
• Lab animals

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Asthma in Health Care Workers - Reported Asthma
Inducers

• Cleaning/sterilizing agents
• Benzylkonium chloride
• Ethylene Oxide
• Formaldehyde
• Glutaraldehyde
• Hexachlorophene

• Resins (casts)
• Diisocyanates
• Pharmaceuticals
• INH and metabolites
• Psyllium
• Natural Rubber Latex
• Lab animals

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Asthma Symptoms in Health Care Workers

• Agents associated with new onset asthma
• Health care jobs with reported cases
• Preventive strategies

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Asthma in Health Care Workers - Occupations
Reported

• Clinical laboratory technicians
• Dentists
• Housekeepers
• Nurses and nurses aides
• Pharmacists and pharmacy aides
• Physicians
• Respiratory therapists and technicians
• Research technicians

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Asthma With Symptom Onset While Working in
Respiratory Therapy
N 194 (RT), 517 (Controls) Kern and Frumkin,
Ann Int Med 89
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Asthma Prevalence, Nonsmokers, by Usual Industry,
1988-1994
REF Work-related Lung Disease Surveillance
Report 99, 3rd National Health and Nutrition
Examination Survey
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Health Industries are 4 of Top 10 in
Proportionate Asthma Mortality 1990-1999
REF Work-related Lung Disease Surveillance
Report 02, from selected states, NCHS multiple
cause of death data
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Health Occupations are 9 of Top 25 in
Proportionate Asthma Mortality 1990-1999
REF Work-related Lung Disease Surveillance
Report 02, from selected states, NCHS multiple
cause of death data
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Asthma Symptoms in Health Care Workers

• Agents associated with new onset asthma
• Health care jobs with reported cases
• Preventive strategies

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Preventing Asthma Symptoms in Health Care Workers

• Control exposures
• Work practices
• Training
• Monitor health
• Diagnosis and management

www.cdc.gov/niosh/homepage.html
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Powdered Glove Usage and Latex Sensitization
among Dental Students
Levy, Burney, et al. JAMA, March 1999
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Asthma Symptoms in Healthcare Workers Can Be
Prevented