Background: Prior analyses of data from a questionnaire survey of healthcare workers identified associations of current asthma and exacerbation of asthma with housekeeping and nursing occupations and cleaning and patient care tasks. These findings are augmented with new evaluations of the association of the same outcomes with using products and combinations of products represented by exposure clusters (ECs).

Methods: The 2,030 participants were cleaners, nurses, and technicians working in hospitals and nursing homes in New York City. Health outcomes were all current asthma (n=173) and a variable with three subsets of these cases: no exacerbation, n=99; moderate exacerbation, n=41; and severe exacerbation, n=33. The two metrics of occupational exposure were self-reported use of 14 cleaning, disinfecting, and medical products, and 5 ECs with a No Products EC reference. Logistic regression models yielded odds ratios (ORs) and 95% confidence intervals (95% CIs) adjusted for age, gender, race, smoking, and allergy history.

Results: Products with elevated ORs were: Chlorine Bleach for all current asthma OR=1.60 (95% CI 1.11, 2.31), no exacerbation OR=1.84 (1.16, 2.90); Aerosolized Medications for all current asthma OR=1.66 (1.14, 2.42), moderate exacerbation OR=2.35 (1.18, 4.66); and Skin Wipes for moderate exacerbation OR=2.17 (1.09, 4.35). The Housekeeping/Chlorine EC had elevated ORs for all current asthma OR=2.01 (1.22, 3.30), no exacerbation OR=1.91 (1.01, 3.60), moderate exacerbation OR=3.11 (1.11, 8.68).

Conclusion: The results confirm previous findings showing associations of asthma outcomes with performing cleaning and patient care tasks in healthcare.