Occup Environ Med

ObjectivesNurses are at increased risk of occupational asthma, an observation that may be related to disinfectants exposure. Whether asthma history influences job type or job changes among nurses is unknown. We investigated this issue in a large cohort of nurses.MethodsThe Nurses' Health Study II is a prospective study of U.S. female nurses enrolled in 1989 (ages 24-44 years). Job status and asthma were assessed in biennial (1989-2011) and asthma-specific questionnaires (1998, 2003). Associations between asthma history at baseline (diagnosis before 1989, n=5, 311) and job type at baseline were evaluated by multinomial logistic regression. The relations of asthma history and severity during follow-up to subsequent job changes were evaluated by Cox models.ResultsThe analytic cohort included 98,048 nurses. Compared to nurses in education/administration (likely low disinfectant exposure jobs), women with asthma history at baseline were less often employed in jobs with likely high disinfectant exposure, such as operating rooms (odds ratio: 0.73[95%CI, 0.63-0.86]) and ER/inpatient units (0.89[0.82-0.97]). During 22-year follow-up, nurses with a baseline history of asthma were more likely to move to jobs with lower exposure to disinfectants (hazard ratio: 1.13[1.07-1.18]), especially among those with more severe asthma (hazard ratio for mild persistent: 1.13; moderate persistent 1.26; severe persistent: 1.50, compared to intermittent asthma, P trend: 0.004).ConclusionAsthma history was associated with baseline job type and subsequent job changes among nurses. This may partly reflect avoidance of tasks involving disinfectant use, and may introduce bias in cross-sectional studies on disinfectant exposure and asthma in nurses.20152016-07-01T00:00:00ZKLB9/Intramural CDC HHS/United StatesR01 OH-10359/OH/NIOSH CDC HHS/United StatesR01 OH010359/OH/NIOSH CDC HHS/United StatesUM1 CA176726/CA/NCI NIH HHS/United States25713153PMC4472505701