Southwest Center for Occupational and Environmental Health


Patel publishes R01 study led by Delclos and Gimeno on asthma in Texas healthcare professionals

Published: April 2, 2024

Dr. Jenil Patel

Assistant Professor Jenil Patel, PhD, served as first author of a study that found an increased prevalence of work-related asthma among selected groups of healthcare professionals.

The study was published in the January issue of the Journal of Occupational and Environmental Medicine (JOEM).

Patel is the pilot project research program director and occupational epidemiology doctoral training program director at the Southwest Center for Occupational and Environmental Health (SWCOEH) at UTHealth Houston School of Public Health.

The publication “Cleaning Tasks and Products and Asthma Among Health Care Professionals,” examined associations of cleaning tasks and products with work-related asthma in health care workers (HCWs) in 2018, comparing them with prior results from a similar 2003 study conducted by lead authors Patel, George Delclos, MD, PhD, and David Gimeno, PhD.

“We conducted this follow-up of a previous study on asthma in Texas healthcare professionals, where the authors found increased prevalence of asthma among selected groups of healthcare professionals, notably nurses, along with increased associated asthma risk for surface and instrument cleaning,” Patel said. “In this new study, conducted 14 years later, we found that prevalence of asthma in healthcare professionals seems unchanged. However, associations of new-onset asthma with exposures to surface cleaning remained and decreased for instrument cleaning.”

The team estimated asthma prevalence by professional group (nurses, physicians, respiratory therapists and occupational therapists) and explored associations of self-reported asthma with job-exposure matrix–based cleaning tasks/products in a representative Texas sample of 9,914 physicians, nurses, respiratory/occupational therapists, and nurse aides.

The study found that overall prevalence rates of new-onset asthma (NOA, 6.7%) and bronchial hyperresponsiveness (BHR) symptoms (31.1%) among HCWs remained high, or were slightly higher, in 2016 as compared with 2003 (6.6% and 27.4%, respectively). Some associations with cleaning tasks and products changed, whereas others remained the same.

Regarding cleaning tasks and products, the use of ortho-phthalaldehyde (OPA), bleach, quaternary compounds, and sprays were twice as likely to be associated with NOA. The association of NOA with patient care cleaners and with instrument cleaning and disinfection of medical instruments decreased substantially (40% to 60%), and exposure to powdered latex appeared even more controlled, but exposure to cleaning of building surfaces remained unchanged. In the updated study, BHR symptoms connected with cleaning of building surfaces and acute exposure to chemical spills, were no longer significantly associated with new onset asthma.

The researchers expanded the cohort of professional groups, by including nurse aids, which are an understudied group in occupational health findings. “Nurse aides are often involved in more cleaning and disinfection practices, compared to other healthcare professionals,” said Patel. “The increased association with exposure to OPA and the continued association with cleaning building surfaces should be monitored, along with using alternative products and practices Overall, improving exposure controls and clinical asthma management could help decrease the asthma burden among HCWs.”

This study was in collaboration with the Baylor College of Medicine, Center for Disease Control, National Institute for Occupational Safety and Health, and the University of Utrecht including George L. Delclos, MD; David Gimeno Ruiz de Porras, PhD; Arch “Chip” Carson, MD; Lawrence W. Whitehead, PhD; Sadie Conway, PhD; Laura E. Mitchell, PhD; Inkyu Han, PhD; Lisa Pompeii, PhD; Jan-Paul Zock, PhD; Paul K. Henneberger, DSc; Riddhi Patel, MPH; and Joy De Los Reyes, MPH.

The SWCOEH provides graduate-level training opportunities for occupational and environmental health professionals through our industrial hygiene, occupational and environmental medicine, occupational epidemiology, and Total Worker Health® programs.