一些评论报告说,接触清洁剂或消毒剂的工人患阻塞性呼吸系统疾病的风险增加,但他们主要集中在专业清洁工上。清洁和消毒是医护人员经常进行的活动。我们通过荟萃分析进行了系统评价,以量化暴露于清洁和消毒剂的医护人员患阻塞性呼吸系统疾病的风险。我们搜索了Medline和Embase数据库,直到2021年2月4日,以找到足够的初步研究。两名独立审稿人筛选了研究的标题/摘要和全文,以及执行数据提取和质量评估。文献检索产生9432条记录,通过手工搜索发现了8项研究。筛选后,14项研究纳入审查。所有人都有很高的偏见风险,大多数研究涉及护士,哮喘,和高反应性(BHR)相关症状。只有一项研究调查了COPD。荟萃分析估计与其他职业相比,护士新发哮喘的风险增加(效应大小(ES)=1.67;95%CI1.11-2.50),并发现暴露于清洁和消毒表面(ES=1.43;95%CI1.09-1.89)和器械(ES=1.34;95%CI1.09-1.65)的护士新发哮喘的风险增加。暴露于特定化学物质如漂白剂和戊二醛(GA)会增加护士患哮喘的风险(漂白剂ES=2.44;95%CI1.56-3.82;GAES=1.91,95%CI1.35-2.70)。暴露于清洁表面的护士出现BHR相关症状的风险更高(ES=1.44;95%CI1.18-1.78)。尽管总体证据被评为低,本综述中发现的局限性暗示了对实际风险的潜在低估.这些发现强调了加强医护人员预防措施的必要性。需要进行类似的研究,以调查其他医护人员之间的这些关联,例如救援服务和疗养院人员。
Several reviews have reported an increased risk of obstructive respiratory diseases in workers exposed to cleaning or disinfection agents, but they have focused mainly on professional cleaners. Cleaning and disinfecting are frequently performed activities by healthcare workers. We conducted a systematic
review with meta-analysis to quantify the risk of obstructive respiratory diseases in healthcare workers exposed to cleaning and disinfection agents. We searched the Medline and Embase databases until 4 February 2021 to find adequate primary studies. Two independent reviewers screened the titles/abstracts and the full texts of the studies, as well as performing data extraction and quality assessment. The literature search yielded 9432 records, and 8 studies were found through a hand search. After screening, 14 studies were included in the
review. All had a high risk of bias, and most studies dealt with nurses, asthma, and hyperresponsiveness (BHR)-related symptoms. Only one study investigated COPD. The meta-analysis estimated an increased risk of new-onset asthma for nurses (Effect size (ES) = 1.67; 95% CI 1.11-2.50) compared with other occupations and found an increase in the risk of new-onset asthma for nurses exposed to cleaning and disinfecting surfaces (ES = 1.43; 95% CI 1.09-1.89) and instruments (ES = 1.34; 95% CI 1.09-1.65). Exposure to specific chemicals such as bleach and
glutaraldehyde (GA) increased the risk of asthma in nurses (bleach ES = 2.44; 95% CI 1.56-3.82; GA ES = 1.91, 95% CI 1.35-2.70). A higher risk for BHR-related symptoms was observed for nurses exposed to cleaning surfaces (ES = 1.44; 95% CI 1.18-1.78). Although the overall evidence was rated as low, the limitations found in this
review hint at a potential underestimation of the real risk. These findings highlight the need for reinforced prevention practices with regard to healthcare workers. Similar research investigating these associations among other healthcare workers such as rescue service and nursing home personnel is needed.