Respiratory therapists are at an increased risk of developing asthma

Oct 11 2004

Respiratory therapists are at an increased risk of developing asthma and asthma-related symptoms due to their involvement in the diagnosis and treatment of patients with respiratory conditions.

A new study in the October issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP), showed that respiratory therapists have an elevated prevalence of asthma diagnosis after they enter into the profession and, when compared to physiotherapists, are more than twice as likely to develop respiratory symptoms. The study also found that the administration of specific aerosolized medications and the use of certain diagnostic equipment were associated with an increased risk of asthma.

"Respiratory therapists play a significant role in the diagnosis and treatment of respiratory conditions in patients. However, routine monitoring and care of patients can expose therapists to trace amounts of airborne agents that can trigger respiratory symptoms and cause exacerbations of acute asthma," said lead author Helen Dimich-Ward, PhD, University of British Columbia, Vancouver, British Columbia, Canada. "Although long-term use of protective masks may not be practical in undertaking certain procedures, their use and the use of other personal protection items are essential when caring for patients who are infectious."

Researchers from the University of British Columbia examined the link between asthma diagnosis and prevalence of respiratory symptoms in respiratory therapists based on their work-related risk factors. Researchers compared personal and work characteristics between 275 respiratory therapists and a control group of 628 physiotherapists (also known as physical therapists). After adjusting for age, gender, childhood asthma, and smoking status, results showed that respiratory therapists were twice as likely as physiotherapists to have reported asthma and respiratory symptoms of wheeze, dyspnea, and asthma attacks. Respiratory therapists who administered aerosolized ribavirin, compared to those who did not, were more than twice as likely to have an asthma attack in the last 12 months and to receive an asthma diagnosis since they began their profession. Respiratory therapists who used an oxygen tent or hood were eight times more likely to have asthma and over three times more likely to have experienced an asthma attack in the past year than those who did not use the equipment. Respiratory therapists who reported sterilizing instruments with glutaraldehyde-based solutions once a month or more, in comparison to those who did not, showed a higher prevalence of wheezing, waking by cough, and reported asthma. In addition, respiratory therapists who perceived their workplace to have inadequate ventilation had an increased risk of waking by cough or by shortness of breath.

Working more than 35 hours per week also was associated with the prevalence of wheeze and waking by cough. Although the majority of respiratory therapists worked at night or on rotating shifts, there was no association of respiratory symptoms or reported asthma with working a graveyard shift or rotating shifts or with treating children less than six years of age at least once a week. Personal protective equipment was worn by 67 percent of respiratory therapists, with nearly 50 percent wearing latex gloves and 36 percent using glasses or goggles.

"It is important for respiratory therapists and other medical professionals to recognize and understand the possible respiratory effects related to the administration of aerosolized substances and take appropriate steps to minimize their exposures to these medications during patient diagnostic procedures and treatments," said Richard S. Irwin, MD, FCCP, President of the American College of Chest Physicians.

http://www.chestnet.org/