Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec 1;19(23):16092.
doi: 10.3390/ijerph192316092.

A Novel Application of Risk-Risk Tradeoffs in Occupational Health: Nurses' Occupational Asthma and Infection Risk Perceptions Related to Cleaning and Disinfection during COVID-19

Amanda M Wilson  1 , Irene Mussio  2 , Susan Chilton  2 , Lynn B Gerald  3 , Rachael M Jones  4 , Frank A Drews  5 , Judy S LaKind  6   7 , Paloma I Beamer  1
Affiliations

A Novel Application of Risk-Risk Tradeoffs in Occupational Health: Nurses' Occupational Asthma and Infection Risk Perceptions Related to Cleaning and Disinfection during COVID-19

Amanda M Wilson et al. Int J Environ Res Public Health. .

Abstract

Background: Nurses face the risk of new onset occupational asthma (OA) due to exposures to cleaning and disinfection (C&D) agents used to prevent infections in healthcare facilities. The objective of this study was to measure nurses' preferences when presented with simultaneous OA and respiratory viral infection (e.g., COVID-19) risks related to increased/decreased C&D activities.

Methods: Nurses working in healthcare for ≥1 year and without physician-diagnosed asthma were recruited for an online anonymous survey, including four risk-risk tradeoff scenarios between OA and respiratory infection with subsequent recovery (Infect and Recovery) or subsequent death (Infect and Death). Nurses were presented with baseline risks at hypothetical "Hospital 1", and were asked to choose Hospital 2 (increased OA risk to maintain infection risk), Hospital 3 (increased infection risk to maintain OA risk), or indicate that they were equally happy.

Results: Over 70% of nurses were willing to increase infection risk to maintain baseline OA risk if they were confident they would recover from the infection. However, even when the risk of infection leading to death was much lower than OA, most nurses were not willing to accept a larger (but still small) risk of death to avoid doubling their OA risk. Age, work experience, and ever having contracted or knowing anyone who has contracted a respiratory viral infection at work influenced choices.

Conclusions: We demonstrate the novel application of a risk-risk tradeoff framework to address an occupational health issue. However, more data are needed to test the generalizability of the risk preferences found in this specific risk-risk tradeoff context.

Keywords: healthcare worker; occupational asthma; risk perception; work-related asthma.

PubMed Disclaimer

Conflict of interest statement

LaKind consults to both governmental and private concerns, and previously had an unrestricted grant from the Household & Commercial Products Association (HCPA). Wilson has previously worked on projects funded by or has been directly funded by hygiene companies, including Gojo Industries Inc., Ecolab Inc., and Zoono USA. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Risk perception ranking of general, COVID-19-related, and cleaning and disinfection (C&D) related activities, ordered from smallest to largest mean score from top to bottom on the y-axis.
Figure 2
Figure 2
Preference choice (x axis) of either increased asthma risk to maintain infection risk (inc. asthma), increased infection risk to maintain asthma risk (inc. infection), or being equally happy with either increase, per individual for each scenario (in chronological order of the survey from top to bottom on the left axis). Scenarios are described based on baseline risks, either equal or unequal risks of occupational asthma (OA) and infection and recovery (infect and recover) or infection and death (infect and death).
See this image and copyright information in PMC

References

    1. Slovic P. The Perception of Risk. Taylor & Francis; Abingdon, UK: 2000.
    1. Arif A.A., Delclos G.L. Association between cleaning-related chemicals and work-related asthma and asthma symptoms among healthcare professionals. Occup. Environ. Med. 2012;69:35–40. doi: 10.1136/oem.2011.064865. - DOI - PubMed
    1. Wilson A.M., Weir M.H., Bloomfield S.F., Scott E.A., Reynolds K.A. Modeling COVID-19 infection risks for a single hand-to-fomite scenario and potential risk reductions offered by surface disinfection. Am. J. Infect. Control. 2021;49:846–848. doi: 10.1016/j.ajic.2020.11.013. - DOI - PMC - PubMed
    1. Arif A.A., Delclos G.L., Serra C. Occupational exposures and asthma among nursing professionals. Occup. Environ. Med. 2009;66:274–278. doi: 10.1136/oem.2008.042382. - DOI - PubMed
    1. Delclos G.L., Gimeno D., Arif A.A., Burau K.D., Carson A., Lusk C., Stock T., Symanski E., Whitehead L.W., Zock J.-P., et al. Occupational risk gactors and asthma among health care professionals. Am. J. Respir. Crit. Care Med. 2007;175:667–675. doi: 10.1164/rccm.200609-1331OC. - DOI - PMC - PubMed