PURPOSE: Occupational asthma (OA) is a common occupational lung disease. Preventive strategies are necessary to decrease the burden of OA. Primary prevention includes workplace chemical safety training. Flaws related to the comprehensibility and accuracy of training methods have been identified, but the impact on occupational disease has not been well studied. This study explores the effect that poor comprehension of safety training has on the prevalence of OA in indoor cleaners.
METHODS: Questions relating to workplace safety practices were incorporated into a cross-sectional study investigating the prevalence of OA among 566 professional cleaners. Indicators of OA used include greater than two or three work-related asthma symptoms (WRAS-2,-3), as well as physician-diagnosed asthma (PDA) and new-onset asthma (NOA). Chi-squared analysis was used to compare safety variables, including reported degree of comprehension of safety training, with OA prevalence. All results were adjusted for confounding factors.
RESULTS: Among the cleaners surveyed, 94% reported receiving chemical safety training and 13% found the topics hard to understand. For those who did not receive safety training, there was a significant increase in WRAS-3 (OR=2.32 (1.00-5.26;p=0.043)). Males with an education greater than high school (HS) who found it hard to understand training were more likely to have WRAS-3 (OR=12.36 (4.0-37.9;p<0.0001)). An increase in WRAS-2 (OR=7.16 (2.63-29.44;p<0.0001) and a trend towards an increase in NOA and PDA was observed in both sexes with education greater than HS.
CONCLUSION: There was an increased prevalence of respiratory symptoms among cleaners that did not receive or had decreased comprehension of safety education. The groups at highest risk were those with a higher education level, which may relate to varying workplace behaviours.
CLINICAL IMPLICATIONS: This study is the first to link inadequate workplace safety education with an increased incidence of OA, but given the cross-sectional nature of the study, does not necessarily imply causation. Further study is needed in order to identify specific reasons for decreased comprehension. Possible interventions may include safety training in different languages, instructor re-training, and testing of safety knowledge.
DISCLOSURE: Daniel Ricciuto, Grant monies (from sources other than industry) Supported by a grant from the Research Advisory Council of the Ontario Workplace Safety & Insurance Board.