Workplace mold odor and renovations and the exacerbation of asthma in healthcare workers

Background: Prior studies indicate that asthma-related symptoms in healthcare workers are associated with workplace mold odor (MO) and the combination of painting with floor and wall renovations (P/FR/WR). We used data from a questionnaire survey of healthcare workers to study whether self-reports of MO and P/FR/WR in the past year were risk factors for current asthma with and without exacerbation. Methods: The 2,030 survey participants were cleaners, nurses, and technicians in over 250 hospitals and nursing homes in New York City. We divided the 173 participants with physician-diagnosed current asthma into three categories based on self-reported asthma-related symptoms and care in the past year: 33 severe exacerbation (hospitalized overnight or increased oral steroids); 41 moderate exacerbation (no severe exacerbation, but urgent care or short-term increase in inhaled steroids or rescue bronchodilators); and 99 current asthma/no exacerbation (but symptoms or care). Multinomial logistic regression models of the asthma categories yielded adjusted odds ratios (ORs) for MO and P/FR/WR. Results: More participants reported all three renovation activities P/FR/WR (n=542, 27%) than MO (n=147, 7.2%) at work. Current asthma outcomes were not associated with MO. Moderate exacerbation (OR 3.08, 95% CI 1.11, 8.56, p=0.03) and current asthma/no exacerbation (OR 1.90, 95% CI 0.98, 3.70, p=0.06) were associated with P/FR/WR. Conclusion: The renovation combination P/FR/WR in healthcare was a risk factor for moderate, but not severe, exacerbation of asthma. Minimizing exposure to dusts and gases during renovations might reduce exacerbation of asthma among workers and other occupants of healthcare facilities.