Late Breaking Abstract - Occupational exposure to disinfectants and COPD incidence in US nurses: a prospective cohort study

Background: Exposure to disinfectants in healthcare workers has been associated with respiratory health effects, including asthma. Despite biological plausibility for an association between disinfectants (irritant chemicals) and COPD, available data are sparse. Aims: To investigate the association between exposure to disinfectants and incident COPD in a large cohort of US female nurses. Methods: The Nurses’ Health Study II is a prospective cohort of 116,430 female registered nurses enrolled in 1989. Analyses included 55,185 participants who were still in a nursing job and with no history of COPD in 2009 (baseline; mean age: 54 years). During ~8 years of follow-up (until May 2017), 663 nurses reported incident physician-diagnosed COPD. Occupational exposure was evaluated by questionnaire and a Job-Task-Exposure Matrix (JTEM). We examined the association between disinfectant exposure and subsequent COPD development, adjusted for age, smoking (pack-years), body mass index, race and ethnicity. Results: Using disinfectants to clean surfaces on a weekly basis (37% exposed) was associated with incident COPD (adjusted odds ratio [aOR], 95% CI: 1.22, 1.04-1.43). An association was suggested for weekly use of disinfectants to clean instruments (19% exposed; aOR: 1.18, 0.98-1.43). High level exposure to several specific disinfectants evaluated by the JTEM (glutaraldehyde, bleach, hydrogen peroxide, alcohol and quats) were significantly (p Conclusions: Results support a prospective association between exposure to disinfectants and higher COPD incidence in nurses. This novel hypothesis merits further investigation.