CONCLUSION
Four state-based surveillance systems for WRA documented
that HCWs are at risk for WRA. Despite demographic
and employment pattern variations across the four
states, health care emerged as the first or second most
frequently reported industry among all cases of WRA
reported from 1993 to 1997, and in proportions exceeding
their workforce representation. Because of the size and
projected growth of this industry, the lessons from these
surveillance data are important in reducing the burden of
asthma in the US population and reducing risk factors for
hundreds of thousands employed in health care.
Exposures to several of the asthma triggers identified by
HCWs may be reduced, and even eliminated, from health
care services by replacement with safer substitutes. To
further minimize the risk, engineering controls and safe work
practices are needed. Exposures may be reduced or prevented
by better planning and control of construction and renovation projects, and adequate facility maintenance to prevent
inadvertent moisture incursion and mold growth. Purchasing
decisions and planning should take into consideration
cleaning products, disinfectants, construction materials,
and gloves that have been tested for their allergenic and
irritant properties.