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Work-related Asthma Risks for Nursing Staff Conducting Cleaning and Disinfection: Translation of Risk-risk Tradeoff Methodology

Sponsored by National Heart, Lung, and Blood Institute

$145K Funding
4 People

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PROJECT SUMMARY/ABSTRACT (limit 30 lines of text)Cleaning and disinfection (C&D) activities pose work-related asthma (WRA) risks for nurses. C&Dinvolves an inherent risk-risk tradeoff: increased C&D leading to increased WRA risks andsimultaneous decreased occupational infection risks. Our preliminary data from a risk-risk tradeoffsurvey indicate that nurses are generally willing to increase infection risks to maintain lower asthmarisks if they think they think they will recover. Translating these concerns to C&D protocol changes ischallenging due to logistical constraints and lack of awareness about asthma risks from C&D. Mylong-term goal is to advance methodologies for relating tolerable occupational respiratorydisease risks to public health policy interventions. Specific training aims are proposed: 1)Develop independent competency in designing behavioral economic surveys for studying riskperceptions and risk tolerances of WRA 2) Develop independent competency in conducting healthpolicy analyses in intervention contexts with qualitative methods 3) Apply bioethics and public healthpolicy principles to risk-risk tradeoff methodologies for assessing evaluations of WRA risk and riskperception. These training aims will be accomplished through formal coursework involvement in theAmerican Thoracic Society qualitative research and health policy trainings and assigned readingsand discussion with mentors. The University of Arizona is an ideal environment for the proposedtraining offering opportunities for training through faculty at the Asthma & Airway Disease ResearchCenter and the Southwest Environmental Health Sciences Center. This training will be appliedthrough 3 specific research aims: 1) Administer a C&D risk-risk tradeoff survey to 1000 nurses in thestate of Arizona to collect data for microbial risk assessments 2) Understand barriers to C&D policychanges in the workplace 3) Identify describe and assess C&D policy options with health policyanalysis. Aim 1 will involve adaption of a current risk-risk tradeoff survey and recruitment of 1000registered nurses. These data will be used in a microbial risk assessment to inform the neededfrequency and intensity of C&D to achieve acceptable risks. Aim 2 will involve interviews withregistered nurses (n=40) and key informant interviews with facilities management legal and workerscompensation staff occupational health specialists and infection preventionists (n=2-3/group). Aim 3will involve the use of a policy Delphi method (n=75). Translating risk-risk tradeoff analysis to informC&D policies will increase the impact of behavioral economics translation in respiratory occupationalhealth research. Understanding barriers to C&D protocol changes and identifying feasible policychange strategies will inform future efforts (NHLBI R01) to quantify acceptable OA and infection risksincluding the perspectives of patients to implement and evaluate C&D policy changes nationally.