News & Events

New report: substances common in hospitals can cause or worsen asthma

From the Massachusetts Nurse Newsletter
November/December 2006 Edition

Unbeknownst to many health care providers, the indoor hospital environment may be making people sick. A new report reveals that substances commonly found in hospitals—including chemicals used to clean floors and medical equipment, fumes from building materials, latex gloves, and other common substances—can trigger an asthma attack or cause the disease. This is new information in the effort to better understand what causes asthma and why occupational rates of the disease have been steadily increasing.

This first-of-its-kind report was written by Health Care Without Harm, an international coalition with 450 groups in 55 countries working to make the health care industry safer and was released by the Alliance for a Healthy Tomorrow, a statewide coalition working to reduce toxic threats to human health. The report presents rigorously researched hazard information about asthma triggers and asthmagens found in health care settings, and shows how to reduce problematic exposures.

“As places of healing, hospitals have a responsibility to protect patients and workers from harmful chemicals and practices. The good news is that safer alternatives are available. We urge hospitals to take immediate action to clean up the indoor environment,” said Bill Ravanesi, spokesman for HCWH.

The key conclusions of the report include:

  • There is considerable cause for concern that substances commonly used and found in health care can cause or trigger asthma.
  • Among the worst exposures in health care are formaldehyde (found in chemically-treated fabrics, carpets, pressed wood and other products); cleaners, disinfectants and sterilants; natural rubber latex; tobacco smoke; and biologic allergens.
  • Nurses may be among the most exposed to some hazardous chemicals identified in the report including the disinfectant gluteraldehyde and the sterilizing agent ethylene oxide.
  • Hospitals can use safer alternatives to many substances or modify standard practices in order to limit peoples’ exposure to asthmagens.

Asthma is a public health crisis. In the U.S., the number of people with asthma has more than doubled over the last two decades. In 2005, the MA DPH found that 9.5 percent of school children in Massachusetts have been diagnosed with asthma and according to a 2006 report by the Asthma Regional Council, nearly 15 percent of adults in New England have had asthma. Asthma now costs the nation $16.1 billion annually in health care, loss of work productivity and premature death.

Workplace exposures are a particular problem. Asthma is the most commonly reported workplace lung condition. An estimated 10 to 23 percent of all adult-onset asthma cases are due to workplace exposures, and a significant portion of those cases occur in health care workers. Furthermore, among the cases of work-related asthma reported to the Massachusetts Department of Public Health between the years of 1993-2004, the health care industry accounted for 30 percent of all work-related asthma cases.

“Many nurses have suffered from workplace asthma due to exposure to chemical sterilants, disinfectants, deodorizers, cleaning products and floor buffing and stripping chemicals,” said Janice Homer, R.N. who developed asthma after being exposed to toxic cleaning products while working at a Massachusetts hospital. “Hospitals should heed recommendations in this report and carefully chose and use chemicals to reduce chemical exposures for patients and nurses,” Homer said.

“Ironically many products used in health care to keep people safe from pathogens can cause or exacerbate asthma in susceptible people,” said Ted Schettler, MD and science director of Science and Environmental Health Network. “Fortunately there are alternative products and practices that hospitals can use to accomplish their goals without increasing asthma risks.”

In the next legislative session the Massachusetts Legislature will consider bills that would replace toxic chemicals in consumer products and in the workplace with safer alternatives, including “An Act for a Healthy Massachusetts: Safer Alternatives to Toxic Chemicals.” The bill would replace toxic chemicals in common products with safer alternatives where feasible. When a safer alternative is not currently available, the bill would stimulate research and development into new technologies and solutions. In the case of hospitals and healthcare settings, safer alternatives are readily available to toxic cleaning products, latex, building materials that contain volatile organic compounds (VOCs), products made of PVC plastic (vinyl), some acrylics and pesticides.

“It doesn’t make sense to continue using dangerous toxic chemicals when there are safer alternatives available,” stated Lee Ketelsen, Clean Water Action New England director. “Unnecessary harm is being done to the health of workers, consumers and children. This unnecessary danger will continue until we pass the Safer Alternatives Bill and create safe products and safe workplaces,” she concluded.

To obtain a copy of the report, visit or call 703.243.0056.