Services

Participating core and specialty programs: Personal Protective Technology

Employers, workers, researchers, unions, professional associations, and policy-makers will use NIOSH information to prevent hazardous exposures and lower and upper airways diseases among services workers.

information to prevent hazardous exposures and lower and upper airways diseases among services workers
Health Outcome Research Focus Worker Population Research Type
A Upper and lower respiratory disease Exposure assessment and Epidemiologic studies on mixed exposures in indoor environments Service workers with exposures (e.g., education, hotel industry, building maintenance, office workers) Basic/etiologic
B Upper and lower respiratory disease New methods to identify disease related to mixed exposures Service workers with exposures (e.g., education, hotel industry, building maintenance, office workers) Surveillance research
C Upper and lower respiratory disease Identifying effective strategies to translate research findings to practices in the workplace (e.g., the NIOSH Dampness and Mold Assessment Tool) Service workers with exposures (e.g., education, hotel industry, building maintenance, office workers) Translation
D Upper and lower respiratory disease Evaluate methods of PPE used to address mixed exposures Building services and maintenance Intervention

Activity Goal 5.13.1 (Basic/etiologic research): Conduct basic/etiologic research to better characterize mixed exposures and their associations with upper and lower respiratory disease among services sector workers.

Activity Goal 5.13.2 (Intervention research): Conduct studies to develop and assess the effectiveness of interventions to address mixed exposures related to upper and lower respiratory disease among services sector workers.

Activity Goal 5.13.3 (Translation research): Develop strategies to translate research findings and theoretical knowledge to practices in the workplace to prevent mixed exposures related to upper and lower respiratory disease among services sector workers

Activity Goal 5.13.4 (Surveillance Research): Conduct surveillance research to explore potential data sources to assess upper and lower respiratory disease among services sector workers.

Burden

The prevalence of asthma among services sector workers is 7.5% compared to 7.2% for all workers [NIOSH 2010]. Considering that the services sector employs over 70 million workers, research on work-related asthma is warranted. One industry of particular concern is educational services. It is the second largest industry in the United States (U.S.) with about 13.3 million workers, including 7.7 million teachers. The educational services industry has a high prevalence of current asthma with 9.1%, or about 1.2 million workers [Dodd and Mazurek 2016). The National Education Association has brought attention to the poor state of schools in the U.S., specifically that two-thirds of the nation’s 80,000 public schools have unhealthy environmental conditions [NEA 2011]. For example, research conducted in New York State indicated that current asthma among teachers was associated with moldy odors, visible mold, moisture damage, dust, and odors from perfumes/air fresheners [Kielb et al. 2015]. Additionally, the services sector includes 1.8 million workers employed in the hotel industry. Hotel room cleaners are exposed to chemicals and other sources of high molecular weight proteins as well as to microbial exposures related to poor indoor environmental quality that can result in allergic sensitization or the development and exacerbation of upper respiratory disease and asthma. Also, there are approximately 2.5 million workers employed in building services. These individuals are exposed to chemicals, microbial agents, and particulates.

Need

Hazards for Services workers include a variety of compounds, such as, microbial agents, high molecular weight allergens, secondary metabolites, volatile organic compounds, low molecular weight agents, and particulates. Studies evaluating hazards from exposure to these agents which often occur together in indoor environments are needed. The National Academies of Sciences 2017 consensus document entitled “Microbiomes of the Built Environment: A Research Agenda for Indoor Microbiology, Human Health, and Buildings” [NAS, 2017], emphasized the need to better understand mixed exposures in damp buildings and the associations of these exposures with respiratory and allergic health outcomes. Stress is an emerging issue related to asthma and should be considered as a possible effect modifier of other exposures in the work environment of Service sector workers. Workers in the Services sector who rely on PPE to reduce exposures need to understand the impact of mixed exposures on respirator change-out schedules and the physiological and psychological impact of wearing the PPE. Basic/etiologic, intervention, translation, and surveillance research are needed to better understand and prevent work-related lower and upper airways diseases associated with mixed exposures in the Services Sector.

Dodd KE, Mazurek JM [2016]. Asthma among employed adults, by industry and occupation — 21 states, 2013. MMWR Morb Mortal Wkly Rep, 65(47), 1325-1331.

Kielb C, Lin S, Muscatiello N, Hord W, Rogers-Harrington J, Healy J [2015]. Building-related health symptoms and classroom indoor air quality: A survey of school teachers in New York State. Indoor Air 25(4), 371-380. doi:10.1111/ina.12154

NAS (National Academies of Sciences, Engineering and Medicine) [2017]. Microbiomes of the Built Environment: A Research Agenda for Indoor Microbiology, Human Health, and Buildings. Washington, DC: The National Academies Press.

NEA (National Education Association) [2011]. Crumbling schools don’t provide strong foundations for America’s students [Press release]. Retrieved from http://www.nea.org/home/49988.htmexternal icon

NIOSH [2010]. National Health Interview Survey Occupational Health Supplement. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, https://www.cdc.gov/niosh/topics/nhis/profile.html

Note: Goal 5.13 was added in October 2019.

Page last reviewed: October 16, 2019