AJM Theme Issue: Pulmonology/AllergyClinical research studyRisk Factors for Work Disability in Severe Adult Asthma
Section snippets
Subject Recruitment
We used data from a prospective cohort study of adult members of Northern California Kaiser Permanente (KP). Recruitment methods have been reported in detail.16, 17, 18 To establish a cohort with more severe asthma, we recruited adults after recent hospitalization for asthma.19, 20, 21, 22, 23 Eligible subjects were adult KP members (≥18 years) who were hospitalized with a principal International Classification of Diseases, 9th revision (ICD-9) discharge diagnosis code for asthma (codes 493.xx)
Risk of Work Disability
Subject characteristics are summarized in Table 1. The prevalence of asthma-related complete work disability was 14% among working-age adults with severe asthma (95% confidence interval [CI] 11%-18%) (Figure 1). Among those who were not currently employed, more than 1 in 4 cases of complete work disability could be attributed to asthma (26%; 95% CI, 21%-32%). In the subgroup who was currently employed, the prevalence of partial work disability was 38% (95% CI, 31%-45%).
As shown in Table 2,
Discussion
In this cohort of insured adults with severe asthma, the prevalence of complete and partial work disability was substantial. Compared with the general population of California adults, adults with asthma were 31% less likely to be currently employed. Sociodemographic factors and medical factors were both associated with the risk of complete work disability caused by asthma, whereas sociodemographic factors and workplace exposures contributed to partial work disability. In addition, poorer asthma
Conclusion
Work disability is common among adults with severe asthma and is associated with adverse downstream health outcomes. On the basis of our results, we identified three sets of risk factors for work disability that are potentially modifiable: smoking, workplace exposures, and asthma severity. A combined clinical approach that includes smoking cessation, a careful occupational history, and optimization of asthma therapy has the potential to prevent work loss, financial deterioration, and negative
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2019, Respiratory MedicineCitation Excerpt :During a follow-up of six years asthma diagnosed in late adulthood was associated with higher risk for drifting out from full-time work compared to asthma diagnosed in childhood. Although work ability and employment status of asthma patients have been studied widely [9–12] and onset age and different phenotypes of asthma have been of interest of researchers recently [1], the evidence on the association of asthma onset age and work ability or employment status is still lacking. The difference in coping in working life between childhood-onset and late-onset asthma may be related to at least three factors.
Occupational asthma
2014, New England Journal of Medicine
Dr. Eisner was supported by K23 HL04201, National Heart, Lung, and Blood Institute, National Institutes of Health, with co-funding by the Social Security Administration.