title: Long-term health and employment outcomes of occupational asthma and their determinants.
abstract: Occupational asthma is common, yet little is known about long-term outcomes in the United States. A case series of 55 (of 72) occupational asthma patients were interviewed in follow-up 31 (+/- 15) months after removal from the cause to evaluate asthma severity and employment outcomes. Standard criteria were used to rate severity. At follow-up, 54 subjects (98%) had active asthma, of which 26 cases (47%) were "severe." Multivariate analysis showed increased risk of "severe" asthma for women (odds ratio [OR] = 13.8; 95% confidence interval [95% CI] = 1.3 to 151.7) and industrial sector workers (OR = 11.9; 95% CI = 1.3 to 109.8). Thirty-eight subjects (69%) were unemployed, risk being greater for those with "severe" asthma (OR = 20.9; 95% CI = 1.9 to 229.8) and for those without a college degree (OR = 7.3; 95% CI = 1.2 to 43.4). These results indicate that occupational asthma is disabling and probably irreversible for most patients referred to a specialty clinic, despite prolonged removal from causative agents. Women, industrial workers, and those with severe asthma or lack of a college degree appear to be at risk for worse outcomes. Greater efforts at primary and secondary prevention should lessen the burden of long-term illness and unemployment due to occupational asthma.
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, USA.
authors.forename: T H
authors.initials: TH
authors.lastname: Gassert
authors.forename: H
authors.initials: H
authors.lastname: Hu
authors.forename: K T
authors.initials: KT
authors.lastname: Kelsey
authors.forename: D C
authors.initials: DC
authors.lastname: Christiani
mesh_terms: D000328:Adult; D001249:Asthma; D004522:Educational Status; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors