title: Pollen and mold exposure impairs the work performance of employees with allergic rhinitis.
abstract: BACKGROUND
  Although quality of life studies suggest that allergic rhinitis has a substantial impact on work impairment, national survey estimates of the magnitude of this impairment have varied widely. Retrospective recall bias is likely to be a major cause of this variability.
  
  
  OBJECTIVE
  This study used a nationally representative daily diary sample to obtain prospective data that improve on previous estimates of the work impairment because of allergic rhinitis.
  
  
  METHODS
  The MacArthur Foundation National Survey of Daily Experience is a daily diary survey that included a nationally representative subsample of 739 employed people, each of whom provided daily reports on work performance for 1 randomly assigned week of the calendar year. National Allergy Bureau monitoring station data were merged with the survey data to study the association of time-space variation in pollen/mold exposure with impaired daily work quality and quantity.
  
  
  RESULTS
  National Allergy Bureau pollen/mold counts are significantly related to work impairments only among respondents with self-reported allergic rhinitis. The average estimated monthly salary-equivalent work impairment costs associated with pollen/mold exposure for each allergy sufferer is between $109 and $156, with an annualized national projection of between $5.4 billion and $7.7 billion.
  
  
  CONCLUSIONS
  The extent to which these costs can be recovered by increasing the proportion of allergy sufferers who are successfully treated remains unknown and can only be evaluated definitively in effectiveness trials.
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts 02115-1248, USA. Kessler@hcp.med.harvard.edu
authors.forename: R C
authors.initials: RC
authors.lastname: Kessler
authors.forename: D M
authors.initials: DM
authors.lastname: Almeida
authors.forename: P
authors.initials: P
authors.lastname: Berglund
authors.forename: P
authors.initials: P
authors.lastname: Stang
mesh_terms: D000328:Adult; D000367:Age Factors; D000485:Allergens / Q000009:adverse effects*; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D003710:Demography; D004522:Educational Status; D017049:Employer Health Costs; D005260:Female; D005658:Fungi / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000191:economics* / Q000453:epidemiology / Q000209:etiology; D016273:Occupational Exposure / Q000191:economics; D011058:Pollen / Q000009:adverse effects*; D015995:Prevalence; D011446:Prospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000191:economics* / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D016526:Workload
chemical_list: D000485:Allergens