Risk factors for work disability in severe adult asthma.
OBJECTIVE
We aimed to elucidate the prevalence of and risk factors for work disability in severe adult asthma and to evaluate the impact of work disability on downstream health outcomes.


METHODS
We used data from a prospective cohort study of 465 adults with severe asthma. Structured telephone interviews ascertained asthma status and employment history. A job exposure matrix (JEM) was used to characterize the likelihood of workplace exposure to "asthmagens."


RESULTS
The prevalence of asthma-related complete work disability was 14% among working-age adults with severe asthma (95% confidence interval, 11%-18%). Among those who were currently employed, the prevalence of partial work disability was 38% (95% confidence interval, 31%-45%). Sociodemographic (P = .027) and medical factors (P = .020) were related to the risk of complete work disability. Both sociodemographic characteristics (P = .06) and work exposures based on the JEM (P = .012) were related to partial work disability. In additional models, poorer asthma severity, physical health status, and mental health status were all associated with a higher risk of complete and partial work disability.


CONCLUSIONS
Work disability is common among adults with severe asthma. There are three sets of risk factors for work disability that are potentially modifiable: smoking, workplace exposures, and asthma severity.
Eisner
Mark D
MD
Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94117, USA. mark.eisner@ucsf.edu
Yelin
Edward H
EH
Katz
Patricia P
PP
Lactao
Gretchen
G
Iribarren
Carlos
C
Blanc
Paul D
PD
D000041:Absenteeism; D000328:Adult; D001249:Asthma / Q000150:complications*; D006233:Persons with Disabilities; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004651:Employment; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects; D017132:Workplace