title: Functional limitations and workdays lost associated with chronic rhinosinusitis and allergic rhinitis.
abstract: BACKGROUND
  Chronic rhinosinusitis (CRS) and allergic rhinitis are associated with functional limitations, but these impacts are not known on a population basis. Our objective was to epidemiologically determine functional limitations and workdays lost that are associated  with CRS and allergic rhinitis in adults.
  
  
  METHODS
  The Medical Expenditure Panel Survey for calendar year 2007 was examined to identify cases of CRS and allergic rhinitis. Functional limitation variables for activity limitation, work limitation, social limitation, and cognitive  limitation determined by the survey also were extracted. Using multivariate models adjusting for age, gender, race, ethnicity, education level, insurance status, geographic region, as well as the Charlson comorbidity index, incremental differences in workdays lost and these functional limitations  were determined for patients with and without CRS and allergic rhinitis.
  
  
  RESULTS
  Among 225.1 million adults, the prevalences of CRS and allergic rhinitis were 4.9 ± 0.2% and 7.9 ± 0.3%, respectively. Patients with CRS demonstrated an incremental 1.04 ±  0.3 workdays lost per year along with significant increased adjusted odds ratios for activity limitation (odds ratio, 1.54), work limitation (1.50), and social limitation (1.49, all p < .005) but not cognitive limitation (1.05, p = .213). Patients with allergic rhinitis demonstrated an  incremental 0.60 ± 0.45 workdays lost along with significant increased adjusted odds ratios for activity limitation (1.42), work limitation (1.43), social limitation (1.47), and cognitive limitation (1.32, all p < .019).
  
  
  CONCLUSIONS
  Both CRS and allergic rhinitis  impart significantly increased odds ratios for activity, work, and social limitations. Allergic rhinitis also carries with it statistically significant odds of functional cognitive limitation. The total aggregate workdays missed in the United States may be estimated at 11.5 million workdays  and 10.7 million workdays for CRS and allergic rhinitis, respectively.
authors.affiliation: Division of Otolaryngology, Brigham and Women's Hospital, Boston, Massachusetts, USA. neiloy@massmed.org
authors.forename: Neil
authors.initials: N
authors.lastname: Bhattacharyya
mesh_terms: D000041:Absenteeism; D000203:Activities of Daily Living; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011788:Quality of Life; D012221:Rhinitis, Allergic, Perennial / Q000453:epidemiology*; D006255:Rhinitis, Allergic, Seasonal / Q000453:epidemiology*; D012852:Sinusitis / Q000453:epidemiology*; D012919:Social Behavior; D014937:Work / Q000706:statistics & numerical data*