The American Journal of Medicine
Volume 119, Issue 10 , Pages 884-891, October 2006

Risk Factors for Work Disability in Severe Adult Asthma

  • Mark D. Eisner, MD, MPH

      Affiliations

    • Division of Occupational and Environmental Medicine and Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco
    • Institute for Health Policy Studies, Department of Medicine, University of California, San Francisco
    • Corresponding Author InformationRequests for reprints should be addressed to Mark D. Eisner, MD, MPH, University of California, San Francisco, 350 Parnassus Avenue, Ste 609, San Francisco, CA 94117.
    • ,
  • Edward H. Yelin, PhD

      Affiliations

    • Institute for Health Policy Studies, Department of Medicine, University of California, San Francisco
    • ,
  • Patricia P. Katz, PhD

      Affiliations

    • Institute for Health Policy Studies, Department of Medicine, University of California, San Francisco
    • ,
  • Gretchen Lactao, BA

      Affiliations

    • Division of Occupational and Environmental Medicine and Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco
    • ,
  • Carlos Iribarren, MD, PhD, MPH

      Affiliations

    • Division of Research, Kaiser Permanente, Oakland, Calif.
    • ,
  • Paul D. Blanc, MD, MSPH

      Affiliations

    • Division of Occupational and Environmental Medicine and Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco

Received 18 July 2005; accepted 15 January 2006.

Abstract 

Purpose

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.

Keywords: Asthma, Work, Employment, Occupation, Disabled persons

 

 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.

PII: S0002-9343(06)00155-0

doi:10.1016/j.amjmed.2006.01.016

The American Journal of Medicine
Volume 119, Issue 10 , Pages 884-891, October 2006

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