ASTHMA, EMPLOYMENT STATUS, AND DISABILITY AMONG ADULTS TREATED BY PULMONARY AND ALLERGY SPECIALISTS

Objective: Identify risk factors for work disability among adults with asthma treated by pulmonary and allergy specialists. Design: Cross-se ctional survey, including retrospective work history data. Participant s: Sixty-eight pulmonary and 16 allergy internal medicine subspecialis ts maintaining a registry of patient visits for asthma; 698 registered patients aged 18 to 50 years, of whom 601 (86%) were studied. Measure s: Computer-assisted, telephone-administered structured interview asse ssing asthma severity, perceived general health status, asthma quality of life, demographics, and work history, Complete work disability def ined as total work cessation attributed to asthma; partial work disabi lity defined as change in job, duties, or reduction in work hours attr ibuted to asthma. Results: Complete cessation of work due to asthma wa s reported by 40 (7%; 95% confidence interval [CI], 5 to 9%) and parti al work disability by 53 (10%; 95% CI, 7 to 12%) of 550 subjects with a history of labor force participation. Severity of asthma score predi cted both complete disability (odds ratio [OR], 7.9; 95% CI, 4.2 to 15 per 10-point increment) and partial disability (OR 2.6; 95% CI, 1.6 t o 4.2). Taking illness severity into account,job conditions, occupatio n, and work exertion carried a combined disability OR of 3.9 (95% CI, 1.7 to 8.6). Conclusions: Work disability is common among adults with asthma receiving specialist care. Severity of disease is a powerful pr edictor, but not the sole predictor of disability in this group. Worki ng conditions, including job-related exposures, are associated with ad ded disability risk even after taking illness severity into account.