LONG-TERM HEALTH AND EMPLOYMENT OUTCOMES OF OCCUPATIONAL ASTHMA AND THEIR DETERMINANTS

Occupational asthma is common., yet little is Known about long-term ou tcomes in the United States. A case series of 55 (of 72) occupational asthma patients were interviewed in follow-up 31 (+/-15) months after removal from the cause to evaluate asthma severity and employment outc omes. Standard criteria were used to rate severity, At follow-up, 54 s ubjects (98%) had active asthma, of which 26 cases (47%) were ''severe ,'' Multivariate analysis showed increased risk of ''severe'' asthma f or women (odds ratio [OR] = 13.8; 95% confidence interval [95% CI] = 1 .3 to 151.7) and industrial sector workers (OR = 11.9; 95 % CI = 1.3 t o 109.8). Thirty-eight subjects (69%) were unemployed, risk being grea ter for those with ''severe'' asthma (OR = 20.9 95% CI = 1.9 to 229.8) and for those without a college degree (OR = 11.9; 95 % CI = 1.2 to 4 3.4), These results indicate that occupational asthma is disabling and probably irreversible for most patients referred to a specialty clini c, despite prolonged removal from causative agents. Women, industrial workers, and those with severe asthma or lack of a college degree appe ar to be at risk for worse outcomes. Greater efforts at primary and se condary prevention should lessen the burden of long-term illness nbd u nemployment due to occupational asthma.