Asthma-related work disability in Sweden - The impact of workplace exposures

Work disability due to respiratory disease, especially asthma, is common an d costly among working age adults. The goal of this analysis was to charact erize the risk factors for such disability. We analyzed data from the Swedi sh part of the European Community Respiratory Health Survey (ECRHS), a rand om population-based sample of adults age 20 to 44, enriched with symptomati c subjects at increased likelihood of having asthma. We analyzed structured interview data available for 2,065 subjects and further analyzed methachol ine challenge and skin prick test data for 1,562 of these. We defined respi ratory work disability as reported job change or work loss due to breathing affected by a job. We used binary generalized linear modeling with a log l ink to estimate disability risk. Eighty-four subjects (4%) reported such wo rk disability. This increased to 13% among those with asthma (45 of 350 sub jects). Adjusting for covariates, occupations at high risk for asthma were associated with disability (prevalence ratio [PR] 1.8; 95% confidence inter val [CI] 1.1 to 3.0), as was self-reported regular exposure to environmenta l tobacco smoke (ETS) at work (PR 1.8; 95% CI 1.1 to 3.1) and self-reported job exposure to vapors, gases, dust, or fumes (VGDF) (PR 4.3; 95% CI 2.2 t o 8.6). Workplace ETS exposure was also associated with methacholine challe nge-positive asthma reported to be symptomatic at work among male subjects (PR 4.2; 95% CI 1.8 to 9.8), whereas high asthma-risk occupations were asso ciated with this outcome among female subjects (PR 2.7; 95% CI 1.05 to 7.1) . Respiratory work disability, defined as breathing-related job change due to work loss, was associated with workplace exposures themselves, even afte r taking into account other covariates. Better control of workplace exposur es, including workplace ETS, may reduce work disability caused by respirato ry conditions, especially adult asthma.