The frequency of workplace exacerbation among health maintenance organization members with asthma

Paul K Henneberger ^1*, Susan J Derk ¹, Susan R Sama ², Randy J Boylstein ¹, Christopher D Hoffman ³, Peggy A Preusse ⁴, Richard A Rosiello ⁴ and Donald K Milton ⁵

¹ National Institute for Occupational Safety and Health, United States
² Harvard School of Public Health, United States
³ National Institute for Occupational Safety and Health
⁴ Fallon Clinic, United States
⁵ University of Massachusetts, United States

^* To whom correspondence should be addressed. E-mail: pkh0{at}cdc.gov.

Accepted 3 March 2006

Abstract

Objectives: Workplace conditions can potentially contribute to the worsening of asthma, yet it is unclear what percentage of adults with asthma experience workplace exacerbation of symptoms. The objective of this investigation was to determine the prevalence of workplace exacerbation of asthma (WEA). Methods: Adults with asthma aged 18-44 were enrolled into the baseline survey of a longitudinal study. Members of a health maintenance organization were considered candidates for participation if they fulfilled membership, diagnostic, and treatment criteria based on automated review of electronic billing, claims, and pharmacy records. Diagnosis and treatment were confirmed by manual review of medical records. A telephone questionnaire was administered. A work-related symptom score was assigned to each participant based on responses to questions about work-related asthma symptoms, medication use, and symptom triggers. Blinded to participants answers to these questions, two researchers independently reviewed the self-reported work histories and assigned exposure ratings. A final exposure score was then calculated. Participants with sufficient evidence for work-related symptoms and exposure were classified as having WEA. Results: Of the 598 participants with complete data, 557 (93%) were working, and 136 (23%) fulfilled the criteria for WEA. Those with WEA were more likely to be male and to report that they had been bothered by asthma symptoms during the past 7 days. Conclusions: Workplace exacerbation of asthma was common in this study population, occurring in over a fifth of these adults with asthma. Physicians should consider that work can contribute to the exacerbation of symptoms when treating adults with asthma.

Keywords: asthma, inhalation exposures, occupational diseases, occupational exposure

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