Article Text

Download PDFPDF
The frequency of workplace exacerbation among health maintenance organisation members with asthma
  1. P K Henneberger1,
  2. S J Derk1,
  3. S R Sama2,
  4. R J Boylstein1,
  5. C D Hoffman1,
  6. P A Preusse3,
  7. R A Rosiello3,
  8. D K Milton4
  1. 1Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, WV, USA
  2. 2Fallon Clinic, Worcester, MA, USA
  3. 3Fallon Clinic Research Department, Worcester, MA, USA
  4. 4Department of Work Environment, University of Massachusetts, Lowell, MA, USA
  1. Correspondence to:
 Dr P Henneberger
 NIOSH/CDC, M/S H2800, 1095 Willowdale Road, Morgantown, WV 26501, USA; pkh0{at}


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 organisation 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 seven 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.

  • FCHP, Fallon Community Health Plan
  • HMO, health maintenance organisation
  • HSRB, Human Subjects Review Board
  • ICD-9, International Classification of Diseases, Ninth Revision
  • NIOSH, National Institute for Occupational Safety and Health
  • SENSOR, Sentinel Event Notification System for Occupational Risks
  • WEA, workplace exacerbation of asthma
  • asthma
  • occupational diseases
  • occupational exposure
  • inhalation exposure
  • exacerbation

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Published Online First 6 April 2006

  • Ethics approval: the NIOSH Human Subjects Review Board (HSRB) reviewed and approved the research protocol, as did the HSRB of the contracted HMO, Fallon Clinic, Inc, Research Department in Eastern and Central Massachusetts.

    Disclaimers: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health (NIOSH). Mention of any company or product does not constitute endorsement by NIOSH.