Chest
Clinical InvestigationsOccupational Asthma in a National Disability Survey
Section snippets
Survey Design
The SDA was completed in 1978 by the Social Security Administration. Questionnaires were administered in household interviews to a national sample of noninstitutionalized adults aged 18 to 64 years. Respondents were derived from two sampling frames. One frame comprised 6,900 subjects selected from 1976 Health Interview Survey (HIS) respondents, representing the community at large but drawing disproportionately among those with activity limitations. The second frame comprised 4,500 subjects
RESULTS
Of 6,063 respondents, 468 (7.7 percent) stated that they had asthma. All but 12 listed this as a physician’s diagnosis. Seventy-two respondents attributed asthma to “bad working conditions.” These occupationally related asthma cases represented 15.4 percent of all asthma and 1.2 percent of all respondents. Table 1 presents demographic data for those with occupationally related asthma, those with all other types of asthma, and nonasthmatic subjects. Occupational cases were older and had a
DISCUSSION
These data indicate that the problem of occupationally related asthma may be larger indeed than previously estimated. These results, which suggest reconsideration of the minor role generally allotted workplace exposures in the etiology of asthma overall, must be interpreted with the caution warranted by the study design.
In the ideal world (if the workplace was not then risk-free), one could study all employees, identifying prospectively, by strict medical criteria, all those with asthma,
CONCLUSION
In summary then, potential effects of selection through sampling error; of assessment in illness and exposure; and of misattribution of cause do not appear to have been major sources of bias in this analysis. Rejecting these as likely explanations for the findings reported here, one must return to the conclusion that the high prevalence of occupationally attributed asthma detected in this study is a valid observation, implying that revision is necessary in our assessment of this public health
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This research and the preparation of this study were assisted by a grant from the Robert Wood Johnson Foundation, Princeton, NJ. The opinions, conclusions, and proposals in the text are those of the author and do not necessarily represent the views of the Robert Wood Johnson Foundation.
Manuscript received December 22; revision accepted March 2.