Risk Factors for Work Disability in Severe Adult Asthma

Abstract Purpose We aimed to elucidate the prevalence of and risk factors for work disability in severe adult asthma and to evaluate the impact of work disability on downstream health outcomes. Methods We used data from a prospective cohort study of 465 adults with severe asthma. Structured telephone interviews ascertained asthma status and employment history. A job exposure matrix (JEM) was used to characterize the likelihood of workplace exposure to “asthmagens.” Results The prevalence of asthma-related complete work disability was 14% among working-age adults with severe asthma (95% confidence interval, 11%-18%). Among those who were currently employed, the prevalence of partial work disability was 38% (95% confidence interval, 31%-45%). Sociodemographic (P = .027) and medical factors (P = .020) were related to the risk of complete work disability. Both sociodemographic characteristics (P = .06) and work exposures based on the JEM (P = .012) were related to partial work disability. In additional models, poorer asthma severity, physical health status, and mental health status were all associated with a higher risk of complete and partial work disability. Conclusions Work disability is common among adults with severe asthma. There are three sets of risk factors for work disability that are potentially modifiable: smoking, workplace exposures, and asthma severity.