Blanc P D, Cisternas M, Smith S, Yelin E H
Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, 94143-0924, USA.
Chest. 1996 Mar;109(3):688-96. doi: 10.1378/chest.109.3.688.
Identify risk factors for work disability among adults with asthma treated by pulmonary and allergy specialists.
Cross-sectional survey, including retrospective work history data.
Sixty-eight pulmonary and 16 allergy internal medicine subspecialists maintaining a registry of patient visits for asthma; 698 registered patients aged 18 to 50 years, of whom 601 (86%) were studied.
Computer-assisted, telephone-administered structured interview assessing asthma severity, perceived general health status, asthma quality of life, demographics, and work history. Complete work disability defined as total work cessation attributed to asthma; partial work disability defined as change in job, duties, or reduction in work hours attributed to asthma.
Complete cessation of work due to asthma was reported by 40 (7%; 95% confidence interval [CI], 5 to 9%) and partial work disability by 53 (10%; 95% CI, 7 to 12%) of 550 subjects with a history of labor force participation. Severity of asthma score predicted both complete disability (odds ratio [OR], 7.9; 95% CI, 4.2 to 15 per 10-point increment) and partial disability (OR 2.6; 95% CI, 1.6 to 4.2). Taking illness severity into account, job conditions, occupation, and work exertion carried a combined disability OR of 3.9 (95% CI, 1.7 to 8.6).
Work disability is common among adults with asthma receiving specialist care. Severity of disease is a powerful predictor, but not the sole predictor of disability in this group. Working conditions, including job-related exposures, are associated with added disability risk even after taking illness severity into account.
确定由肺科和过敏科专家治疗的成年哮喘患者工作致残的风险因素。
横断面调查，包括回顾性工作史数据。
68名肺科和16名过敏内科亚专科医生，他们保存了哮喘患者就诊登记；698名年龄在18至50岁的登记患者，其中601名（86%）接受研究。
通过计算机辅助电话进行结构化访谈，评估哮喘严重程度、感知的总体健康状况、哮喘生活质量、人口统计学和工作史。完全工作致残定义为因哮喘导致完全停止工作；部分工作致残定义为因哮喘导致工作岗位、职责改变或工作时间减少。
在550名有劳动力参与史的受试者中，40名（7%；95%置信区间[CI]，5%至9%）报告因哮喘完全停止工作，53名（10%；95%CI，7%至12%）报告部分工作致残。哮喘严重程度评分可预测完全致残（比值比[OR]，7.9；95%CI，每增加10分，4.2至15）和部分致残（OR 2.6；95%CI，1.6至4.2）。考虑疾病严重程度后，工作条件、职业和工作强度的综合致残OR为3.9（95%CI，1.7至8.6）。
在接受专科治疗的成年哮喘患者中，工作致残很常见。疾病严重程度是一个有力的预测因素，但不是该组致残的唯一预测因素。即使考虑了疾病严重程度，工作条件，包括与工作相关的暴露，也与额外的致残风险相关。
