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Ekström S, Hernando-Rodriguez JC, Andersson N, Murley C, Arfuch VM, Merritt AS, Janson C, Bodin T, Johansson G, Kull I. Asthma Is Associated With Increased Sickness Absence Among Young Adults. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00518-X. [PMID: 38759791 DOI: 10.1016/j.jaip.2024.04.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/02/2024] [Accepted: 04/19/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND There is limited knowledge about how asthma affects sickness absence in young adulthood. OBJECTIVE To examine how asthma and different asthma phenotypes affect sickness absence among young adults and potential modifying factors. A secondary aim was to estimate productivity losses related to sickness absence for asthma. METHODS The study included 2391 participants from the Swedish population-based cohort BAMSE (Barn/Child, Allergy, Milieu, Stockholm, Epidemiology). Information on asthma, asthma phenotypes, and lifestyle factors was collected from questionnaires and clinical examinations at age approximately 24 years (2016-2019). Information on sickness absence for longer than 14 days was obtained from a national register for the years 2020 and 2021. Associations between asthma, asthma phenotypes, and sickness absence were analyzed with logistic regression models adjusted for sex, birth year, education, and overweight status. RESULTS At age 24 years, 272 (11.4%) fulfilled the definition of asthma. Sickness absence was more common among those with asthma than among those without (15.1% vs 8.7%; P = .001; adjusted odds ratio 1.73; 95% CI, 1.19-2.51). Analyses of asthma phenotypes showed that the association tended to be stronger for persistent asthma, uncontrolled asthma, and asthma in combination with rhinitis; no consistent differences were observed across phenotypes related to allergic sensitization or inflammation. The association tended to be stronger among those with overweight than among those with normal weight. Asthma, especially uncontrolled asthma, was associated with higher productivity losses from sickness absence. CONCLUSIONS Asthma may be associated with higher sickness absence and productivity losses. Achieving better asthma control and reducing allergic symptoms may reduce sickness absence among individuals with asthma.
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Affiliation(s)
- Sandra Ekström
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Julio C Hernando-Rodriguez
- Unit of Occupational and Environmental Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Chantelle Murley
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Victoria M Arfuch
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Anne-Sophie Merritt
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Theo Bodin
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden; Unit of Occupational and Environmental Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gun Johansson
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden; Unit of Occupational and Environmental Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Inger Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
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2
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Suarthana E, Le Moual N, Lemière C, Bousquet J, Pierre S, Sousa-Pinto B, Afadiyanti Parfi A, Van Brussel P, Nassiri Kigloo H, Vandenplas O, Henneberger PK. Work-Related Asthma and Its Impact on Quality of Life and Work Productivity. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:372-382.e2. [PMID: 37918649 PMCID: PMC10922585 DOI: 10.1016/j.jaip.2023.10.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 10/03/2023] [Accepted: 10/23/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND The impact of work-related asthma (WRA) on quality of life (QoL) and work productivity remains largely neglected/uncertain despite its high prevalence. OBJECTIVE To investigate the association of WRA with QoL and work productivity as compared with subjects with non-WRA and those without asthma and rhinitis. METHODS A cross-sectional survey was carried out among workers during their periodic occupational health visit in Belgium. The Mini Asthma Quality of Life Questionnaire, the 8-item Medical Outcome Study Short Form instrument, and the Work Productivity and Activity Impairment-General Health questionnaire were administered. Survey participants were divided into 3 groups: (1) WRA (current asthma with ≥2 respiratory symptoms at work; n = 89); (2) non-WRA (current asthma without work-related respiratory symptoms; n = 119); and (3) the reference group (no asthma and no lower respiratory, nasal, or eye symptoms; n = 815). Associations of QoL and work productivity with WRA were evaluated by multivariable regression analyses. RESULTS WRA and having poor asthma control were significantly associated with lower global Mini Asthma Quality of Life Questionnaire scores compared with non-WRA. Asthmatic subjects had significantly lower physical and mental health component scores of the 8-item Medical Outcome Study Short Form instrument and overall work productivity compared with the reference group, with greater impairment in workers with WRA than in those without WRA. Moreover, workers with WRA had higher percentages of doctor visits and income reduction because of respiratory symptoms than those with non-WRA. Work-related rhinitis and depression were associated with reduced QoL, independent of the effect of WRA. CONCLUSIONS WRA should be managed comprehensively to reduce the worsening of QoL and work productivity of those affected.
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Affiliation(s)
- Eva Suarthana
- Research Institute of the McGill University Health Center, Montreal, Quebec, Canada; Research Centre, Centre Intégré Universitaire de santé et de services sociaux du Nord-de-l'île-de-Montréal, Montreal, Quebec, Canada.
| | - Nicole Le Moual
- Université Paris-Saclay, UVSQ, Univ Paris-Sud, INSERM, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France
| | - Catherine Lemière
- Research Centre, Centre Intégré Universitaire de santé et de services sociaux du Nord-de-l'île-de-Montréal, Montreal, Quebec, Canada; Faculty of Medicine, Université de Montreal, Montreal, Quebec, Canada
| | - Jean Bousquet
- Institute of Allergology, Charite Universit€ atsmedizin Berlin, Corporate Member of Freie Universit€ at Berlin and Humboldt-Universtat zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Stephie Pierre
- Research Centre, Centre Intégré Universitaire de santé et de services sociaux du Nord-de-l'île-de-Montréal, Montreal, Quebec, Canada
| | - Bernardo Sousa-Pinto
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal; RISE-Health Research Network, University of Porto, Porto, Portugal
| | - Alfi Afadiyanti Parfi
- Research Centre, Centre Intégré Universitaire de santé et de services sociaux du Nord-de-l'île-de-Montréal, Montreal, Quebec, Canada
| | - Philippe Van Brussel
- Service de Prévention et Protection au Travail-Centre de Service Interentreprises (CESI), Brussels, Belgium
| | - Hormoz Nassiri Kigloo
- Research Institute of the McGill University Health Center, Montreal, Quebec, Canada; Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Olivier Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
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3
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Loeb E, Zock JP, Miravitlles M, Rodríguez E, Soler-Cataluña JJ, Soriano JB, García-Río F, de Lucas P, Alfageme I, Casanova C, Rodríguez González-Moro JM, Ancochea J, Cosío BG, Ferrer Sancho J. Association between occupational exposure and chronic obstructive pulmonary disease and respiratory symptoms in the Spanish population. Arch Bronconeumol 2024; 60:16-22. [PMID: 38176851 DOI: 10.1016/j.arbres.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 01/06/2024]
Abstract
INTRODUCTION The aim of this study was to analyze the impact of occupational exposure on chronic obstructive pulmonary disease (COPD) and respiratory symptoms in the general Spanish population. METHODS This was a study nested in the Spanish EPISCAN II cross-sectional epidemiological study that included participants who had completed a structured questionnaire on their occupational history, a questionnaire on respiratory symptoms, and forced spirometry. The data were analyzed using Chi-square and Student's t tests and adjusted models of multiple linear regression and logistic regression. RESULTS We studied 7502 subjects, 51.1% women, with a mean age of 60±11 years. Overall, 53.2% reported some respiratory symptoms, 7.9% had respiratory symptoms during their work activity, 54.2% were or had been smokers, and 11.3% (851 subjects) met COPD criteria on spirometry. A total of 3056 subjects (40.7%) reported exposure to vapors, gases, dust or fumes (VGDF); occupational exposure to VGDF was independently associated with the presence of COPD (OR 1.22, 95% CI: 1.03-1.44), respiratory symptoms (OR 1.45, 95%: CI 1.30-1.61), and respiratory symptoms at work (OR 4.69, 95% CI: 3.82-5.77), with a population attributable fraction for COPD of 8.2%. CONCLUSIONS Occupational exposure is associated with a higher risk of COPD and respiratory symptoms in the Spanish population. These results highlight the need to follow strict prevention measures to protect the respiratory health of workers.
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Affiliation(s)
- Eduardo Loeb
- Departamento de Medicina, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain; Servicio de Neumología, Centro Médico Teknon, Grupo Quironsalud, Barcelona, Spain
| | - Jan-Paul Zock
- Instituto Nacional de Salud Pública y Medio Ambiente (RIVM), Bilthoven, The Netherlands
| | - Marc Miravitlles
- Servicio de Neumología, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Esther Rodríguez
- Departamento de Medicina, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain; Servicio de Neumología, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Juan José Soler-Cataluña
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Arnau de Vilanova-Lliria, Departamento de Medicina, Universitat de Valencia, Valencia, Spain
| | - Joan B Soriano
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Universitario La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Francisco García-Río
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
| | - Pilar de Lucas
- Servicio de Neumología, Hospital General Gregorio Marañon, Madrid, Spain
| | - Inmaculada Alfageme
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de Valme, Universidad de Sevilla, Sevilla, Spain
| | - Ciro Casanova
- Servicio de Neumología-Unidad de Investigación Hospital Universitario Nuestra Señora de Candelaria, CIBERES, ISCIII, Universidad de La Laguna, Tenerife, Spain
| | | | - Julio Ancochea
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Universitario La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Borja G Cosío
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Universitario Son Espases-IdISBa, Departamento de Medicina, Universidad de las Islas Baleares, Palma de Mallorca, Spain
| | - Jaume Ferrer Sancho
- Departamento de Medicina, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain; Servicio de Neumología, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
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4
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Hisinger-Mölkänen H, Honkamäki J, Kankaanranta H, Tuomisto L, Backman H, Andersen H, Lindqvist A, Lehtimäki L, Sovijärvi A, Rönmark E, Pallasaho P, Ilmarinen P, Piirilä P. Age at asthma diagnosis is related to prevalence and characteristics of asthma symptoms. World Allergy Organ J 2022; 15:100675. [PMID: 36185544 PMCID: PMC9489807 DOI: 10.1016/j.waojou.2022.100675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 06/24/2022] [Accepted: 07/05/2022] [Indexed: 11/15/2022] Open
Abstract
Background Although asthma may begin at any age, knowledge about relationship between asthma age of onset and the prevalence and character of different symptoms is scarce. Objectives The aim of this study was to investigate if adult-diagnosed asthma is associated with more symptoms and different symptom profiles than child-diagnosed asthma. Methods A FinEsS postal survey was conducted in a random sample of 16 000 20-69-year-old Finnish adults in 2016. Those reporting physician-diagnosed asthma and age at asthma diagnosis were included. Age 18 years was chosen to delineate child- and adult-diagnosed asthma. Results Of responders (N = 8199, 51.5%), 842 (10.3%) reported asthma diagnosis. Adult-diagnosed asthma was reported by 499 (59.3%) and child-diagnosed by 343 (40.7%). Of responders with adult-diagnosed and child-diagnosed asthma, 81.8% versus 60.6% used asthma medication (p < 0.001), respectively. Current asthma was also more prevalent in adult-diagnosed asthma (89.2% versus 72.0%, p < 0.001). Risk factors of attacks of breathlessness during the last 12 months were adult-diagnosis (OR = 2.41, 95% CI 1.64–3.54, p < 0.001), female gender (OR = 1.49, 1.07–2.08, p = 0.018), family history of asthma (OR = 1.48, 1.07–2.04, p = 0.018) and allergic rhinitis (OR = 1.49, 1.07–2.09, p = 0.019). All the analysed asthma symptoms, except dyspnea in exercise, were more prevalent in adult-diagnosed asthma in age- and gender-adjusted analyses (p = 0.032-<0.001) which was also more often associated with 5 or more asthma symptoms (p < 0.001) and less often with non-symptomatic appearance (p < 0.001) than child-diagnosed asthma. Conclusion Responders with adult-diagnosed asthma had more often current asthma and a higher and multiform asthma symptom burden, although they used asthma medication more often compared to responders with child-diagnosed asthma.
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Affiliation(s)
| | - Jasmin Honkamäki
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Hannu Kankaanranta
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland.,Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Leena Tuomisto
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Helena Backman
- Department of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine/ the OLIN Unit, Umeå University, Umeå, Sweden
| | - Heidi Andersen
- Karolinska University Hospital, Thoracic Oncology Unit, Tema Cancer, Stockholm, Sweden
| | - Ari Lindqvist
- Clinical Research Unit of Pulmonary Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Lauri Lehtimäki
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Allergy Centre, Tampere University Hospital, Tampere, Finland
| | - Anssi Sovijärvi
- Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Unit of Clinical Physiology, HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine/ the OLIN Unit, Umeå University, Umeå, Sweden
| | | | - Pinja Ilmarinen
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Päivi Piirilä
- Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Unit of Clinical Physiology, HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland
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5
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Dierick BJH, Flokstra-de Blok BMJ, van der Molen T, Toledo-Pons N, Román-Rodríguez M, Cosío BG, Soriano JB, Kocks JWH, van Boven JFM. Work absence in patients with asthma and/or COPD: a population-based study. NPJ Prim Care Respir Med 2021; 31:9. [PMID: 33594082 PMCID: PMC7887233 DOI: 10.1038/s41533-021-00217-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/16/2020] [Indexed: 12/26/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) and asthma impact on work productivity, but their population-based burden and clinical predictors are understudied. In this observational, real-life study, work absence of 14,383 asthma and/or COPD patients present in the MAJORICA cohort (Spain) was compared with the general population. Using multivariable regression, we studied the association of work absence with demographic and clinical characteristics. Patients with asthma and/or COPD had more work absence than the general population (15.2% vs 8.9%, p < 0.0001). Patients with asthma had more often periods of work absence compared to patients with COPD (16.0% vs 12.8%, p < 0.0001). The number of days absent were, however, less in asthma than in COPD (median: 15 days [IQR: 5–51] vs 39 days [IQR: 13–134], p < 0.001). Patients with asthma–COPD overlap were in between (14.5% with absence; median: 27 days [IQR: 10–82]). Comorbid anxiety, allergic rhinitis, and sleep apnoea were independently associated with more work absence.
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Affiliation(s)
- Boudewijn J H Dierick
- University of Groningen, University Medical Center Groningen, Groningen Institute for Asthma and COPD (GRIAC), Department of General Practice & Elderly Care Medicine, Groningen, The Netherlands.
| | | | - Thys van der Molen
- University of Groningen, University Medical Center Groningen, Groningen Institute for Asthma and COPD (GRIAC), Department of General Practice & Elderly Care Medicine, Groningen, The Netherlands
| | - Núria Toledo-Pons
- Department of Respiratory Medicine, Hospital Universitario Son Espases, and CIBERES, Madrid, Spain.,Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma de Mallorca, Spain
| | - Miguel Román-Rodríguez
- University of Groningen, University Medical Center Groningen, Groningen Institute for Asthma and COPD (GRIAC), Department of General Practice & Elderly Care Medicine, Groningen, The Netherlands.,Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma de Mallorca, Spain.,Primary Care Health Service, Servei de Salut de les Illes Balears, Palma de Mallorca, Spain
| | - Borja G Cosío
- Department of Respiratory Medicine, Hospital Universitario Son Espases, and CIBERES, Madrid, Spain.,Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma de Mallorca, Spain
| | - Joan B Soriano
- Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Job F M van Boven
- University of Groningen, University Medical Center Groningen, Groningen Institute for Asthma and COPD (GRIAC), Department of General Practice & Elderly Care Medicine, Groningen, The Netherlands
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6
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Occupational exposures and genetic susceptibility to occupational exposures are related to sickness absence in the Lifelines cohort study. Sci Rep 2020; 10:12963. [PMID: 32737337 DOI: 10.1038/s41598-020-69372-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/17/2020] [Indexed: 11/09/2022] Open
Abstract
In this cross-sectional study, we investigated the association between occupational exposures and sickness absence (SA), the mediating role of respiratory symptoms, and whether genetic susceptibility to SA upon occupational exposures exists. Logistic regression was used to examine associations and structural equation modelling was used for mediation analyses. Genetic susceptibility was investigated by including interactions between occupational exposures and 11 candidate single nucleotide polymorphisms (SNPs). Biological dust, mineral dust, and pesticides exposure were associated with a lower prevalence of any SA (OR (95% CI) = 0.72 (0.58-0.89), 0.88 (0.78-0.99), and 0.70 (0.55-0.89), respectively) while gases/fumes exposure was associated with a higher prevalence of long-term SA (1.46 (1.11-1.91)). Subjects exposed to solvents and metals had a higher prevalence of any (1.14 (1.03-1.26) and 1.68 (1.26-2.24)) and long-term SA (1.26 (1.08-1.46) and 1.75 (1.15-2.67)). Chronic cough and chronic phlegm mediated the association between high gases/fumes exposure and long-term SA. Two of 11 SNPs investigated had a positive interaction with exposure on SA and one SNP negatively interacted with exposure on SA. Exposure to metals and gases/fumes showed a clear dose-response relationship with a higher prevalence of long-term SA; contrary, exposure to pesticides and biological/mineral dust showed a protective effect on any SA. Respiratory symptoms mediated the association between occupational exposures and SA. Moreover, gene-by-exposure interactions exist.
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7
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Gruffydd-Jones K, Thomas M, Roman-Rodríguez M, Infantino A, FitzGerald JM, Pavord I, Haddon JM, Elsasser U, Vogelberg C. Asthma impacts on workplace productivity in employed patients who are symptomatic despite background therapy: a multinational survey. J Asthma Allergy 2019; 12:183-194. [PMID: 31372003 PMCID: PMC6636188 DOI: 10.2147/jaa.s204278] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 05/21/2019] [Indexed: 01/13/2023] Open
Abstract
Background: Asthma affects millions of people worldwide, with many patients experiencing symptoms that affect their daily lives despite receiving long-term controller medication. Purpose: Work is a large part of most people’s lives, hence this study investigated the impact of uncontrolled asthma on work productivity in adults receiving asthma maintenance therapy. Patients and methods: An online survey was completed by employed adults in Brazil, Canada, Germany, Japan, Spain and the UK. Participants were confirmed as symptomatic using questions from the Royal College of Physicians’ 3 Questions for Asthma tool. The survey contained the Work Productivity and Activity Impairment – Specific Health Problem questionnaire and an open-ended question on the effect of asthma at work. Results: Of the 2,055 patients on long-term maintenance therapy screened, 1,598 were symptomatic and completed the survey. The average percentage of work hours missed in a single week due to asthma symptoms was 9.3%, ranging from 3.5% (UK) to 17.4% (Brazil). Nearly three-quarters of patients reported an impact on their productivity at work caused by asthma. Overall work productivity loss (both time off and productivity whilst at work) due to asthma was 36%, ranging from 21% (UK) to 59% (Brazil). When asked how asthma made participants feel at work, many respondents highlighted how their respiratory symptoms affect them. Tiredness, weakness and mental strain were also identified as particular challenges, with respondents describing concerns about the perception of colleagues and feelings of inferiority. Conclusions: This study emphasizes the extent to which work time is adversely affected by asthma in patients despite the use of long-term maintenance medication, and provides unique personal insights. Strategies to improve patients’ lives may include asthma education, optimizing asthma management plans and running workplace well-being programs. Clinicians, employers and occupational health teams should be more aware of the impact of asthma symptoms on employees, and work together to help overcome these challenges. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: http://www.youtube.com/watch?v=DoaEgER_CSE
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Affiliation(s)
| | - Mike Thomas
- Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | | | - Antonio Infantino
- Società Italiana Interdisciplinare per le Cure Primarie (SIICP) , Bari, Italy
| | - J Mark FitzGerald
- Institute for Heart and Lung Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ian Pavord
- Respiratory Medicine Unit and Oxford Respiratory NIHR Biomedical Research Centre, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jennifer M Haddon
- TA Dig Excellence + Healthcare Inno Med, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | - Ulrich Elsasser
- Biostatistics and Data Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Christian Vogelberg
- Department of Pediatric Pneumology and Allergology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
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8
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Rai KK, Adab P, Ayres JG, Siebert WS, Sadhra SS, Sitch AJ, Fitzmaurice DA, Jordan RE. Factors associated with work productivity among people with COPD: Birmingham COPD Cohort. Occup Environ Med 2017; 74:859-867. [PMID: 28899966 DOI: 10.1136/oemed-2016-104014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 03/30/2017] [Accepted: 05/17/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) are more likely to take time off work (absenteeism) and report poor performance at work (presenteeism) compared to those without COPD. Little is known about the modifiable factors associated with these work productivity outcomes. AIM To assess the factors associated with work productivity among COPD patients. METHODS Cross-sectional analysis of baseline data from a subsample (those in paid employment) of the Birmingham COPD Cohort study. Absenteeism was defined by self-report over the previous 12 months. Presenteeism was assessed using the Stanford Presenteeism Scale. Logistic regression analysis was used to assess the effects of sociodemographic, clinical and occupational characteristics on work productivity. RESULTS Among 348 included participants, increasing dyspnoea was the only factor associated with both absenteeism and presenteeism (p for trend<0.01). Additionally, increasing history of occupational exposure to vapours, gases, dusts or fumes (VGDF) was independently associated with presenteeism (p for trend<0.01). CONCLUSIONS This is the first study to identify important factors associated with poor work productivity among patients with COPD. Future studies should evaluate interventions aimed at managing breathlessness and reducing occupational exposures to VGDF on work productivity among patients with COPD.
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Affiliation(s)
- Kiran K Rai
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Peymané Adab
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jon G Ayres
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - W Stanley Siebert
- The Department of Business and Labour Economics, The University of Birmingham, Birmingham, UK
| | - Steven S Sadhra
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Alice J Sitch
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - David A Fitzmaurice
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Rachel E Jordan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Taponen S, Lehtimäki L, Karvala K, Luukkonen R, Uitti J. Correlates of employment status in individuals with asthma: a cross-sectional survey. J Occup Med Toxicol 2017; 12:19. [PMID: 28747990 PMCID: PMC5525303 DOI: 10.1186/s12995-017-0165-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/14/2017] [Indexed: 11/10/2022] Open
Abstract
Background This study aims to elucidate factors that among adults with asthma are associated with working full-time. Methods This cross-sectional survey of 2613 working-age adults with asthma included questions on asthma history, symptoms and use of asthma medication, socioeconomic factors and health behavior. Full-time workers were compared to groups according to employment status: unemployed, work disability and retired due to age. Results Adults with asthma working full time were younger and more often nonmanual workers, experienced less asthma symptoms, used less asthma medication and smoked less than subjects with work disability. After adjusting for age, gender, smoking and professional status, having frequent symptoms of asthma during last month was associated with an increase in the risk of unemployment (OR 2.3, 95% CI 1.3–4.2) and with an increase in the risk of work disability (OR 4.4, 95% CI 2.3–8.2). Conclusions Among adults with asthma, full-time work was associated with younger age, less symptomatic asthma despite of less medication, nonmanual work and less smoking. Having more severe symptoms of asthma was associated with undesirable employment status such as unemployment or work disability. Possibilities to change from manual to nonmanual work may be important in preventing work disability and early exit from work. Electronic supplementary material The online version of this article (doi:10.1186/s12995-017-0165-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Saara Taponen
- Finla Occupational Health, Satakunnankatu 18 B, 33210 Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
| | - Lauri Lehtimäki
- Allergy Centre, Tampere University Hospital, PO Box 2000, 33521 Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
| | - Kirsi Karvala
- Finnish Institute of Occupational Health, PO Box 40, 00251 Helsinki, Finland
| | - Ritva Luukkonen
- Clinicum, Faculty of Medicine, University of Helsinki, PO Box 63, 00014 Helsinki, Finland
| | - Jukka Uitti
- Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland.,Finnish Institute of Occupational Health, PO Box 40, 00251 Helsinki, Finland
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An official American Thoracic Society Workshop Report: presentations and discussion of the fifth Jack Pepys Workshop on Asthma in the Workplace. Comparisons between asthma in the workplace and non-work-related asthma. Ann Am Thorac Soc 2016. [PMID: 26203621 DOI: 10.1513/annalsats.201505-281st] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The fifth Jack Pepys Workshop on Asthma in the Workplace focused on the similarities and differences of work-related asthma (WRA) and non-work-related asthma (non-WRA). WRA includes occupational asthma (OA) and work-exacerbated asthma (WEA). There are few biological differences in the mechanisms of sensitization to environmental and occupational allergens. Non-WRA and OA, when due to high-molecular-weight agents, are both IgE mediated; it is uncertain whether OA due to low-molecular-weight agents is also IgE mediated. Risk factors for OA include female sex, a history of upper airway symptoms, and a history of bronchial hyperresponsiveness. Atopy is a risk factor for OA due to high-molecular-weight agents, and exposure to cleaning agents is a risk factor for both OA and non-WRA. WEA is important among workers with preexisting asthma and may overlap with irritant-induced asthma, a type of OA. Induced sputum cytology can confirm airway inflammation, but specific inhalation challenge is the reference standard diagnostic test. Inhalation challenges are relatively safe, with the most severe reactions occurring with low-molecular-weight agents. Indirect health care costs account for about 50% of total asthma costs. Workers with poor asthma control (WRA or non-WRA) are less likely to be employed. Income loss is a major contributor to the indirect costs of WRA. Overall, asthma outcomes probably are worse for adult-onset than for childhood-onset asthma but better for OA than adult-onset non-WRA. Important aspects of management of OA are rapid and proper confirmation of the diagnosis and reduction of exposure to sensitizers or irritants at work and home.
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