Occupational Asthma Reference

Lim T, Liss G M, Vernich L, Buyantseva L, Tarlo SM, Work-exacerbated asthma in a workers’ compensation population, Occup Med (Oxford), 2014;64:206-210,
(Plain text: Lim T, Liss G M, Vernich L, Buyantseva L, Tarlo SM, Work-exacerbated asthma in a workers' compensation population, Occup Med (Oxford))

Keywords: Canada, sickness absence, work-exacerbated asthma, healthcare, teaching, service, dust

Known Authors

Garry Liss, Toronto Garry Liss

Susan Tarlo, Toronto Susan Tarlo

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Abstract

Background Asthma is becoming more prevalent with large numbers of individuals suffering from work-exacerbated asthma.Aims To examine the characteristics of workplace exposures and working days lost in relation to work-exacerbated asthma (WEA) in a workers’ compensation population.Methods An analysis of accepted workers’ compensation asthma claims in Ontario over a 5-year period. Claims among the top three industry groups were categorized based on working time lost of 1 day or less, 2–5 days and 6 days or more. Attributable agents were subdivided into dusts, smoke, chemicals and sensitizers.Results Among the asthma claims, 72% (645) fulfilled criteria for WEA from their history. The commonest industry groups were services, education and health care, with 270 claims that met our analysis requirements. Within these industry groups, education had a lower proportion of workers with short exacerbations (missing 1 day or less: 27%) while the health care industry had a higher than expected proportion of short exacerbations (55%). The agents to which WEA was attributed differed across the groups, with dusts having the highest proportion in the education group (65%), smoke in the service industry (34%) and sensitizers in health care (41%). Those agents more commonly attributed to exacerbations tended to have lower rates of prolonged exacerbation compared with less commonly involved agents.Conclusions The morbidity of WEA and the type of agents to which it was attributed varied between industry groups.

Plain text: Background Asthma is becoming more prevalent with large numbers of individuals suffering from work-exacerbated asthma.Aims To examine the characteristics of workplace exposures and working days lost in relation to work-exacerbated asthma (WEA) in a workers' compensation population.Methods An analysis of accepted workers' compensation asthma claims in Ontario over a 5-year period. Claims among the top three industry groups were categorized based on working time lost of 1 day or less, 2-5 days and 6 days or more. Attributable agents were subdivided into dusts, smoke, chemicals and sensitizers.Results Among the asthma claims, 72% (645) fulfilled criteria for WEA from their history. The commonest industry groups were services, education and health care, with 270 claims that met our analysis requirements. Within these industry groups, education had a lower proportion of workers with short exacerbations (missing 1 day or less: 27%) while the health care industry had a higher than expected proportion of short exacerbations (55%). The agents to which WEA was attributed differed across the groups, with dusts having the highest proportion in the education group (65%), smoke in the service industry (34%) and sensitizers in health care (41%). Those agents more commonly attributed to exacerbations tended to have lower rates of prolonged exacerbation compared with less commonly involved agents.Conclusions The morbidity of WEA and the type of agents to which it was attributed varied between industry groups.

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Comments

Work-exacerbated asthma as defined required pre-existing asthma in nearly all, no evidence of sensitasion, generally a history of worsening asthma with work exposure, and if specific challenges were done they had to be negative. Symptoms had to persist for >4 weeks. All had to have asthma confirmed. Acute iurriutant asthma was also excluded. This seems to be as good as you can get for a diagnosis of work-exacerbated asathma. The sickness absence data was taken from the compensation application form and seems to have no denominator. Nearly half reported no time off. Sickness absence for work-exacerbated asthma was more common in education and less in service industry workers and intermediate in healthcare workers.
4/12/2014

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