Asthma medication use among adults with current asthma by work-related asthma status, Asthma Call-back Survey, 29 states, 2012–2013

ABSTRACT

Objective: Asthma severity is defined as the intensity of treatment required to achieve good control of asthma symptoms. Studies have shown that work-related asthma (WRA) can be associated with poorer asthma control and more severe symptoms than non-WRA. Associations between asthma medications and WRA status were assessed using data from the 2012–2013 Asthma Call-back Survey among ever-employed adults (≥18 years) with current asthma from 29 states. Methods: Persons with WRA had been told by a physician that their asthma was work-related. Persons with possible WRA had asthma caused or made worse by their current or previous job, but did not have physician-diagnosed WRA. Asthma medications were classified as controller (i.e., long-acting β-agonist, inhaled corticosteroid, oral corticosteroid, cromolyn/nedocromil, leukotriene pathway inhibitor, methylxanthine, anti-cholinergics) and rescue (i.e., short-acting β-agonist). Demographic and clinical characteristics were examined. Associations between asthma medications and WRA status were assessed using a multivariate logistic regression to calculate adjusted prevalence ratios (PRs). Results: Among an estimated 15 million ever-employed adults with current asthma, 14.7% had WRA and an additional 40.4% had possible WRA. Compared with adults with non-WRA, those with WRA were more likely to have taken anti-cholinergics (PR = 1.80), leukotriene pathway inhibitor (PR = 1.59), and methylxanthine (PR = 4.76), and those with possible WRA were more likely to have taken methylxanthine (PR = 2.85). Conclusions: Results provide additional evidence of a higher proportion of severe asthma among adults with WRA compared to non-WRA. To achieve optimal asthma control, adults with WRA may require additional intervention, such as environmental controls or removal from the workplace exposure.

KEYWORDS:

• ACBS
• BRFSS
• WRA

Acknowledgements

The authors thank the Behavioral Risk Factor Surveillance System state coordinators for their assistance in collecting the data used in this analysis. The authors also thank Dr. Susan Tarlo, University of Toronto, Toronto Western Hospital, and Dr. Carrie Redlich, Yale University School of Medicine, for their helpful comments, and Dr. Hatice Zahran, National Center for Environmental Health, Centers for Disease Control and Prevention, for her advice on coding the Asthma Call-back Survey medications section data.

Declaration of interest

The authors report no conflicts of interest. A portion of this work was conducted while Ms. Dodd was an Association of Schools and Programs of Public Health (ASPPH)/Centers for Disease Control and Prevention (CDC) Public Health Fellow and was supported by Cooperative Agreement Number 3U36OE000002 from the CDC and ASPPH. The findings and conclusions in this report are those of the authors and do not necessarily represent the official views of the CDC or ASPPH. Mention of company names or products does not constitute endorsement by the National Institute for Occupational Safety and Health.

Meeting presentation

Data from this manuscript were presented at the 2016 American Thoracic Society (ATS) International Conference, San Francisco, CA, May 15, 2016.