Asthma control and productivity loss in those with work-related asthma: A population-based study

ABSTRACT

Objective: In Canada, asthma is the third leading cause of work loss, yet little is known about the associated productivity loss. The goal of this study was to look at the relationship between asthma control and productivity loss, particularly contrasting those with work-related asthma (WRA) and non-work-related asthma (NWRA). Methods: A population-based random sample of adults with asthma in British Columbia, Canada, was prospectively recruited. Asthma control was graded according to Global Initiative for Asthma classification, while productivity loss and presence of WRA was assessed using questionnaires. Ordinal regression models were then used to associate WRA with asthma control. Generalized linear models were applied to estimate the average productivity loss associated with different levels of asthma control among those with WRA and NWRA. Results: The study included 300 employed adults. Sixty (20%) had WRA. The odds of being controlled were significantly lower in those with WRA (OR = 0.23, 95% CI: 0.09, 0.56; P < 0.01). Those with WRA and uncontrolled asthma had a significant difference in productivity loss due to presenteeism ($659.1 [95% CI: 12.9, 1581.5; P = 0.04]), but not absenteeism ($88.7 [95% CI: −86.5, 279.6; P = 0.35]), when compared to those with NWRA and uncontrolled asthma. There was no significant difference when a similar comparison was made for those with controlled or partially controlled asthma. Conclusions: WRA is associated with worse asthma control and increased productivity loss. Presenteeism makes a significant contribution to productivity loss and should be considered when evaluating the overall economic burden of asthma, particularly WRA.

KEYWORDS:

• Epidemiology
• economics
• work-related asthma

Acknowledgments

We are grateful to Dr. Paul Henneberger for his invaluable advice and discussions about the manuscript, as well as to the EBA Study Team.

Declaration of interest

The authors declare that there are no conflicts of interest. The authors are responsible for the content and writing of the article.

Funding

Peer-reviewed funding was provided by GlaxoSmithKline through the peer-reviewed, investigator-initiated Collaborative Innovative Research Fund. The sponsor had no role in the design of the study, the collection and analysis of the data, or the preparation of the manuscript.