Asthma, employment status, and disability among adults treated by pulmonary and allergy specialists
Asthma, employment status, and disability among adults treated by pulmonary and allergy specialists
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DOI：
10.1378/chest.109.3.688
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发表时间：
1996-03-01
期刊：
影响因子：
9.6
通讯作者：
Yelin, EH
中科院分区：
文献类型：
--
作者：
Blanc, PD;Cisternas, M;Yelin, EH
目标：在接受肺科和过敏科专家治疗的成人哮喘患者中，识别工作能力丧失的危险因素。设计：横断面调查，包括回顾性工作史数据。参与者：68名肺科和16名过敏内科专家，维持哮喘患者就诊登记; 698名年龄在18至50岁的登记患者，其中601人（86%）接受了研究。测量：计算机辅助、电话管理的结构化访谈评估哮喘严重程度、感知的一般健康状况、哮喘生活质量、人口统计学和工作史，完全工作残疾定义为哮喘导致的完全工作停止;部分工作残疾定义为哮喘导致的工作、职责变化或工作时间减少。在550名有劳动力参与史的受试者中，有40人（7%; 95%置信区间[CI]，5至9%）因哮喘完全停止工作，53人（10%; 95% CI，7至12%）因部分工作残疾。哮喘评分的严重程度预测完全残疾（比值比[OR]，7.9; 95%CI，4.2 - 15/10分增量）和部分残疾（OR 2.6; 95%CI，1.6 - 4.2）。考虑到疾病的严重程度，工作条件，职业和工作劳累进行了合并残疾OR为3.9（95%CI，1.7至8.6）。结论：工作残疾是常见的成人哮喘接受专科护理。疾病的严重程度是一个强有力的预测因素，但不是这一组残疾的唯一预测因素。工作条件，包括与工作有关的暴露，与增加的残疾风险有关，即使考虑到疾病的严重程度。
Objective: Identify risk factors for work disability among adults with asthma treated by pulmonary and allergy specialists.Design: Cross-sectional survey, including retrospective work history data.Participants: 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.Measures: 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.Results: 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).Conclusions: 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.