Asthma Prevalent Among Health Care Workers

A recent National Health Interview Survey (NHIS) has identified health care industries and occupations as those with the highest prevalence of workers with asthma.

The Prevalence of Asthma, Asthma Attacks, and Emergency Department Visits for Asthma Among Working Adults survey, published Friday by the CDC, found that 6.8% of 160.7 million working adults had asthma during the 2011-2016 period of study. Among those with asthma, 44.7% had experienced an asthma attack in the previous year, and 9.9% had an asthma-related emergency department visit.¹

The NHIS survey data also indicated that 8.8% of workers employed in the health care and social assistance industries had asthma, as did 8.8% of workers in health care support occupations. Those workers were closely followed by individuals with asthma in the educational services industry (8.2%), and personal care and service occupations (8.6%).¹

The survey’s findings were based on self-reported asthma, asthma attacks, and asthma-related ED visits, and those reports were not validated by medical records. In addition, no temporal information on asthma onset and exacerbations was available.

According to the CDC report, the number of workers reporting asthma attacks and asthma-related ED visits in specific industries and occupations correlates with the number of workers and current asthma prevalence in each group. The increased prevalence of current asthma, asthma attacks, and asthma-related ED visits in certain industries and occupations might indicate a link between workplace exposures and increased risks for these health outcomes.¹

Workplace exposures can cause asthma in previously healthy individuals or can trigger asthma exacerbations in workers with current asthma, according to the CDC.¹In fact, the American Academy of Allergy Asthma and Immunology identifies occupational asthma as the condition caused by inhaling fumes, gases, dust, or other potentially harmful substances on the job.²

New onset work-related asthma has been associated with exposure to cleaning and disinfecting products, powdered latex gloves, and aerosolized medications. Other workplace conditions and exposures associated with asthma include irritant chemicals, secondhand smoke, allergens and sensitizers, emotional stress, worksite temperature, and physical exertion.¹

In addition to current asthma prevalence, health care and social assistance (8.8%), and educational services (8.2%) industry groups had the highest numbers of workers with asthma attacks (860,000 and 602,000, respectively) and asthma-related ED visits (212,000 and 102,000, respectively). The highest prevalence of asthma attacks was among workers with asthma in the transportation and warehousing (51.7%) industries, and the highest prevalence of asthma-related ED visits was among workers in the retail trade (12.4%).¹

In detailed industries, current asthma prevalence was highest among workers in electronics and appliance stores (11.9%). Asthma attack prevalence was highest among workers in wood products manufacturing (57.3%) and plastics and rubber products manufacturing (56.7%), and prevalence of asthma-related ED visits was highest among workers in private households (22.9%). The highest numbers of asthma attacks (307,000) and asthma-related ED visits (75,000) occurred among individuals working in ambulatory health care services.¹

While current asthma prevalence was highest among workers in health care support and personal care and service occupations, the highest prevalence of asthma attacks was among workers in education, training, and library (51.5%) occupations. The highest prevalence of asthma-related ED visits also was among workers in personal care and service (17.4%) occupations. The highest numbers of workers with asthma attacks (711,000) and asthma-related ED visits (137,000) were in the office and administrative support major occupation.¹

By detailed occupation subgroups, workers in other education, training, and library occupations, had the highest prevalence of current asthma (10.7%) and asthma attack in the past 12 months (64.0%). Asthma-related ED visits were most prevalent among personal appearance workers (25.0%). The highest number of workers with asthma attacks was among those working in other management occupations (302,000), and the highest number of workers with asthma-related ED visits was among retail sales workers (99,000).¹

The survey’s findings may help physicians to identify workers who should be evaluated for possible work-related asthma, as well as to assist public health officials in identifying workplaces where detailed investigations for prevention and control might be appropriate.¹According to the CDC, continued surveillance is key to assessing asthma prevalence and trends by industry and occupation.

References

1. Mazurek J, Syamlal G. Centers for Disease Control and Prevention. Prevalence of Asthma, Asthma Attacks, and Emergency Department Visits for Asthma Among Working Adults — National Health Interview Survey, 2011—2016. MMWR.www.cdc.gov/mmwr/volumes/67/wr/mm6713a1.htm?s_cid=mm6713a1_e. Published April 6, 2018. Accessed April 6, 2018.
2. American Academy of Allergy Asthma and Immunology. Asthma overview. AAAAI website.www.aaaai.org/conditions-and-treatments/asthma. Accessed April 6, 2018.