Asthma disrupts work productivity, leads to more sick days
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Key takeaways:
- Participants with both asthma and overweight had the greatest risk for sickness absence.
- Productivity losses included 1,280 EUR for those with asthma and 933 EUR for those without asthma.
Asthma is associated with increased work absences and loss of productivity, according to a study in The Journal of Allergy and Clinical Immunology: In Practice.
The study further shows the societal costs of asthma and the health consequences of the disease, Sandra Ekström, PhD, of the department of clinical science and education, Södersjukhuset, Karolinska Institutet, Stockholm, and colleagues wrote. The effect is even more noticeable in asthma patients who are overweight.
The study included 2,391 participants who were employed and for whom data on asthma and sickness benefits (absence for longer than 14 days) in 2020 or 2021 were available from the Swedish population-based BAMSE birth cohort study.
BAMSE included children born between 1994 and 1996 and followed them throughout childhood, adolescence and young adulthood. At around 24 years, between 2016 and 2019, participants answered a questionnaire on allergy and asthma symptoms and medications.
Some participants (n = 2,270) underwent a clinical examination including blood sampling, fractional exhaled nitric oxide measurements and anthropometrics. Blood samples were tested for IgE antibodies (n = 2,235) and eosinophil cell counts (n = 2,185).
Asthma was defined with a doctor-confirmed diagnosis along with breathing difficulties or asthma medication use within the last 12 months. The BMI, physical activity (low, moderate, vigorous), smoking, education level and depression diagnoses were obtained using the 24-year questionnaire.
Among the 2,391 participants in the analysis (mean age, 22.5 years; 54.3% women), 272 (11.4%) had asthma, including 60% with persistent asthma, 32.3% with uncontrolled asthma, 74.4% with allergic asthma and 39.9% with type 2 asthma with high eosinophils or high FeNO. Many asthmatic participants also had rhinitis (63.7%) while also being more likely to have overweight vs. those without asthma (36.2% vs 23%; P = .001).
Among the participants, 226 (9.5%) had at least one instance of a sickness absence that lasted longer than 14 days, with absences being more common among those with asthma than those without (15.1% vs. 8.7%; P = .001).
Those with vs. without persistent asthma had an increased risk for sickness absence (adjusted OR = 1.95; 95% CI, 1.20-3.15), as did participants with uncontrolled asthma (aOR = 1.93; 95% CI, 1.06-3.49). A significant association was also found in participants with both asthma and rhinitis with an odds ratio of (aOR = 2; 95% CI, 1.27-3.15).
A larger proportion of participants with both overweight and asthma (20.4%; n = 20) had a greater prevalence of sickness absence vs. those with just asthma (12.1%; n = 21), just overweight (11.8%; n = 57) or neither overweight or asthma (7.8%; n = 127). Similar proportions were seen in those with asthma and low vs. high levels of physical activity.
The net days of sickness absence was higher for those with vs. without asthma (9.1 days vs. 6.6 days), and the estimated productivity losses were also higher among those with vs. without asthma (1,280 EUR vs. 933 EUR; P < .001, respectively). This amount was higher in those with uncontrolled asthma (1,973 EURO; P < .003). Between 2020 and 2021, the estimated average excess productivity losses were 369 EUR (P < .001) per person in those with asthma and 1,117 EUR in those with uncontrolled asthma.
The causes for the sickness absences varied. Only 33 participants with asthma had available data on diagnosis. Among them, six (18.2%) had “diseases of the respiratory system,” compared with 10 (5.9%) without asthma.
Study authors emphasized that due to these results, health care providers should focus on helping patients control their asthma and reduce their symptoms to minimize the negative health consequences and costs of asthma.
Perspective
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These findings help to prove what I think most of us treating asthma already suspected —they are not surprising. These findings are consistent with my own clinical experience. Asthma patients do miss work and school days. It is a common reason I fill out FMLA paperwork. Any asthma patient missing school or work should be referred to a specialist because there are many effective asthma treatments, particularly biologic medications, that can reduce asthma exacerbation numbers and improve day-to-day quality of life. This is an interesting study due to the size of the cohort as well.
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