Working while unwell: Workplace impairment in people with severe asthma

S A Hiles; E S Harvey; V M McDonald; M Peters; P Bardin; P N Reynolds; J W Upham; M Baraket; Z Bhikoo; J Bowden; B Brockway; L P Chung; B Cochrane; G Foxley; J Garrett; M Hew; L Jayaram; C Jenkins; C Katelaris; G Katsoulotos; M S Koh; V Kritikos; M Lambert; D Langton; A Lara Rivero; G B Marks; P G Middleton; A Nanguzgambo; N Radhakrishna; H Reddel; J Rimmer; A M Southcott; M Sutherland; F Thien; P A B Wark; I A Yang; E Yap; P G Gibson

doi:10.1111/cea.13153

Working while unwell: Workplace impairment in people with severe asthma

Clin Exp Allergy. 2018 Jun;48(6):650-662. doi: 10.1111/cea.13153. Epub 2018 May 17.

Authors

S A Hiles¹, E S Harvey^{1

2}, V M McDonald¹, M Peters³, P Bardin⁴, P N Reynolds⁵, J W Upham^{6

7}, M Baraket⁸, Z Bhikoo⁹, J Bowden¹⁰, B Brockway¹¹, L P Chung¹², B Cochrane^{13

14}, G Foxley¹⁵, J Garrett¹⁶, M Hew¹⁷, L Jayaram^{18

19}, C Jenkins^{3

20

21

22}, C Katelaris^{14

23}, G Katsoulotos²⁴, M S Koh^{25

26}, V Kritikos^{27

28}, M Lambert²⁹, D Langton^{30

31}, A Lara Rivero²⁴, G B Marks^{15

32}, P G Middleton^{33

34

35}, A Nanguzgambo²⁹, N Radhakrishna¹⁷, H Reddel²⁸, J Rimmer^{15

36}, A M Southcott¹⁹, M Sutherland³⁷, F Thien³⁸, P A B Wark^{1

2}, I A Yang^{39

40}, E Yap¹⁶, P G Gibson^{1

2}

Affiliations

¹ Centre of Excellence in Severe Asthma and Priority Research Centre for Healthy Lungs, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia.
² Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia.
³ Department of Thoracic Medicine, Concord Hospital, Concord, NSW, Australia.
⁴ Lung and Sleep Medicine, Monash University and Medical Centre, Clayton, Vic., Australia.
⁵ Lung Research, Hanson Institute and Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia.
⁶ Department of Respiratory Medicine, Princess Alexandra Hospital, Woolloongabba, Qld, Australia.
⁷ The University of Queensland Diamantina Institute, Woolloongabba, Qld, Australia.
⁸ Department of Respiratory Medicine, Liverpool Hospital School of Medicine, UNSW Sydney, Liverpool, NSW, Australia.
⁹ Respiratory Department, Waikato Hospital, Hamilton, New Zealand.
¹⁰ Department of Respiratory, Allergy and Sleep Medicine, Flinders Medical Centre, Bedford Park, SA, Australia.
¹¹ Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
¹² Department of Respiratory Medicine, Fiona Stanley Hospital, Murdoch, WA, Australia.
¹³ Department of Respiratory and Sleep Medicine, Campbelltown Hospital, Campbelltown, NSW, Australia.
¹⁴ School of Medicine, Western Sydney University, Campbelltown, NSW, Australia.
¹⁵ Woolcock Institute of Medical Research, Glebe, NSW, Australia.
¹⁶ Respiratory Department, Middlemore Hospital, Auckland, New Zealand.
¹⁷ Difficult Asthma Clinic, Allergy, Asthma & Clinical Immunology, Alfred Health, Melbourne, Vic., Australia.
¹⁸ Department of Medicine, Melbourne Clinical School, University of Melbourne, Melbourne, Vic., Australia.
¹⁹ Department of Respiratory and Sleep Disorders Medicine, Western Health, Footscray, Vic., Australia.
²⁰ Concord Clinical School and Respiratory Discipline, University of Sydney, Concord, NSW, Australia.
²¹ The George Institute for Global Health, Newtown, NSW, Australia.
²² Respiratory Medicine, UNSW Sydney, Liverpool, NSW, Australia.
²³ Immunology Department, Campbelltown Hospital, Campbelltown, NSW, Australia.
²⁴ St George Specialist Centre, Kogarah, NSW, Australia.
²⁵ Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore.
²⁶ Duke-National University Singapore Medical School, Singapore.
²⁷ Quality Use of Respiratory Medicines, Woolcock Institute of Medical Research, Glebe, NSW, Australia.
²⁸ Department of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
²⁹ Respiratory Services, MidCentral Health, Palmerston North Hospital, Palmerston North, New Zealand.
³⁰ Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Vic., Australia.
³¹ Department of Thoracic Medicine, Frankston Hospital, Frankston, Vic., Australia.
³² South Western Sydney Clinical School, UNSW Sydney, Liverpool, NSW, Australia.
³³ Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.
³⁴ Ludwig Engel Centre for Respiratory Research, Westmead Institute of Medical Research, Westmead, NSW, Australia.
³⁵ Department of Respiratory and Sleep Medicine, Westmead Hospital, Westmead, NSW, Australia.
³⁶ St Vincent's Clinic, Darlinghurst, NSW, Australia.
³⁷ Department of Respiratory and Sleep Medicine, Austin Hospital, Heidelberg, Vic., Australia.
³⁸ Department of Respiratory Medicine, Eastern Health and Monash University, Box Hill, Vic., Australia.
³⁹ The Prince Charles Hospital, Metro North Hospital and Health Service, Chermside West, Qld, Australia.
⁴⁰ UQ Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Chermside, Qld, Australia.

PMID: 29676834
DOI: 10.1111/cea.13153

Abstract

Background: Severe asthma affects quality of life; however, its impact on workplace productivity is poorly understood.

Objective: To compare workplace productivity-absenteeism and presenteeism-and impairment in daily activities in severe and non-severe asthma over time and identify characteristics associated with presenteeism in severe asthma.

Methods: The Severe Asthma Web-based Database is an ongoing observational registry from Australia, New Zealand and Singapore. At April 2017, 434 patients with severe asthma and 102 with non-severe asthma were enrolled (18-88 years; 59% female). Participants provided comprehensive clinical and questionnaire data at baseline and were followed-up every 6 months for 24 months. Absenteeism (percentage of time not at work), presenteeism (self-reported impairment at work) and impairment in daily activities outside work due to health problems in the last week were calculated.

Results: At baseline, 61.4% of participants with severe asthma and 66.2% with non-severe asthma under 65 years were employed. At younger ages (30-50 years), fewer severe asthma participants were employed (69% vs 100%). Presenteeism and impairment in daily activity were more frequently reported in severe asthma and in participants with poorer asthma control, poorer lung function and more past-year exacerbations (P < .01). Over time, deteriorating asthma control was associated with increasing presenteeism. Although absenteeism was not different between severe and non-severe asthma, worse asthma control was associated with absenteeism (P < .001). In participants with severe asthma, presenteeism was reported more frequently in those with poorer asthma control, poorer asthma-related quality of life and symptoms of depression or anxiety (P < .01).

Conclusion and clinical relevance: Severe asthma was associated with impairment at work and outside the workplace. Improving asthma control and mental health may be important targets for optimizing workplace productivity in severe asthma. Presenteeism and absenteeism may represent key metrics for assessing intervention efficacy in people with severe asthma of working age.

Keywords: absenteeism; presenteeism; registry; severe asthma; work disability; workplace productivity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Absenteeism*
Activities of Daily Living
Adult
Aged
Asthma / diagnosis
Asthma / epidemiology*
Asthma / etiology
Efficiency*
Female
Humans
Male
Middle Aged
Quality of Life*
Registries
Severity of Illness Index
Surveys and Questionnaires
Workplace*