![[ Visit Client Website ]](images/banner.png)
BACKGROUND: We aim to compare the results of two data sources describing the burden of asthma in Washington State (WA) and estimate the prevalence of asthma in workers in Washington State by occupation.
METHODS: Data from the 2006-2009 Behavioral Risk Factor Surveillance System (BRFSS) and the BRFSS Asthma Call-Back Survey (ACBS) in WA were analyzed, along with data from Washington State’s occupational asthma surveillance program utilizing workers’ compensation claims and worker interviews. Using state-added and coded Industry and Occupation questions, we calculated prevalence ratios (PR) for 19 occupational groups in WA BRFSS respondents.
RESULTS: There were 92,467 respondents to the WA BRFSS in 2006-2009, and of these, 6,099 participated in the ACBS. Of BRFSS respondents, 41,935 were currently employed and had occupation data. The prevalence of current asthma among WA workers participating in the BRFSS survey was 8.1% (95% Confidence Interval (CI) 7.7%-8.5%). When compared to the occupational reference group of Executive, Administration, and Managerial, three groups had significantly higher PRs of current asthma: Teachers, all levels, including Counselors (PR 1.3, 95% CI 1.1-1.6); Administrative Support, including Clerical (PR 1.5, 95% CI 1.2-1.9); and Other Health Services (PR 1.5, 95% CI 1.2-1.9). State occupational asthma surveillance data identified many of the same occupations and further characterizes the asthma-causing agent as well as the asthma type. While half of ACBS respondents (55.1%) indicated that they believed exposure at work had caused or worsened their asthma, only 11% had discussed the work-relatedness of their asthma with a health-care provider. This communication gap highlighted by the ACBS is exemplified by WA State’s experience in seeking physician, worker, and industry awareness to address hop-plant induced asthma in the agricultural setting.
CONCLUSIONS: Some occupations have a higher prevalence of current asthma than others and the routine collection of industry and occupation information in BRFSS would allow more states to regionally identify worker populations with a high burden of asthma. BRFSS and state surveillance results can be complementary and better inform occupational asthma prevention efforts. Very few individuals whose asthma is caused or made worse through work discuss this with a health care provider. The lack of patient to doctor communication has implications for asthma management and highlights the potential under-reporting of cases in surveillance systems that are based on workers’ compensation. The use of occupation data to identify at risk populations is valuable for targeting prevention efforts to reduce the burden of disease and to aid clinician recognition and treatment.