Highest Asthma Rates Reported in Healthcare Workers

In an announcement Friday, the Centers for Disease Control and Prevention (CDC) detailed the occupations with the highest instances of asthma, and the information should hit close to home for those in the healthcare profession.

More so than in any other field, workers in the healthcare and social assistance industry reported being asthmatic, at a rate of 10.7%. When broken down by occupations within the field, healthcare support staff and community and social services workers led all occupations at 12.4% and 12.2%, respectively. A few rows below were healthcare practitioners and technical staff, bringing the industry average down with a still-noteworthy asthma rate of 9.2%.

Part of the sprawling, continuously-conducted Behavioral Risk Factor Surveillance System (BRFSS), the Asthma Call-back Survey (ACBS) compiled data from over 200,000 respondents in more than 20 states. Data from the 2006-2007 survey showed that as many as 48% of adult asthma cases may be work-related and, as such, preventable. Work-related asthma includes both occupational asthma, for which working conditions are primarily or entirely the cause, or pre-existing asthma exacerbated by such conditions.

For this new announcement, researchers at the CDC analyzed data from the 2013 version of the study, which asked Americans over the age of 18 questions about their occupation and health. Those who answered “yes” to both “Has a doctor, nurse, or other health professional ever told you that you had asthma?” and “Do you still have asthma?” were deemed to have asthma for the study’s purposes.

Following the healthcare industry somewhat distantly were education at 9.1% and arts, entertainment, and recreation at 9.0%. Perhaps surprisingly were some of the industries at the bottom of the list-manufacturing (6.1%), mining, oil and gas (6.0%), and construction (5.9%). The agriculture, forestry, fishing and hunting industry reported the lowest incidence of asthma at 4.2%.

The survey also broke down responses by state, and demographic markers like age, income, ethnicity, and education. The highest rates of asthma were reported by workers in Michigan (10%), Massachusetts (9.9%), and Oregon (9.2%). No other of the 21 states from the 2013 data reported rates over 9%, and Mississippi was by far the lowest at only 5% reporting.

More than one in five healthcare support workers in Michigan, the state with the highest instance of the disease, reported having asthma (21.5%). Every occupation carries its own unique set of risks for employees.

According to the announcement, “it is well recognized that workers in the health care and social assistance industry who are exposed to cleaning and disinfection products, powdered latex gloves, and aerosolized medications have a twofold increased likelihood of new-onset asthma.”

Other factors associated with high asthma rates were income below $15,000 annually (11.4%), Black race (8.9%), and female gender (10.2% of women reported having asthma, as compared to only 5.7% of men). The study does note limitations, chiefly that its data was self-reported and not drawn from official medical records, and that sample sizes for some industries in some states were small. Given that only 21 states were represented, it cannot be easily applied to asthma rates across the whole country, and the researchers postulated that those with pre-existing asthma might quickly leave occupations that exacerbated it, leading to some fields being skewed.

The researchers do stress the importance in examining these trends, recommending doctors “consider collecting a detailed occupational history among adults with asthma because this is critical for making a work-related asthma diagnosis and recommending optimal treatment and management.”

The work, entitled “Asthma Among Employed Adults, by Industry and Occupation — 21 States, 2013” was published online in the CDC’s Morbidity and Mortality Weekly Report (MMWR) last week.