ABSTRACT
Based on the US National Health Interview Survey (NHIS) data from the decade of the 1990s, 3.3% of US adults aged 35-64 and 4.2% aged 15-34 reported an episode of asthma or an asthma attack in the previous year, accounting for ~6,650,000 persons with this condition (1). Follow-up US NHIS data from 2001 to 2009 showed that the prevalence of current asthma had increased among adults from 6.9% at the beginning of the decade to 7.7%, by 2009, 5.5% among males and 9.7% among females (2). It is important to note that the greater asthma prevalence among females than males above age 18 (as opposed to younger age) is a well-established pattern. Of note, these data include all adults above age 18, and therefore are not restricted solely to those of working age. Data from the US National Health and Nutrition Examination Survey (NHANES) from 2001 to 2004, however, are consistent with these estimates with a prevalence of current asthma of 9.9% among those aged 20-29, dipping to 7.1% among those aged 30-39 and climbing to 10.6% among those aged 50-59 before falling off again in older age; lifetime asthma prevalence was estimated to be about 50% higher (3). The US Behavioral Risk Factor Surveillance System (BRFSS) has estimated that the annual asthma incidence (reported new diagnosis by a health-care provider) was 4.9 per 1000 person-years among adult females and 2.8 per 1000 person-years among males (4). These US-specific data should be generalized with caution. Clearly, in certain regions, asthma among adults of working age is even more prevalent; for example, an estimated 17% of persons in New Zealand aged 20-64 have been estimated to
case history A 32-year-old male is referred for disability evaluation. He was diagnosed with adult-onset asthma at age 25. He has been intermittently prescribed systemic (oral) corticosteroids since that time, although currently he is only using an inhaled steroid (in a combination product also containing a long-acting beta
He has been out of work for the past 2 years. At the time of his asthma diagnosis, he was employed as an autobody spray painter using both isocyanates and epoxy formulations. He started that job after a high-school apprentice program and, in retrospect, had respiratory symptoms for several years before a doctor told him he had asthma. No one told him that his condition might be work related. He continued at the same job but had to give it up a few years later because he missed so many days due to his asthma, and when he was at work, his job performance was poor. After a period of unemployment, he did find a job in a supermarket, but going in and out of the cold room made him cough incessantly, so he quit.
