At Work With the CDC

Asthma’s Effect on Employees — Why Businesses Need to Care

By Scott Damon and Seymour Williams

Although both hospitalization and death rates for asthma are on the wane, asthma’s impact on health and business remains substantial.

Approximately 22 million Americans, one of every 14 people in the nation, suffer from asthma. One in every five American families must cope with the disease. Each year, asthma results in about 14.5 million days of work lost — in part because of the effect on parents of 14 million days of school missed annually by children and 100 million days of restricted activity.

The estimated cost of workdays lost by people with asthma is $800 million per year. An additional $900 million per year is lost because of workdays missed by parents caring for children with asthma. In 1998, the most recent year for which figures are available, asthma cost the U.S. economy a staggering $12.7 billion, a figure that may rise to $18 billion by 2020.

Asthma is a chronic and potentially life-threatening disease of the lungs and airways, characterized by inflammation and narrowing of the airways, frequently resulting in the shortness of breath, wheezing, breathlessness and chest tightness of an asthma attack.

Asthma is presently incurable but achievable goals of managing the disease include preventing and controlling symptoms, maintaining normal or near normal lung function and activity levels, reducing the number and frequency of emergency room visits and hospitalizations, and maintaining optimal medication use with the fewest adverse side effects.

Employer Action

A cooperative partnership of employers and employees will increase the possibility of successful asthma management, minimizing both the personal health effects and the economic costs. Some 5 to 25 percent of both newly diagnosed cases and aggravation of previously diagnosed asthma in adults are work-related due to substances in the workplace that act as triggers. Businesses can reduce work-related health costs by identifying, assessing and mitigating the presence of potential asthma triggers in the workplace; supporting the use of asthma medications in the workplace; and developing emergency response procedures for employees who may have asthma reactions.

Employers can take an important step toward preventing asthma attacks by designating the workplace as a "no smoking area" and supporting smoking-cessation programs. They can also help by promoting and participating in community asthma activities.

Additionally, businesses that provide health care coverage can improve the health of both their employees and their balance sheets by ensuring that the care they purchase includes the key elements of asthma management recommended by the National Asthma Education and Prevention Program ( http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5206a1.htm ). Quality and cost-effective health care plans for people with asthma should include coverage for these 10 clinical activities:

• Establishing an asthma diagnosis

• Classifying the severity of an individual’s asthma

• Scheduling routine follow-up asthma care

• Assessing individuals with asthma for possible referral to specialty care

• Recommending measures to control and avoid asthma triggers

• Treating or preventing all other medical conditions that could exacerbate the individual’s asthma

• Prescribing medications according to the severity of the individual’s asthma

• Monitoring the use of prescribed medications

• Developing a written asthma management plan for the individual

• Providing routine education on self-management of asthma to people with asthma

Since 1998, the Centers for Disease Control and Prevention has worked with the National Business Coalition on Health, the Washington Business Group on Health, the Employers Managed Health Care Association and other partners to explore ways to reduce the burden of asthma on businesses and improve employees’ asthma management through education.

Scott C. Damon is a health communication specialist and Seymour G. Williams, MD, is an epidemiologist at the Air Pollution and Respiratory Health Branch of the National Center for Environmental Health. For a reference list, e-mail SDamon@cdc.gov .

Be sure to check out previous "At Work With the CDC" columns in our archive.

Resource Links:

CDC’s Asthma sitehttp://www.cdc.gov/nceh/airpollution/default.htm

American Academy of Allergy, Asthma and Immunologyhttp://www.aaaai.org/

Asthma and Allergy Foundation of Americahttp://www.aafa.org/

Scott Damon, Seymour Williams. Asthma’s Effect on Employees: Why Businesses Need to Care.

Business and Health

May 15, 2003;21.