Workplace exposures and employment patterns in adult onset asthmatics and diabetics

Little is known about the impact of working conditions on employment decisions after the onset of chronic diseases in adult life.To determine the effects of job characteristics on employment in patients attending asthma and diabetes clinics.Patients aged 16-60 years were interviewed when attending outpatient clinics or undergoing day case surgery. The asthmatics (n=165) and diabetics (n=283) were taking regular prescribed medication for their condition, and were in paid employment at the time of diagnosis. Job titles at diagnosis were rated for exposures with the potential to cause or aggravate asthma or diabetes, and median ratings were used to assess the impact of exposures on the probability of changing the job held at diagnosis.Exposure to irritants or sensitizers at the time of diagnosis was more likely in asthmatics than in the comparison group (odds ratio = 7.09; 95% CI 3.12-16.17); physical activity was unrelated to diagnosis. At interview, on average 8.5 years after diagnosis, more asthmatics were unemployed (44%; mean age 47 years) than diabetics (31%; mean age 49 years) with ill-health being the most common reason given. No relation was found between exposure in the job held at diagnosis and subsequent job change.No evidence was found that changing jobs was used as a strategy to find more tolerable working conditions. The high proportion of unemployment due to ill-health among adult onset asthmatics deserves further investigation.