The employment history of people with and without asthma

Abstract

Introduction People with asthma may have a greater likelihood of leaving employment due to ill health, spending more time in unemployment and changing jobs more frequently because of their disease. Some studies have reported that people with childhood asthma were disadvantaged in later employment. The aim of this analysis is to investigate the effects of asthma on employment history from early-to mid-adult life (age 42) in a British birth cohort. Methods Members of the National Child Development Study (NCDS) cohort with information on asthma and an employment history from ages 16 to 42 were included (n=9881). Asthma was defined as childhood asthma (0-16), severe childhood asthma, current asthma at age 16 and adult onset asthma. Outcomes were ever having a period out of employment, total periods of employment and unemployment and total time out of employment. The associations between asthma and the outcomes were assessed separately for men and women using Mann-Whitney or Kruskal Wallis tests, with significant results explored using a logistic regression model for binary outcomes and a negative binomial regression model (with a zero inflated model for outcomes with large numbers of zeros) for count data. Results By age 42, 43% of the cohort had experienced at least one period out of employment and the median number of employment periods was 6, with women reporting on average one more job by age 42 than men. Women reporting adult onset asthma were likely to have had more periods of employment when compared to women who never had asthma (p=0.003). For both men and women with adult onset asthma there was a doubling of the risk of ever being out of employment due to ill health compared to those without asthma (men OR 1.94 [95% CI 1.24-3.04], women OR 2.00 [95% CI 1.43-2.80]). Conclusion There is evidence that adult onset (but not childhood) asthma affects employment history, particularly for women. It is not known whether this reflects the experience of more recent cohorts.