Comparison of socioeconomic outcomes and asthma control in patients with work-exacerbated and occupational asthma in São Paulo, Brazil

Rationale: Work-related asthma (WRA) encompasses occupational asthma (OA) and work-exacerbated asthma (WEA).Despite its high prevalence of 21% in asthmatic adults,WEA receives less attention in the literature than OA. Aim: To compare psychological,quality of life,asthma control and socioeconomic differences between patients with OA and WEA. Methods: 81 OA and 47 WEA patients were evaluated and interviewed about their occupational exposure, socioeconomic status and responded to asthma control questionnaires (ACQ6 and ACT), Hospital Anxiety and Depression Scale (HADS) and Juniper asthma quality of life questionnaire (AQLQ). Results: The OA group suffered wage reduction after diagnosis and shows worse asthma control (Table 1 and 2). No difference were found in asthma control in the OA group between those removed from exposure (65.4%) and those who weren´t (34.6%),differing from WEA where individuals removed (57.4%) showed a tendency to clinical improvement in the ACQ6 score (p=0.09;Cohen d=0.5). Conclusion: OA has worse asthma control and socioeconomic outcomes than WEA, even if they get more social secuirty benefit.However WEA takes longer to be diagnosed and WEA individuals who stay exposed show a trend of worse asthma control.Social security laws must be improved and employers held accountable to ensure socioeconomic stability for patients removed from exposure.