Workplace aggravation of asthma symptoms among immigrants with asthma in an urban working population

Work-related asthma is one of the most common occupational respiratory diseases in the United States. An estimated 10–23% of new-onset asthma cases in adults are attributable to occupational factors. Little is known about the prevalence of work-related asthma among immigrants living in the United States. A questionnaire was administered by interviewer to low income, minority, working patients with physician-diagnosed asthma seen at a large municipal hospital in New York City. The objective of this investigation is to compare the prevalence of workplace aggravation of asthma symptoms (WAAS) in immigrant patients (born outside the U.S.) with the prevalence in patients born in the U.S. We hypothesized that the prevalence of WAAS would vary based on immigrant status. Of a total of 481 patients, 51% (246/481) reported WAAS in their current or most recent job. The prevalence of WAAS reported by immigrant patients (58%, 94/161) was significantly higher than the prevalence in non-immigrant patients (48%, 152/320) (p = 0.02). In spite of this difference, immigrant patients were not more likely than non-immigrant patients to have left a job due to asthma symptoms. The results of this study suggest that immigrants may be more likely to have work-aggravated asthma. Workplace environmental exposures combined with limited access to health care may be important risk factors for work-related asthma among immigrant workers. Public health officials, policy makers, and clinicians should consider secondary prevention strategies for asthmatic workers at risk for work-related asthma, making sure to include low-income, urban, and immigrant populations.