A Framework for Assessing Impairment from Asthma: Determination of Disease Severity (7)These clinical measures remain largely unstudied in adults, and their relationship to prognosis is unknown. Equally unclear is their relationship to epidemiologic measures of disease severity. An additional potential problem with clinical measures of severity is that they may be influenced by access to medical care. buy asthma inhalers
In summary, a large number of factors thought to influence asthma severity have not been rigorously tested. There appears to be little consensus in the medical literature as to the most important elements in determining disease severity, and no work is available relating disease severity to prognosis.
Defining the Environmental Agent(s) Causing Asthma
The worker who develops new-onset asthma in a work environment with exposure to a known sensitizing agent or to a known cause of occupational asthma presents less of a problem in terms of impairment assessment than a worker in a more ambiguous clinical scenario. Of greater concern are workers who are at increased risk of disease by virtue of clinical or epidemiologic characteristics, such as cigarette smoking. Also at issue are the significant number of asthmatics for whom workplace exposure is not the cause of their asthma but is an exacerbating factor. Any impairment assessment scheme must clearly define the manner in which these clinical situations will be addressed.
Also at issue is the worker who is exposed to multiple agents, or workers in whom work-related asthma is clearly diagnosed, yet the causal agent cannot be defined. Although impairment assessment can be carried out in these settings, the attribution of exposure to a specific agent and the natural history of the disease may be impossible to define.