Few issues are as complex as the scientific questions that surround the assessment of respiratory impairment from asthma, occupational or otherwise. The definition of impairment adopted by the American Thoracic Society is “a medical condition resulting from functional abnormality that may be temporary or permanent and that may preclude gainful employment. By contrast, the definition of disability considers the total effect of impairment on a subjects life assessment, which requires nonmedical as well as. medical information and therefore can be only partially defined by the examining physician.
Careful analysis of the definition of impairment provides insight into the difficulties surrounding assessment of impairment from asthma. The physician must resolve 4 issues in order to define impairment from asthma — buy asthma inhalers. First, there must be a clear, unambiguous definition of disease. Second, clear and precise criteria for disease severity must be established. Third, the exposure must contribute to impairment. Fourth, the natural history or prognosis of the disease must be generally known. Each of these 4 areas must be fully understood with a clinical consensus for each before criteria for impairment can be uniformly accepted. This article discusses each of these areas and reviews existing data to provide a framework for considering asthma impairment.
Tags: Airway responsiveness, Asthma, bronchial responsiveness, lung function, smoking