Am. J. Respir. Crit. Care Med., Vol 152, No. 1, 07 1995, 153-156.
Work disability in adults with cystic fibrosis
M Gillen, D Lallas, C Brown, E Yelin and P Blanc
California Public Health Foundation, Berkeley, USA.
Greater numbers of persons with cystic fibrosis (CF) reach adulthood and,
therefore, actively participate in the labor force. In this study, we
estimated labor force participation rates and determined risk factors for
work disability among persons with CF. We recruited 49 (73%) of 67 adults
followed at one of two hospital-based CF centers. We ascertained employment
history and CF-attributed work disability by structured questionnaire.
Independently, we reviewed medical records for demographics and illness
severity indicators. We analyzed potential risk factors for work disability
by logistic regression analysis. All of those studied reported past or
present labor force participation, consistent with high work motivation.
Complete cessation of work attributed to CF was reported by 17 (35%; 95%
CI, 21 to 49%). Although 23 (47%; 95% CI, 32 to 60%) of those surveyed
stated that CF had affected career choice, only nine respondents had ever
received career counselling and 16 had ever discussed job choice with their
physicians. After adjusting for standard measures of disease severity by
multiple logistic regression, age, adult diagnosis of CF, female gender,
and single marital status, analyzed as a group, provided significant
additional explanatory power to a predictive model of disability risk
(model chi square [4 d.f.] = 11.5, p < 0.05). Health care professionals
who design interventions targeted at work disability among persons with CF
should address demographic factors as well as illness severity and should
assess the vocational needs of persons with CF and the potential benefit of
career counselling.
