Treatment of allergic rhinitis: effect on occupation productivity and work force costs

Allergic rhinitis, one of the most common chronic illnesses, can have a negative impact on occupational productivity in the work-place. Allergic rhinitis affects over 13 million workers (6.15 million men and 6.11 million women) of the United States work force. Work place productivity can be reduced in the several ways: (1) Employee works at suboptimal efficiency because of the disease or its treatment; (2) employee takes a sick day away from work because of allergic rhinitis or its complications; (3) employee takes time off from work to care for or transport a child or dependent who needs care for allergic rhinitis or its complications, and (4) worker takes time off because of a work-related injury related to the disease or the medication used to treat the illness. Although nonsedating antihistamines and intranasal anti-inflammatory medications have been developed as effective therapies and are available as prescription drugs, many workers (50%) indicate that they manage their allergic rhinitis with over-the-counter medications. Most of these over-the-counter medicines contain sedating antihistamines which are known to alter cognitive and motor function. To determine whether the medications used by 3394 members of a health maintenance organization were associated with incident work-related injury, they were compared to two control groups selected from the membership and matched for age, gender, and Standard Industrial Classification Code of their employer. Medication use was determined from pharmacy data. The injuries included 496 fractures on dislocations, 2728 open, crushing, or superficial injuries, 176 burns, and 63 internal injuries. The risk of injury was statistically significantly elevated among users of sedating antihistamines. Utilizing demographic data the annual cost of last productivity to employers and society as the result of allergic rhinitis and its therapy with the over-the-counter sedating antihistamines is estimated to be greater than $4 billion.