P-493 Direct Cost of Recognized Allergic Occupational Asthma in Southern Tunisia

Abstract Introduction Occupational asthma (OA) is one of the most common respiratory pathologies in the workplace. It mainly affects young workers and has significant socio-economic consequences. Methods This was a retrospective descriptive study of all cases of OA recognized in the southern Tunisian region during the years from 2002 to 2017. The direct cost of OA included the total amounts paid by the national health insurance fund (CNAM) to the socially insured (total temporary and permanent work allowances) from the date of OA diagnostic or consolidation until November 1, 2021. Results A total of 73 cases of recognized allergic OA were identified. Employees’ average age was 42.15 ± 8.78 years. The average rate of permanent partial disability (PPD) was 20.56 ± 15.85%. The total sum paid by the CNAM was 1,161,641.540 dinars with an average of 15,912.850 ± 56,070.89 dinars and an individual median sum of 7,208 dinars. The PPD rate was significantly associated with a cost above 7,000 dinars. Discussion Under-reporting of OA in this study could be due to misdiagnosis, or ignorance of the law by treating physicians or physicians responsible for making the diagnosis. Also, some workers with real OA might not report their disease for fear of losing their job or because compensation is perceived to be low. Conclusion The diagnosis of OA could have serious socio-economic consequences not only for the workers but also for the employer and the health system. Estimating the magnitude of OA remains a crucial step in implementing effective prevention strategies.