Birmingham COPD Cohort: a cross-sectional analysis of the factors associated with the likelihood of being in paid employment among people with COPD

Abstract

BackgroundEmployment rates among those with chronic obstructive pulmonary disease (COPD) are lower than those without COPD, but little is known about the factors that affect COPD patients’ ability to work.MethodsMultivariable analysis of the Birmingham COPD Cohort Study baseline data was used to assess the associations between lifestyle, clinical, and occupational characteristics and likelihood of being in paid employment among working-age COPD patients.ResultsIn total, 608 of 1,889 COPD participants were of working age, of whom 248 (40.8%) were in work. Older age (60–64 years vs 30–49 years: odds ratio [OR] =0.28; 95% confidence interval [CI] =0.12–0.65), lower educational level (no formal qualification vs degree/higher level: OR =0.43; 95% CI =0.19–0.97), poorer prognostic score (highest vs lowest quartile of modified body mass index, airflow obstruction, dyspnea, and exercise (BODE) score: OR =0.10; 95% CI =0.03–0.33), and history of high occupational exposure to vapors, gases, dusts, or fumes (VGDF; high VGDF vs no VGDF exposure: OR =0.32; 95% CI =0.12–0.85) were associated with a lower probability of being employed. Only the degree of breathlessness of BODE was significantly associated with employment.ConclusionThis is the first study to comprehensively assess the characteristics associated with employment in a community sample of people with COPD. Future interventions should focus on managing breathlessness and reducing occupational exposures to VGDF to improve the work capability among those with COPD.

Factors associated with work productivity among people with COPD: Birmingham COPD Cohort

“…In a separate analysis, examining the factors associated with the likelihood of being employed among patients with COPD, we found that the same characteristics as those identified in this study (increasing dyspnoea and workplace exposures to VGDF) were important 40. This suggests that there may be a continuum, from impact on work productivity among those in paid employment to unemployment among the most severely affected.…”

Prevalence of osteoarthritis in individuals with COPD: a systematic review

“…Six studies 30 , 33 , 35 , 38 – 40 were conducted on populations in the USA, and one study 34 examined patients from nine countries. The remainder (published in English) were from the following: the Netherlands, 31 , 41 UK, 32 , 42 Korea, 37 South Africa 36 and Germany. 43 Seven studies 31 , 33 , 37 – 39 , 42 , 43 (50%) followed the observational cohort design; six 30 , 32 , 34 – 36 , 41 were cross-sectional (43%) and only one 40 (7%) was a case–control study.…”

“…The remainder (published in English) were from the following: the Netherlands, 31 , 41 UK, 32 , 42 Korea, 37 South Africa 36 and Germany. 43 Seven studies 31 , 33 , 37 – 39 , 42 , 43 (50%) followed the observational cohort design; six 30 , 32 , 34 – 36 , 41 were cross-sectional (43%) and only one 40 (7%) was a case–control study. Studies varied in sample size 39 , 42 (27–52,643) as well as age 33 , 42 (59.3–76 years).…”

“…Studies varied in sample size 39 , 42 (27–52,643) as well as age 33 , 42 (59.3–76 years). In six studies, 32 – 34 , 36 , 37 , 40 data on age and/or sex could not be extracted, and in five, 33 , 36 , 40 – 42 data on obesity was unavailable. Seven studies 31 , 33 , 34 , 36 , 39 , 41 , 42 out of 14 reported data on smoking status among their sample.…”

“…The results may have been biased toward one large study, 39 which was responsible for approximately 23% of the overall calculated weighted mean of the prevalence of OA in COPD. The observation that the weighted mean of the prevalence of OA in COPD in eight studies 30 , 32 , 36 – 38 , 40 – 42 out of 14 was <1% suggests that only a few studies significantly contributed to the overall calculated average prevalence rate.…”