The Impact of Chronic Obstructive Pulmonary Disease on Work Loss in the United States

Abstract

Chronic obstructive pulmonary disease (COPD) is a rapidly growing public health problem in the United States and elsewhere. Although direct costs of COPD are well documented, the impact of COPD and its severity on labor force participation is not well known. Using population-based data from the Third National Health and Nutrition Examination Survey (NHANES III), we determined the adjusted relationship between COPD (and its severity) and labor force participation in the U.S. We used data from 12,436 participants involved in NHANES III; 1,073 of these participants (8.6% of the total) reported COPD. These participants were 3.9% (95% confidence interval, 1.3% to 6.4%) less likely to be in the labor force than those without COPD. Increasing severity of COPD was associated with decreased probability of being in the labor force (p for linear trend = 0.001). Mild, moderate, and severe COPD was associated with a 3.4%, 3.9%, and 14.4% reduction in the labor force participation rate relative to those without COPD. These data suggest that COPD has a considerable adverse impact on work force participation. Based on these data, we estimate that, in 1994, COPD was responsible for work loss of approximately $9.9 billion in the U.S.

Functional evaluation of pallid mice with genetic emphysema

“…At the end of the last expiration of volume history, the mice were forced to inspire up to an airway pressure of 30 cmH 2 O (maximum mouth pressure) and hold it for a brief period (0.4 s). TLC was defined as the lung volume at a plateau airway-opening pressure of 30 cmH 2 O after breath holding for 0.4 s. After 0.4 s of breath holding, the lungs were slowly expired to the RV at a pressure of À30 cmH 2 O with an applied speed of 1 ml/s. The expiratory time must be at least 1 s. The quasi-static PV was …”

“…1,2 To develop a treatment for pulmonary emphysema, many studies using animal models that involve intratracheal elastase instillation have been reported. [3][4][5] Although such models are well established, they have some limitations.…”

Lifetime environmental tobacco smoke exposure and the risk of chronic obstructive pulmonary disease

“…We used the standard epidemiologic definition of COPD, based on a self-reported physician diagnosis of chronic bronchitis, emphysema, or COPD [1,14,15]. This surveybased approach enabled us to evaluate a populationbased sample of adults who resided throughout the continental United States, which ensured generalizable results.…”

Smokers with airway obstruction are more likely to quit smoking

“…Direct annual costs for COPD in the US were estimated to be over $18 billion, 3 and the economic impact of work loss accounted for an additional $10 billion. 4 The morbidity and mortality from cardiovascular diseases have been successfully reduced over the last 40 years as a result of effective preventive measures. However, the concurrent failure of pharmacological treatment to affect the increasing death rates from COPD should encourage new methods to be sought to reverse this trend.…”