Severity of Airflow Obstruction and Work Loss in a Nationwide Population of Working Age

Jihwan Park,Don D Sin,Juhee Cho,Sun Hye Shin,Hyun Lee,Hye Yun Park

doi:10.1038/s41598-018-27999-6

Abstract

The impact of COPD severity on labor force participation and work loss is not well known. This study aimed to describe the characteristics of occupations and to evaluate the reason for work loss based on the severity of airflow obstruction (AO). We performed a cross-sectional study using data from the Korean National Health and Nutrition Examination Survey V−VI. We identified 9,901 people aged 40 to 60 years who had normal or AO in spirometry test results. AO was defined as a pre-bronchodilator forced expiratory volume in 1 second/forced vital capacity <70%. AO was present in 7.6% of the subjects, and 81.5%, 82.9%, and 71.6% of subjects with mild, moderate, and severe-to-very severe AO were in the labor force, respectively. Multivariable analyses revealed that severe-to-very severe AO subjects were more likely to have precarious job (adjusted OR = 4.71, 95% CI = 1.70–13.06) and cite health-related problem as the reason for not being in the labor force (adjusted OR = 3.38, 95% CI = 1.03–11.02). Overall, AO was not associated with any significant changes in labor force participation. However, subjects with severe-to-very severe disease were more likely to drop out of the labor force owing to their health-related problems.

Highlights

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide that is responsible for substantial economic and social burden[1,2]
The proportion of subjects working as manager/professional or office workers was lower in severe-to-very severe airflow obstruction (AO) subjects compared to other groups, while the proportion of subjects working as skilled labor/machine operators was higher in severe-to-very severe AO subjects compared to other groups
Using Korean National Health and Nutrition Examination Survey (KNHANES) database, our study showed that prevalence of labor force participation on average was not significantly different between subjects with normal spirometry and those with AO, those with AO were more likely to be employed in precarious jobs

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide that is responsible for substantial economic and social burden[1,2]. COPD patients of working age have a lower probability of labor force participation[5,6,7] and higher numbers of missed working days[8,9]. Not surprisingly, these patients are forced to retire prematurely[10], as shown in an international survey that reported that 45% of COPD patients under 65 years of age had work loss due to their heath conditions[11]. We used nationally representative data to evaluate reasons for work loss and to describe the characteristics of the occupations in which subjects with airflow obstruction (AO) work based on the severity of airflow limitation

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Results

Conclusion