Rai Kiran K, Jordan Rachel E, Siebert W Stanley, Sadhra Steven S, Fitzmaurice David A, Sitch Alice J, Ayres Jon G, Adab Peymané
Institute of Applied Health Research.
The Department of Business and Labour Economics.
Int J Chron Obstruct Pulmon Dis. 2017 Jan 11;12:233-242. doi: 10.2147/COPD.S119467. eCollection 2017.
Employment 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.
Multivariable 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.
In 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.
This 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.
慢性阻塞性肺疾病（COPD）患者的就业率低于非COPD患者，但对于影响COPD患者工作能力的因素知之甚少。
对伯明翰COPD队列研究的基线数据进行多变量分析，以评估生活方式、临床和职业特征与工作年龄的COPD患者从事有偿工作可能性之间的关联。
在1889名COPD参与者中，共有608人处于工作年龄，其中248人（40.8%）有工作。年龄较大（60 - 64岁与30 - 49岁相比：优势比[OR]=0.28；95%置信区间[CI]=0.12 - 0.65）、教育水平较低（无正规学历与学位/高等水平相比：OR =0.43；95% CI =0.19 - 0.97）、预后评分较差（改良体重指数、气流受限、呼吸困难和运动能力（BODE）评分的最高四分位数与最低四分位数相比：OR =0.10；95% CI =0.03 - 0.33）以及有高职业暴露于蒸汽、气体、粉尘或烟雾（VGDF）的病史（高VGDF暴露与无VGDF暴露相比：OR =0.32；95% CI =0.12 - 0.85）与就业可能性较低相关。只有BODE评分中的呼吸困难程度与就业显著相关。
这是第一项全面评估COPD社区样本中与就业相关特征的研究。未来的干预措施应侧重于管理呼吸困难和减少职业性VGDF暴露，以提高COPD患者的工作能力。
