Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada; Department of Pulmonary and Critical Care Medicine, King Fahad Medical City, Riyadh, Saudi Arabia.
Respiratory Evaluation Sciences Program, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC, Canada.
Chest. 2019 Nov;156(5):887-895. doi: 10.1016/j.chest.2019.04.016. Epub 2019 Apr 30.
Fibrotic interstitial lung diseases (ILDs) are highly morbid chronic disorders that frequently occur in working age individuals. The goal of this study was to determine workplace productivity loss, its determinants, and its estimated costs in patients with fibrotic ILD.
Patients with idiopathic pulmonary fibrosis, chronic hypersensitivity pneumonitis, idiopathic nonspecific interstitial pneumonia, or unclassifiable ILD were identified from the six-center Canadian Registry for Pulmonary Fibrosis (CARE-PF). The Work Productivity and Activity Impairment questionnaire was used to determine health-related productivity loss. Independent predictors of low workplace productivity were identified by using multivariate regression. Patient data were compared with Canadian population census data. The average productivity loss (hours per week) and the individual's hourly wage were used to estimate the costs of productivity loss.
Of 650 eligible patients, 148 (23%) were employed. Productivity loss was reported by 55% of employed patients with an average productivity loss of 7.8 ± 0.9 h per week (2.3 ± 0.6 h per week related to absenteeism and 5.5 ± 0.6 h per week related to presenteeism). Employment among patients with ILD aged 25 to 54 years was 23% lower than the age- and sex-matched general Canadian population (60% vs 83%; P < .001). Employment among patients with ILD aged ≥ 55 years was 18% lower than in the age- and sex-matched population (20% vs 38%; P < .001). Dyspnea and cough were independent predictors of workplace productivity loss. Estimated annual costs of productivity loss were 11,610 Canadian dollars per employee with ILD.
Workplace productivity loss is common in fibrotic ILD, strongly correlated with symptom severity, and associated with significant cost.
纤维化间质性肺疾病（ILDs）是高度病态的慢性疾病，常发生在工作年龄段的人群中。本研究的目的是确定纤维化 ILD 患者的工作场所生产力损失、其决定因素及其估计成本。
从加拿大肺纤维化注册中心（CARE-PF）的六个中心确定特发性肺纤维化、慢性过敏性肺炎、特发性非特异性间质性肺炎或无法分类的 ILD 患者。使用工作生产力和活动障碍问卷确定与健康相关的生产力损失。使用多元回归确定低工作场所生产力的独立预测因素。将患者数据与加拿大人口普查数据进行比较。使用平均生产力损失（每周小时数）和个人每小时工资来估计生产力损失的成本。
在 650 名符合条件的患者中，有 148 名（23%）患者有工作。55%的在职患者报告存在生产力损失，平均每周生产力损失 7.8 ± 0.9 小时（2.3 ± 0.6 小时与缺勤有关，5.5 ± 0.6 小时与在职有关）。25 至 54 岁 ILD 患者的就业率比同龄和同性别一般加拿大人口低 23%（60%比 83%；P<0.001）。≥55 岁 ILD 患者的就业率比同龄和同性别人群低 18%（20%比 38%；P<0.001）。呼吸困难和咳嗽是工作场所生产力损失的独立预测因素。估计每位 ILD 患者每年因生产力损失而产生的成本为 11610 加元。
纤维化 ILD 患者的工作场所生产力损失较为常见，与症状严重程度密切相关，并带来显著的成本。
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