Occupational Medicine, Finnish Institute of Occupational Health, Topeliuksenkatu 41 B, 00250, Helsinki, Finland.
Espoo City Health Services, Espoo, Finland.
BMC Public Health. 2020 Feb 3;20(1):165. doi: 10.1186/s12889-020-8277-9.
Spirometry is widely used in medical surveillance in occupational health and as a diagnostic test for obstructive and restrictive lung disease. We evaluated the effect of spirometry parameters on the risk of all-cause disability pension in a follow-up study of an occupationally active general population-based cohort.
We measured the pulmonary function of 3386 currently working participants of the Health 2000 Survey in the clinical phase at baseline using spirometry. We obtained the retirement events of the cohort from the nationwide register for 2000-2011. Cox proportional hazards models were used to determine disability pensions.
At baseline, we identified 111 (3.3%) participants with obstructive spirometry, 95 (2.8%) with restrictive spirometry, and 3180 controls without restriction or obstruction. The age, sex, educational level, body-mass index, co-morbidities (1 or ≥ 2), and the smoking-adjusted hazard ratio of disability pension was 1.07 (95% confidence interval, CI 0.64-1.78) for those with obstructive spirometry, and 1.44 (95% CI 0.89-2.32) for those with restrictive spirometry. As continuous variables, and divided into quartiles, the risk of the lowest quartile of forced ventilation capacity (FVC)% of predicted was 1.49 (95%CI 1.10-2.01) and forced expiratory volume in one second (FEV)% of predicted 1.66 (95%CI: 1.23-2.24) in comparison to the highest quartile in the adjusted models.
Obstructive or restrictive spirometry did not predict disability pension when dichotomized classified variables (normal compared to abnormal) were used. As continuous variables and when divided into quartiles, lower lung volumes showed an increase in the risk of disability pension. Physicians should take this into account when they use spirometry as a prognostic factor of work disability.
肺量测定法在职业健康的医学监测以及作为阻塞性和限制性肺疾病的诊断测试中得到广泛应用。我们在一项针对职业活跃的一般人群队列的随访研究中，评估了肺量测定参数对全因残疾抚恤金风险的影响。
我们在基线临床阶段使用肺量测定法测量了来自健康 2000 调查的 3386 名目前在职的参与者的肺功能。我们从 2000 年至 2011 年的全国登记处获得了队列的退休事件。使用 Cox 比例风险模型确定残疾抚恤金。
在基线时，我们确定了 111 名（3.3%）有阻塞性肺量测定法的参与者，95 名（2.8%）有限制性肺量测定法的参与者，以及 3180 名没有限制或阻塞的对照组。年龄、性别、教育程度、体重指数、合并症（1 或≥2 种）以及调整后的残疾抚恤金风险比为阻塞性肺量测定法 1.07（95%置信区间，0.64-1.78），限制性肺量测定法为 1.44（95%置信区间，0.89-2.32）。作为连续变量，并分为四等分，最低四分位数的强制通气能力（FVC）%预测值为 1.49（95%CI 1.10-2.01），用力呼气量（FEV）%预测值为 1.66（95%CI：1.23-2.24），与调整后的模型中最高四分位数相比。
当使用二分分类变量（正常与异常）时，阻塞性或限制性肺量测定法并不能预测残疾抚恤金。作为连续变量和四等分，较低的肺容量显示残疾抚恤金风险增加。医生在使用肺量测定法作为工作残疾的预后因素时应考虑到这一点。
