Abstract
Objectives: Recently, the conditions for disability benefits were redefined in several countries, stimulating employees to participate on the labour market as long as reasonably possible. Little is known of labour participation and quality of life (QoL) of employees with chronic diseases. This study examines the associations between employment status and QoL in COPD patients. Additionally, the role of lung function, and work-related symptoms and exposures on QoL were explored. Methods: Secondary analyses were conducted on baseline data from a randomized control trail. Patients were categorized as: “paid-workers”; “voluntary non-paid workers” (e.g., early retired, house wives) or “disabled for work”. QoL was assessed by the Chronic Respiratory Questionnaire (CRQ). Between-group differences in CRQ scores, and associations between work-related symptoms or irritants and CRQ scores were uni- and multivariately analysed. Results: Two hundred and ten patients with COPD were included [mean age 53.9 (SD 6.8) years, FEV1 %predicted 63.5 (SD 18.5)]. No statistically significant differences in lung function between the employment status subgroups were observed. Multivariable analysis showed that the “disabled” had lower CRQ scores as compared with “paid workers” (0.52 point difference, p<0.001). The CRQ scores of “voluntary non-paid workers” were not significantly different from “paid workers”. Within the group paid workers, patients with many work-related clinical symptoms and being susceptible to various work-related irritants experienced a lower QoL than patients who had respectively no symptoms, or who were not susceptible to these factors. Conclusions: Patients with COPD who were disabled for work showed equal severity of airflow limitation but worse QoL, as compared with paid workers.
Similar content being viewed by others
References
Alexopoulos EC, Burdorf A (2001) Prognostic factors for respiratory sickness absence and return to work among blue collar workers and office personnel. Occup Environ Med 58(4):246–252
American Thoracic Society (1995) Standardization of spirometry, 1994 update. Am J Respir Crit Care Med 152(3):1107–1136
Becklake MR (1989) Occupational exposures: evidence for a causal association with chronic obstructive pulmonary disease. Am Rev Respir Dis 140:S85–S91
Blake C, Codd MB, Cassidy A et al (2000) Physical function, employment and quality of life in end-stage renal disease. J Nephrol 13(2):142–149
Blanc PD, Jones M, Besson C et al (1993) Work disability among adults with asthma. Chest 104(5):1371–1377
Blanc PD, Cisternas M, Smith S et al (1996) Asthma, employment status, and disability among adults treated by pulmonary and allergy specialists. Chest 109(3):688–696
Boot CR, Van Der Gulden JW, Orbon KH et al (2004) Asthma and chronic obstructive pulmonary disease: differences between workers with and without sick leave. Int Arch Occup Environ Health 77(5):357–362
Burge PS (1994) Occupation and chronic obstructive pulmonary disease (COPD). Eur Respir J 7:1032–1034
Chavannes N, Schermer T, Wouters E et al (2001) Treatment of COPD in general practice: the COOPT study. Eur Respir J 18(Suppl. 33):348s
Eisner MD, Yelin EH, Trupin L et al (2002) The influence of chronic respiratory conditions on health status and work disability. Am J Public Health 92(9):1506–1513
Erickson SR, Kirking DM (2002) A cross-sectional analysis of work-related outcomes in adults with asthma. Ann Allergy Asthma Immunol 88(3):292–300
Faulkner MA, Hilleman DE (2002) The economic impact of chronic obstructive pulmonary disease. Expert Opin Pharmacother 3(3):219–228
Fletcher C, Peto R (1977) The natural history of chronic airflow obstruction. Br Med J 1(6077):1645–1648
Gosselink R, Decramer M (1998) Peripheral skeletal muscles and exercise performance in patients with chronic obstructive pulmonary disease. Monaldi Arch Chest Dis 53(4):419–423
Guyatt GH, Berman LB, Townsend M et al (1987a) A measure of quality of life for clinical trials in chronic lung disease. Thorax 42(10):773–778
Guyatt GH, Townsend M, Berman LB et al (1987b) Quality of life in patients with chronic airflow limitation. Br J Dis Chest 81(1):45–54
Hajiro T, Nishimura K, Tsukino M et al (1998a) Analysis of clinical methods used to evaluate dyspnea in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 158(4):1185–1189
Hajiro T, Nishimura K, Tsukino M et al (1998b) Comparison of discriminative properties among disease-specific questionnaires for measuring health-related quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 157(3 Part 1):785–790
Kleinbaum DG (1994) Logistic regression statistics in the health science—a self-learning text, 4th edn. Springer, Berlin Heidelberg New York
Leigh JP, Romano PS, Schenker MB et al (2002) Costs of occupational COPD and asthma. Chest 121(1):264–272
O’Neill J, Hibbard MR, Brown M et al (1998) The effect of employment on quality of life and community integration after traumatic brain injury. J Head Trauma Rehabil 13(4):68–79
Redelmeier DA, Guyatt GH, Goldstein RS (1996) Assessing the minimal important difference in symptoms: a comparison of two techniques. J Clin Epidemiol 49(11):1215–1219
Reinhold-Keller E, Herlyn K, Wagner-Bastmeyer R et al (2002) Effect of Wegener’s granulomatosis on work disability, need for medical care, and quality of life in patients younger than 40 years at diagnosis. Arthritis Rheum 47(3):320–325
Rutten-van Molken M, Roos B, Van Noord JA (1999) An empirical comparison of the St George’s Respiratory Questionnaire (SGRQ) and the Chronic Respiratory Disease Questionnaire (CRQ) in a clinical trial setting. Thorax 54(11):995–1003
Siafakas NM, Vermeire P, Pride NB et al (1995) Optimal assessment and management of chronic obstructive pulmonary disease (COPD). The European Respiratory Society Task Force. Eur Respir J 8(8):1398–1420
Sin DD, Stafinski T, Ng YC et al (2002) The impact of chronic obstructive pulmonary disease on work loss in the United States. Am J Respir Crit Care Med 165(5):704–707
Sullivan SD, Ramsey SD, Lee TA (2000) The economic burden of COPD. Chest 117(2 Suppl):5S–9S
Van Dongen CJ (1996) Quality of life and self-esteem in working and nonworking persons with mental illness. Community Ment Health J 32(6):535–548
Wijkstra PJ, TenVergert EM, Van Altena R et al (1994) Reliability and validity of the chronic respiratory questionnaire (CRQ). Thorax 49(5):465–467
Wijnhoven HA, Kriegsman DM, Hesselink AE et al (2001) Determinants of different dimensions of disease severity in asthma and COPD: pulmonary function and health-related quality of life. Chest 119(4):1034–1042
Zock JP, Sunyer J, Kogevinas M et al (2001) Occupation, chronic bronchitis, and lung function in young adults. An international study. Am J Respir Crit Care Med 163(7):1572–1577
Acknowledgements
This study was funded by the Dutch Council of Health Insurances. Additional financial support was provided by the Dutch Asthma Foundation and the Dutch Ministry of Health, Welfare and Sport. The authors would like to thank Mr H. van den Hoogen for his statistical advice. All executed experiments comply with the current laws in The Netherlands.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Orbon, K.H., Schermer, T.R., van der Gulden, J.W. et al. Employment status and quality of life in patients with chronic obstructive pulmonary disease. Int Arch Occup Environ Health 78, 467–474 (2005). https://doi.org/10.1007/s00420-005-0617-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00420-005-0617-7