title: Employment status and quality of life in patients with chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  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, FEV(1) %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.
authors.affiliation: Netherlands Expert Centre for Work-related Respiratory Disorders, Department of Pulmonology Dekkerswald, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. K.Orbon@hag.umcn.nl
authors.forename: Karin H
authors.initials: KH
authors.lastname: Orbon
authors.forename: Tjard R
authors.initials: TR
authors.lastname: Schermer
authors.forename: Joost W
authors.initials: JW
authors.lastname: van der Gulden
authors.forename: Niels H
authors.initials: NH
authors.lastname: Chavannes
authors.forename: Reinier P
authors.initials: RP
authors.lastname: Akkermans
authors.forename: Onno P van
authors.initials: OP
authors.lastname: Schayck
authors.forename: Chris
authors.initials: C
authors.lastname: van Weel
authors.forename: Hans T
authors.initials: HT
authors.lastname: Folgering
mesh_terms: D006233:Persons with Disabilities; D004651:Employment; D006801:Humans; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012129:Respiratory Function Tests