title: Determinants of health-related quality of life among residents with and without COPD in a historically industrialised area.
abstract: OBJECTIVE
  Chronic obstructive pulmonary disease (COPD) is associated with substantial morbidity, including impaired health-related quality of life (HRQoL). Despite the prominent role of occupational factors in the aetiology of COPD, the relationship between these exposures and HRQoL has not been well elucidated.
  
  
  METHODS
  A subpopulation from an epidemiological study, designed to assess the workplace contribution to COPD, was administered the EQ5D HRQoL tool. Demographics, an index of economic deprivation, health endpoints including the presence of COPD and lung function were also recorded. Workplace exposures were categorised using both self-reported exposures and also by the use of an established job exposure matrix (JEM).
  
  
  RESULTS
  A total of 623 individuals participated (mean age 67.1 years). One hundred and forty-eight (24%) reported having received a physician diagnosis of COPD, 355 (57%) were male, and 386 (62%) were ever smokers. As anticipated, the presence of COPD was associated with a poorer HRQoL. Additionally, however, HRQoL was significantly lower in the presence of both self-reported vapours, gases, dusts and fumes exposure and JEM-based exposure irrespective of the presence of COPD. Regression analysis, adjusting for a variety of covariates including the presence of COPD, confirmed a persisting higher likelihood of occupational exposure categorised by JEM being associated with poorer HRQoL scores (β estimate: -0.069; p < 0.05).
  
  
  CONCLUSIONS
  Our findings suggest that work may have an important link to HRQoL and that this effect can persist even among those who have retired. In those with COPD, HRQoL is worse than among those without this condition, but the work-associated decrement appears to be similar across both groups.
authors.affiliation: Health and Safety Laboratory, Centre for Workplace Health, Harpur Hill, Buxton, Derbyshire, SK173JN, UK, d.fishwick@sheffield.ac.uk.
authors.forename: David
authors.initials: D
authors.lastname: Fishwick
authors.forename: Leon
authors.initials: L
authors.lastname: Lewis
authors.forename: Anthony
authors.initials: A
authors.lastname: Darby
authors.forename: Charlotte
authors.initials: C
authors.lastname: Young
authors.forename: Ruth
authors.initials: R
authors.lastname: Wiggans
authors.forename: Judith
authors.initials: J
authors.lastname: Waterhouse
authors.forename: Jeremy
authors.initials: J
authors.lastname: Wight
authors.forename: Paul D
authors.initials: PD
authors.lastname: Blanc
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology / Q000523:psychology*; D016273:Occupational Exposure / Q000009:adverse effects*; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology / Q000523:psychology*; D011788:Quality of Life; D012179:Retirement / Q000523:psychology; D011795:Surveys and Questionnaires