title: A case of fitness to work in a worker with COPD using the exercise stress test.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease characterized by persistent airflow limitation. Therefore, both work ability and workday length may be affected in individuals with this disease. We studied a worker with suspected COPD and assessed fitness to work using post-bronchodilator spirometry, symptom assessment scales, and the exercise stress test.
  
  
  METHODS
  The patient was a 58-year-old man due to work as a field supervisor in the ship construction sector. He had a 40 pack-year smoking history and experienced occasional dyspnea when climbing stairs. He visited this hospital to receive cardiopulmonary function tests and to determine his ability to work. Post-bronchodilator spirometry revealed severe irreversible airway obstruction corresponding to a modified Medical Research Council grade of 2 on the dyspnea scale. His COPD Assessment Test score was 12, placing him in patient group D (high risk, more symptoms) based on the Global Initiative for Chronic Obstructive Lung Disease classification system. His maximum oxygen uptake (VO2max) was determined to be 19.16 ml/kg/min, as measured by the exercise stress test, and his acceptable workload for 8 h of physical work was calculated to be 6.51 ml/kg/min. His work tasks required an oxygen demand of 6.89 ml/kg/min, which exceeded the acceptable workload calculated. Accordingly, he was advised to adjust the work tasks that were deemed inappropriate for his exercise capacity.
  
  
  CONCLUSIONS
  As COPD incidence is expected to rise, early COPD diagnosis and determination of fitness to work is becoming increasingly important. Performing the exercise stress test, to evaluate the functional capacity of workers with COPD, is considered an acceptable solution.
authors.affiliation: Department of Occupational and Environmental Medicine, Inje University Haeundae Paik Hospital, 875 Haeundae-ro, 612-862 Busan, Haeundae-Gu South Korea.
authors.forename: Yewon
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Occupational and Environmental Medicine, Inje University Haeundae Paik Hospital, 875 Haeundae-ro, 612-862 Busan, Haeundae-Gu South Korea.
authors.forename: Kyungyong
authors.initials: K
authors.lastname: Jung
authors.affiliation: Department of Occupational and Environmental Medicine, Inje University Haeundae Paik Hospital, 875 Haeundae-ro, 612-862 Busan, Haeundae-Gu South Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Ryu
authors.affiliation: Department of Occupational and Environmental Medicine, Inje University Haeundae Paik Hospital, 875 Haeundae-ro, 612-862 Busan, Haeundae-Gu South Korea.
authors.forename: Dae Hwan
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Occupational and Environmental Medicine, Inje University Haeundae Paik Hospital, 875 Haeundae-ro, 612-862 Busan, Haeundae-Gu South Korea.
authors.forename: Sangyoon
authors.initials: S
authors.lastname: Lee
keywords: Chronic obstructive pulmonary disease; Exercise stress test; Fitness to work