title: Relationship of airflow limitation severity with work productivity reduction and sick leave in a Japanese working population.
abstract: BACKGROUND
  The aim of this study was to reveal the association between airflow limitation (AL) severity and reduction with work productivity as well as use of sick leave among Japanese workers.
  
  
  METHODS
  This cross-sectional study included 1,378 workers who underwent a lung function test during a health checkup at the Japanese Red Cross Kumamoto Health Care Center. AL was defined as forced expiratory volume in 1 second/forced vital capacity of <0.7. Workers completed a questionnaire on productivity loss at work and sick leave. The quality and quantity of productivity loss at work were measured on a ten-point scale indicating how much work was actually performed on the previous workday. Participants were asked how many days in the past 12 months they were unable to work because of health problems. Logistic regression analysis was used to assess the associations between AL severity and the quality and quantity of productivity loss at work as well as use of sick leave.
  
  
  RESULTS
  Compared with workers without AL, workers with moderate-to-severe AL showed a significant productivity loss (quality: odds ratio [OR] =2.04, 95% confidence interval [CI]: 1.12-3.71, P=0.02 and quantity: OR =2.19, 95% CI: 1.20-4.00, P=0.011) and use of sick leave (OR =2.69, 95% CI: 1.33-5.44, P=0.006) after adjusting for sex, age, body mass index, smoking status, hypertension, hyperglycemia, dyslipidemia, sleep duration, work hours per day, and workplace smoking environment.
  
  
  CONCLUSIONS
  AL severity was significantly associated with work productivity loss and use of sick leave. Our findings suggested that early intervention in the subjects with AL at the workforce might be beneficial for promoting work ability.
authors.affiliation: Department of Biomedical Laboratory Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Onoue
authors.affiliation: Department of Biomedical Laboratory Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Hisamitsu
authors.initials: H
authors.lastname: Omori
authors.affiliation: Department of Public Health, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Katoh
authors.affiliation: Japanese Red Cross Kumamoto Health Care Center, Kumamoto, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kubota
authors.affiliation: Japanese Red Cross Kumamoto Health Care Center, Kumamoto, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Nonami
authors.affiliation: Japanese Red Cross Kumamoto Health Care Center, Kumamoto, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ogata
authors.affiliation: Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Inoue
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D003430:Cross-Sectional Studies; D004526:Efficiency; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D012720:Severity of Illness Index; D018582:Sick Leave / Q000706:statistics & numerical data*
keywords: absenteeism; airflow limitation; chronic obstructive pulmonary disease; presenteeism; sick leave; work productivity