title: Birmingham COPD Cohort: a cross-sectional analysis of the factors associated with the likelihood of being in paid employment among people with COPD.
abstract: BACKGROUND
  Employment rates among those with chronic obstructive pulmonary disease (COPD) are lower than those without COPD, but little is known about the factors that affect COPD patients' ability to work.
  
  
  METHODS
  Multivariable analysis of the Birmingham COPD Cohort Study baseline data was used to assess the associations between lifestyle, clinical, and occupational characteristics and likelihood of being in paid employment among working-age COPD patients.
  
  
  RESULTS
  In total, 608 of 1,889 COPD participants were of working age, of whom 248 (40.8%) were in work. Older age (60-64 years vs 30-49 years: odds ratio [OR] =0.28; 95% confidence interval [CI] =0.12-0.65), lower educational level (no formal qualification vs degree/higher level: OR =0.43; 95% CI =0.19-0.97), poorer prognostic score (highest vs lowest quartile of modified body mass index, airflow obstruction, dyspnea, and exercise (BODE) score: OR =0.10; 95% CI =0.03-0.33), and history of high occupational exposure to vapors, gases, dusts, or fumes (VGDF; high VGDF vs no VGDF exposure: OR =0.32; 95% CI =0.12-0.85) were associated with a lower probability of being employed. Only the degree of breathlessness of BODE was significantly associated with employment.
  
  
  CONCLUSIONS
  This is the first study to comprehensively assess the characteristics associated with employment in a community sample of people with COPD. Future interventions should focus on managing breathlessness and reducing occupational exposures to VGDF to improve the work capability among those with COPD.
authors.affiliation: Institute of Applied Health Research.
authors.forename: Kiran K
authors.initials: KK
authors.lastname: Rai
authors.affiliation: Institute of Applied Health Research.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Jordan
authors.affiliation: The Department of Business and Labour Economics.
authors.forename: W Stanley
authors.initials: WS
authors.lastname: Siebert
authors.affiliation: Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Steven S
authors.initials: SS
authors.lastname: Sadhra
authors.affiliation: Institute of Applied Health Research.
authors.forename: David A
authors.initials: DA
authors.lastname: Fitzmaurice
authors.affiliation: Institute of Applied Health Research.
authors.forename: Alice J
authors.initials: AJ
authors.lastname: Sitch
authors.affiliation: Institute of Applied Health Research; Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Jon G
authors.initials: JG
authors.lastname: Ayres
authors.affiliation: Institute of Applied Health Research.
authors.forename: Peymané
authors.initials: P
authors.lastname: Adab
mesh_terms: D000328:Adult; D000367:Age Factors; D000395:Air Pollutants, Occupational / Q000009:adverse effects; D003430:Cross-Sectional Studies; D004391:Dust; D004417:Dyspnea / Q000191:economics / Q000503:physiopathology / Q000628:therapy; D004522:Educational Status; D004651:Employment / Q000191:economics*; D004739:England; D005260:Female; D005740:Gases; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016273:Occupational Exposure / Q000009:adverse effects; D009790:Occupations / Q000191:economics; D016017:Odds Ratio; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000191:economics* / Q000503:physiopathology* / Q000628:therapy; D012307:Risk Factors; D012456:Salaries and Fringe Benefits / Q000191:economics*; D012720:Severity of Illness Index; D014478:Unemployment; D014938:Work Capacity Evaluation
chemical_list: D000395:Air Pollutants, Occupational; D004391:Dust; D005740:Gases
keywords: UK; VGDF; breathlessness; chronic obstructive pulmonary disease; employed; severity; work