| Popis: |
Background: We used data from the Burden of Obstructive Lung Disease (BOLD) study to examine correlates of productivity losses in COPD. Methods: Spirometry and interviews were performed at 26 sites in 22 countries. The main outcome was number of sick leave days (SLDs) the preceding year. We examined correlates of this outcome by zero-inflated negative binomial regression analysis. The analyses were adjusted for sex, age, lung function, education, smoking habits, airway symptoms, study site and self-reported comorbidities. COPD was defined as post-bronchodilator FEV1/FVC Results: In total 10119 individuals reported number of sick leave days, and of these, 8.5% had spirometric COPD. The latter group reported a mean (SD) of 8.7 (36.6) SLDs the preceding year, whereas subjects without COPD reported a mean (SD) of 4.7 (24.7) SLDs. Site variation was considerable, ranging from zero days in Tunis, China and Algeria to 24.7 days in the Netherlands. In the multivariable regression model, the relative risk (RR) for number of SLDs with spirometric COPD (95% CI) was 3.00 (1.98-4.54), whereas hypertension and heart disease were considerably lower (RR 1.49 and 1.76, respectively). The RR (95% CI) associated with being female and being an ex-smoker (vs never-smokers) was 1.44 (1.14-1.82) and 1.44 (1.09-1.92), respectively. When we added airway symptoms to the model, the signal of other covariates disappeared, except for sex and study site. Conclusion: Sick leave was considerably higher in COPD patients than in subjects without COPD, even in comprehensively adjusted regression models. Nearly all productivity losses associated with COPD was explained by airway symptoms. |
