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Impact of chronic airflow obstruction in a working population

¹ René Descartes University of Paris, Respiratory and Intensive Care Medicine, Hôtel-Dieu Hospital, ² National Committee against Respiratory Diseases, ⁶ INSERM U700, Xavier Bichat Medical University, ⁷ Caisse Nationale d’Assurance Maladie, Paris, ³ University of Limoges, UF Clinical Research and Biostatistics, Limoges, ⁴ University of Lille, Respiratory Medicine, Calmette Hospital, Lille, and ⁵ Technical Support and Formation Centre, Saint-Étienne, France.

CORRESPONDENCE: N. Roche, Service de Pneumologie et Réanimation, Hôtel-Dieu de Paris, 1 Parvis Notre Dame, F-75181 Paris 04, France. Fax: 33 142348448. E-mail: nicolas.roche{at}htd.aphp.fr

Keywords: Chronic obstructive pulmonary disease, dyspnoea, prevalence, quality of life, work loss

Received: July 16, 2007
Accepted January 6, 2008

Data on the individual and collective impact of chronic airflow obstruction at a population level are scarce. In a nationwide survey, dyspnoea, quality of life and missed working days were compared between subjects with and without spirometrically diagnosed chronic airflow obstruction.

Subjects aged 45 yrs were recruited in French health prevention centres (n = 5,008). Results of pre-bronchodilator spirometry and questionnaires (European Community Respiratory Health Survey-derived questionnaire and European quality of life five-dimension questionnaire) were collected. Adequate datasets were available for 4,764 subjects aged 60±10 yrs (only 2% were aged 80 yrs).

The prevalence of airflow obstruction (forced expiratory volume in one second/forced vital capacity of <0.70) was 7.5%. The vast majority (93.9%) of cases had not been diagnosed previously. Health status was significantly influenced by dyspnoea. Both were associated with the number of missed working days. Despite mild-to-moderate severity, subjects with chronic airflow obstruction exhibited more dyspnoea, poorer quality of life and higher numbers of missed working days (mean 6.71 versus 1.45 days·patient^–1·yr^–1 in patients without airflow obstruction, for the population with no known heart or lung disease).

In conclusion, even mild-to-moderate airflow obstruction is associated with an impaired health status, which represents an additional argument in favour of early detection in chronic obstructive pulmonary disease.