Impact of chronic airflow obstruction in a working population

¹ Université Paris René Descartes, Service de Pneumologie et Réanimation, Hôtel-Dieu de Paris, Paris; and Comité National contre les Maladies Respiratoires, Paris
² Université de Limoges, UF recherche clinique et biostatistique, Limoges
³ Université de Lille, Service de Pneumologie, Hôpital Calmette, Lille
⁴ Centre Technique d'Appui et de Formation, Saint Etienne
⁵ Laboratoire INSERM U700, Faculté de Médecine Xavier Bichat, Paris
⁶ Caisse Nationale d'Assurance Maladie, Paris

^* To whom correspondence should be addressed. E-mail: nicolas.roche{at}htd.aphp.fr.

	Abstract

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 spirometry-diagnosed chronic airflow obstruction.

Subjects aged 45 years or more were recruited in French health prevention centres (n=5008). Results of pre-bronchodilator spirometry and questionnaires (European Community Respiratory Health Survey-derived and EuroQOL-5D questionnaires) were collected. Adequate datasets were available in 4764 subjects aged 60±10 years (only 2% were 80 years old or more).

Prevalence of airflow obstruction (FEV₁/FVC<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 had more dyspnoea, poorer quality of life and higher numbers of missed working days (mean values: 6.71 days vs 1.45 days per patient per year in patients without airflow obstruction, p=0.0015, 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 COPD.