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COPD uncovered: an international survey on the impact of chronic obstructive pulmonary disease [COPD] on a working age population

Fletcher, MJ; Upton, J; Taylor-Fishwick, J; Buist, SA; Jenkins, C; Hutton, J; Barnes, N; Van Der Molen, T; Walsh, JW; Jones, P; et al. Fletcher, MJ; Upton, J; Taylor-Fishwick, J; Buist, SA; Jenkins, C; Hutton, J; Barnes, N; Van Der Molen, T; Walsh, JW; Jones, P; Walker, S (2011) COPD uncovered: an international survey on the impact of chronic obstructive pulmonary disease [COPD] on a working age population. BMC PUBLIC HEALTH, 11 (612). ISSN 1471-2458 https://doi.org/10.1186/1471-2458-11-612
SGUL Authors: Jones, Paul Wyatt

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Abstract

Background: Approximately 210 million people are estimated to have chronic obstructive pulmonary disease [COPD] worldwide. The burden of disease is known to be high, though less is known about those of a younger age. The aim of this study was to investigate the wider personal, economic and societal burden of COPD on a cross country working-age cohort. Methods: A cross-country [Brazil, China, Germany, Turkey, US, UK] cross-sectional survey methodology was utilised to answer the research questions. 2426 participants aged 45-67 recruited via a number of recruitment methods specific to each country completed the full survey. Inclusion criteria were a recalled physician diagnosis of COPD, a smoking history of > 10 pack years and the use of COPD medications in the previous 3 months prior to questioning. The survey included items from the validated Work Productivity and Activity Impairment [WPAI] scale and the EuroQoL 5 Dimension [EQ-5D] scale. Disease severity was measured using the 5-point MRC [Medical Research Council] dyspnoea scale as a surrogate measure. Results: 64% had either moderate [n = 1012] or severe [n = 521] COPD, although this varied by country. 75% of the cohort reported at least one comorbid condition. Quality of life declined with severity of illness [mild, mean EQ-5D score = 0.84; moderate 0.58; severe 0.41]. The annual cost of healthcare utilisation [excluding treatment costs and diagnostic tests] per individual was estimated to be $2,364 [£1,500]. For those remaining in active employment [n: 677]: lost time from work cost the individual an average of $880 [£556] per annum and lifetime losses of $7,365 [£4,661] amounting to $596,000 [£377,000] for the cohort. 447 [~40%] of the working population had retired prematurely because of COPD incurring individual estimated lifetime income losses of $316,000 [£200,000] or a combined total of $141 m [£89.6 m]. As the mean age of retirees was 58.3 and average time since retirement was 4 years, this suggests the average age of retirement is around 54. This would mean a high societal and economic impact in all study countries, particularly where typical state retirement ages are higher, for example in Brazil, Germany and the UK [65] and the US [65,66,67], compared to Turkey [58 for women, 60 for men] and China [60]. Conclusions: Although generalisation across a broader COPD population is limited due to the varied participant recruitment methods, these data nevertheless suggest that COPD has significant personal, economic and societal burden on working age people. Further efforts to improve COPD diagnosis and management are required.

Item Type: Article
Additional Information: Copyright: 2011 Fletcher et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Aged, Cross-Sectional Studies, Employment, Female, Health Surveys, Humans, Internationality, Male, Middle Aged, Pulmonary Disease, Chronic Obstructive, Science & Technology, Life Sciences & Biomedicine, Public, Environmental & Occupational Health, PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH, SCI, GLOBAL BURDEN, RISK-FACTORS, PREVALENCE, HEALTH, DISABILITY, SMOKING, COMORBIDITIES, EPIDEMIOLOGY, PROJECTIONS, MORTALITY, Public Health, 1117 Public Health And Health Services
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: BMC PUBLIC HEALTH
ISSN: 1471-2458
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Dates:
DateEvent
1 August 2011Published
Web of Science ID: WOS:000294302000001
URI: http://openaccess.sgul.ac.uk/id/eprint/107047
Publisher's version: https://doi.org/10.1186/1471-2458-11-612

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