Article Text


Work-related respiratory disease
P4 Breathlessness and work performance in older adults in Kent
  1. J Szram,
  2. SJ Schofield,
  3. APM Woods,
  4. P Cullinan
  1. Imperial College, London, UK


Dyspnoea and functional limitation due to airway obstruction may adversely affect work performance, particularly, it might be thought, in those with manual occupations. This is likely to have an impact on policies that seek to keep people employed to an older age. A questionnaire was sent to the 20 693 adults aged 51–60 registered with 33 general practitioners in Kent. Of 6732 (33%) respondents, 5315 (79%) were in full or part time paid work; of these, 26% declared breathlessness, a proportion significantly lower than of those not in current employment (43%, p<0.001). Across four categories of increasing breathlessness (modified MRC (mMRC) scale 0–3) was associated with higher levels of self-reported poor work performance, a trend more marked in men (5.0%, 17.4%, 28.6% and 42.9%). General health-related and respiratory-specific work disability shared similar relationships with increasing dyspnoea. Breathless individuals also took more extended sickness absence and were more likely to indicate that they would retire due to ill health (3.2%, 7.8%, 9.9% and 25.0% for mMRC0-3 respectively). Regression analysis confirmed the relationship between breathlessness and work performance in both sexes and indicated that it was independent of age, employment status, physical job demands and a number of psychological traits (Abstract P4 Table 1). Significant modification was observed (p=0.04) when including in the model the interaction term between breathlessness and occupational group in men. Stratum specific OR for occupational group were examined; breathlessness had the largest effect on work performance in managerial, professional and technical occupations rather than those in the more physically demanding plant, process, production and elementary occupations. (Abstract P4 Table 1). The reported prevalence of doctor-diagnosed respiratory disease was low (15%), in particular smoking related lung disease (COPD, 5%). An increased prevalence of impaired work performance was seen in breathless individuals with co-existent respiratory, cardiovascular or musculoskeletal disease with highest rates in those with declared lung disease. Dyspnoea, in many cases probably the result of COPD, is strongly and independently associated with sub-optimal performance at work in later life. Strategies to better accommodate employees with breathlessness will be needed if, as planned, the age of the UK workforce does increase.

Abstract P4 Table 1

Logistic regression of relationship between breathlessness (graded on the mMRC scale: 0=none, 1=mild, 2=moderate, 3=severe) and poor self-rated work performance, stratified by sex. Stratum-specific OR for occupational group are also presented

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