Introduction COPD is known to significantly affect health and quality of life, and is increasingly recognised to have a significant contribution from occupational exposures, particularly vapours, gases, dusts and fumes (VGDF). However, there is a paucity of evidence exploring the relationship between exposure to VGDF at work and health-related quality of life.
Methods A random selection of adults aged over 55 years in the Sheffield area of the UK were mailed a self-completed questionnaire (including questions on respiratory symptoms and physician-diagnosed disease, smoking and occupational history); responders were invited to perform lung function (FEV1 and FVC), and to complete the EQ-5D-3L quality of life instrument. A measure of socioeconomic deprivation (SED), using the proportion of individuals within a participants postal code receiving income support, was also collected.
Results Out of 4000 questionnaires, 2001 were returned. From these, 623 provided further data as detailed above. 57% were male, 62% had been, or were, smokers, 24% had a physician diagnosis of COPD and 62% reported having been exposed to VGDF in the past. In univariate analysis those with COPD were more likely to be older, have smoked, been exposed to VGDF and have a lower quality of life (all p<0.001). A history of exposure to VGDF was associated with a lower quality of life (p<0.001). Both VGDF exposure and COPD were associated with greater levels of SED (p<0.001). A linear regression analysis was performed using the EQ_5D summary index as the dependant variable and age, gender, SED, smoking status, physician diagnosed COPD and percentage predicted FEV1 and VGDF exposure as independent variables. Female gender, greater SED, VGDF exposure and physician diagnosed COPD were identified as predictors of reduced quality of life (as measured by EQ-5D VAS and summary index scores).
Discussion These results support the link between COPD and reduced quality of life, and additionally provide evidence to link occupational exposures to VGDF to a reduction in quality of life. These findings are of significance to health care professionals and policy makers, given future expectations for longer working lives.