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Original Article
Factors associated with work productivity among people with COPD: Birmingham COPD Cohort
  1. Kiran K Rai1,
  2. Peymané Adab1,
  3. Jon G Ayres2,
  4. W Stanley Siebert3,
  5. Steven S Sadhra2,
  6. Alice J Sitch1,
  7. David A Fitzmaurice1,
  8. Rachel E Jordan1
  9. on behalf of the BLISS research team*
  1. 1 Institute of Applied Health Research, University of Birmingham, Birmingham, UK
  2. 2 Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
  3. 3 The Department of Business and Labour Economics, The University of Birmingham, Birmingham, UK
  1. Correspondence to Prof Peymané Adab, Public Health, Epidemiology and Biostatistics, The University of Birmingham, Edgbaston B15 2TT, Birmingham; p.adab{at}


Background Patients with chronic obstructive pulmonary disease (COPD) are more likely to take time off work (absenteeism) and report poor performance at work (presenteeism) compared to those without COPD. Little is known about the modifiable factors associated with these work productivity outcomes.

Aim To assess the factors associated with work productivity among COPD patients.

Methods Cross-sectional analysis of baseline data from a subsample (those in paid employment) of the Birmingham COPD Cohort study. Absenteeism was defined by self-report over the previous 12 months. Presenteeism was assessed using the Stanford Presenteeism Scale. Logistic regression analysis was used to assess the effects of sociodemographic, clinical and occupational characteristics on work productivity.

Results Among 348 included participants, increasing dyspnoea was the only factor associated with both absenteeism and presenteeism (p for trend<0.01). Additionally, increasing history of occupational exposure to vapours, gases, dusts or fumes (VGDF) was independently associated with presenteeism (p for trend<0.01).

Conclusions This is the first study to identify important factors associated with poor work productivity among patients with COPD. Future studies should evaluate interventions aimed at managing breathlessness and reducing occupational exposures to VGDF on work productivity among patients with COPD.

  • cross sectional studies
  • work productivity
  • absenteeism
  • presenteeism
  • chronic obstructive pulmonary disease

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  • Contributors PA and DAF are co-principal investigators for the BLISS programme which was conceived in consultation with REJ, KKC, JGA and RS and with BGC, AD, SG, KJ, SJ, JM, MRM, RR, SSi and AMT as co-investigators. PA led the cohort study; RJ, the TargetCOPD trial; and JGA, the occupational subcohort. AE oversaw programme management, and APD was the research fellow for the cohort. KKR oversaw the occupational measures for the cohort, conducted the data analysis and drafted the manuscript with advice from PA and REJ. SSS developed the job exposure matrix. AJS and SSi advised on data analysis. PA had responsibility for the final content. All authors reviewed and approved the final submission.*The BLISS research team: KK Cheng, BG Cooper, A Daley, AP Dickens, A Enocson, S Greenfield, K Jolly, S Jowett, J Marsh, MR Miller, R Riley, R Stockley, AM Turner.

  • Funding This paper summarises independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference Number RP-PG-0109-10061). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The Birmingham COPD Cohort study is part of the Birmingham Lung Improvement StudieS – BLISS. Details of the funded NIHR proposal can be found on the institutional website.47

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval The Birmingham COPD Cohort received ethical approval from the National Research Ethics Service Committee West Midlands - Solihull (ref: 11/WM/0304).

  • Provenance and peer review Not commissioned; externally peer reviewed.