Abstract
Asthma and COPD have been associated with the elevated risk of leaving work prior age of 65 in the cross-sectional setting (Yelin et al J Occup Med Toxicol 2006; 1:2).
We aimed to evaluate the risk of disability pension in asthma, COPD and Asthma- COPD overlap syndrome (ACOS) in the longitudinal setting.
This study is based on the nationally representative Health 2000 Survey. At the baseline in 2000-2001 altogether 3406 subjects fulfilled the inclusion criteria: being 30 to 63 years, being currently full- or half time employed, and having participated in the health examination including spirometry. Asthma was defined as having doctor-diagnosed asthma in the questionnaire and COPD as having FEV1/FVC < 0.7 in the spirometry. ACOS was defined as having both asthma and COPD. The Finnish Centre for Pensions Register provided complete information on all retirement events granted before December, 31 2011. The Cox proportional hazards regression models were used.
A total of 200 (5.9%) participants with asthma, 87 (2.6%) with COPD and 25 with ACOS (0.7%) were identified. During a follow-up time 362 (10.6%) participants granted disability pension: 31 (15.5%) asthmatics, 22 (25.3%) subjects with COPD, 2 (8.0%) subjects with ACOS and 307 (9.9%) controls. Age, sex, educational level, BMI and co-morbidities adjusted hazard ratio of disability pension was 1.42 (95% CI 0.98-2.06) for asthma, 1.99 (95% CI 1.28-3.09) for COPD and 0.74 (95% CI 0.18-2.98) for ACOS.
Spirometry verified COPD doubled the risk of disability pension in the 11-year follow-up. Asthma increased less the risk of disability pension.
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