Lower workforce participation is associated with more severe persisting breathlessness

Abstract

Background Not being able to work has negative health, social and financial consequences. Persisting breathlessness is prevalent in working-aged people. Is it associated with lower workforce participation? This study, using the South Australian Health Omnibus, aimed to explore associations between paid workforce participation and persisting breathlessness intensity, and economic impacts on income in people of working age. Methods This cross-sectional study conducted face-to-face interviews with a random sample of adults in South Australia (n = 8916). Questions included key demographic data, workforce participation and the presence and intensity of persisting breathlessness. Data from working-aged respondents (20–65 years of age) were standardised to the census for regression analyses. Work was coded to paid full- or part-time work or ‘other’. Persisting breathlessness (more than three of the last six months) used the modified Medical Research Council breathlessness scale (aggregated to 0, 1, 2–4). Opportunity cost valuations compared annual income foregone by persisting breathlessness severity. Results Of people interviewed, 6,608 were working-aged (49.9% male; 67.5% had post-secondary qualifications; 70.9% were in paid full- or part-time work; and 1.7% had mMRC score 2–4). Workforce participation dropped in working aged people with increasing breathlessness: mMRC 0, 70.6%; mMRC 1, 51.7%; mMRC 2–4, 20.3%. In the regression model, people with the most severe breathlessness were much less likely to work (OR 0.14; 95% CI 0.09, 0.22). Annual income foregone by people with persisting breathlessness was AU$10.7 billion (AU$9.1b for full-time and AU$1.6b for part-time work; range AU$5.9b, AU$49.7b). Conclusion Worsening persisting breathlessness is associated with lower workforce participation with direct financial consequences, greatest for older males.

Contribution of obesity to breathlessness in a large nationally representative sample of Australian adults

“…28 Therefore, the global prevalence of breathlessness is also likely to have increased. Second, breathlessness is associated with reduced workforce participation, 29 so obesity could have a significant contribution to reduced national productivity through increasing breathlessness. Third, despite the observed relationship between obesity and breathlessness, such symptoms should not be assumed to be due to obesity.…”

Burden of respiratory problems in low-income and middle-income countries

“…Findings that respiratory problems cause financial hardship in LMICs correlate with empirical evidence from a high-income country (Australia) [27 ▪ ]. Clark et al reported that worsening persistent breathlessness is associated with lower workforce participation with direct financial consequences, especially for older men.…”

Prevalence, severity and impacts of breathlessness in Indian adults: An exploratory, nationally representative, cross-sectional online survey

“…Living with the symptom of breathlessness, is one of the most debilitating experiences for people with chronic complex or chronic progressive illnesses [ 1 , 2 ]. Breathlessness is associated with poorer quality of life, increased anxiety and depression, worsening function and sexual wellbeing, limited activities of daily living, reduced workforce participation and increased social isolation [ 3 – 9 ]. The symptom also has strong negative effects on caregivers and families [ 10 ].…”