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, 20 (1), 165

Does Lung Function Predict the Risk of Disability Pension? An 11-year Register-Based Follow-Up Study


Does Lung Function Predict the Risk of Disability Pension? An 11-year Register-Based Follow-Up Study

Irmeli Lindström et al. BMC Public Health.


Background: Spirometry is widely used in medical surveillance in occupational health and as a diagnostic test for obstructive and restrictive lung disease. We evaluated the effect of spirometry parameters on the risk of all-cause disability pension in a follow-up study of an occupationally active general population-based cohort.

Methods: We measured the pulmonary function of 3386 currently working participants of the Health 2000 Survey in the clinical phase at baseline using spirometry. We obtained the retirement events of the cohort from the nationwide register for 2000-2011. Cox proportional hazards models were used to determine disability pensions.

Results: At baseline, we identified 111 (3.3%) participants with obstructive spirometry, 95 (2.8%) with restrictive spirometry, and 3180 controls without restriction or obstruction. The age, sex, educational level, body-mass index, co-morbidities (1 or ≥ 2), and the smoking-adjusted hazard ratio of disability pension was 1.07 (95% confidence interval, CI 0.64-1.78) for those with obstructive spirometry, and 1.44 (95% CI 0.89-2.32) for those with restrictive spirometry. As continuous variables, and divided into quartiles, the risk of the lowest quartile of forced ventilation capacity (FVC)% of predicted was 1.49 (95%CI 1.10-2.01) and forced expiratory volume in one second (FEV1)% of predicted 1.66 (95%CI: 1.23-2.24) in comparison to the highest quartile in the adjusted models.

Conclusions: Obstructive or restrictive spirometry did not predict disability pension when dichotomized classified variables (normal compared to abnormal) were used. As continuous variables and when divided into quartiles, lower lung volumes showed an increase in the risk of disability pension. Physicians should take this into account when they use spirometry as a prognostic factor of work disability.

Keywords: Asthma; COPD; Disability; Follow-up; Lung disease; Population-based; Spirometry.

Conflict of interest statement

The authors declare that they have no competing interests.


Fig. 1
Fig. 1
Survival functions for different spirometry parameters and disability pension. The total number of study subjects is 3386 and the number of the participants in each quartile is 846 or 847. Each quartile’s range of the spirometry parameter is in paracenteses. All models are adjusted with age, gender, education level, body mass index, co-morbidities, smoking and cotinine. * In the survival functions of FEV1/FVC and disability pension highest and 3rd quartile are equal. FEV1= forced expiratory volume in one second, FVC= forced ventilation capacity

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