Breathlessness limiting exertion and under- and unemployment: results from a national, online population survey

Background Loss of, or unwanted changes in employment reduces economic wellbeing and is associated with lower quality of life. People living with chronic breathlessness are less likely to participate in the workforce. The influence of breathlessness on change in employment status is unknown. This study investigates associations between self-reported breathlessness limiting exertion (hereafter breathlessness ) and changes in employment status. Methods Cross-sectional, online population survey of individuals aged 18–65 years old from Australia. Current and change of employment status, and breathlessness (assessed using modified Medical Research Council [mMRC] ≥ 1) were analysed using multivariate logistic regression to establish odds ratio (OR) and 95% confidence intervals (95%CI), adjusted for possible confounding effects. Results Eight thousand people were included; 5,730 (72%) were employed and 43% reported breathlessness . Breathlessness was associated with a change from full-time employment to another employment status: mMRC1 OR: mMRC1 OR: 6.60 (3.4–13.7); mMRC2 OR: 15.7 (7.7–34.2); and mMRC3-4 OR: 31.9 (13.8–75.4); and with being unemployed: mMRC1 OR: 1.20 (1.05–1.4); mMRC2 OR: 1.57 (1.3–1.9); and mMRC3-4 OR: 1.59 (1.1–2.3). Conclusion Breathlessness is associated with lower rates of employment and a higher probability of reducing work hours or becoming unemployed. The presence of chronic breathlessness should lead health professionals to explore the employment (and financial) consequences for the person.