Development in employment status in patients with COPD from 1980-2018

<bold>Background:</bold> Little is known about the development in employment status in patients with COPD compared with the general population. <bold>Aim:</bold> To evaluate the development in employment status in female and male cases with Chronic Obstructive Pulmonary Disease (COPD) compared with matched controls during 39 years. <bold>Methods:</bold> Cases aged 40-66 years diagnosed with COPD (1980 – 2018) were identified in the Danish National Patient Registry. Cases were matched 1:4 with non-COPD controls from the general population. Cases and controls were included in one of three study periods (P1: 1983-1993; P2: 1994-2007 and P3: 2008-2018) based on the year of diagnosis. Data on employment status prior to diagnosis was obtained from national databases. <bold>Results:</bold> We identified 357.109 cases and 1.426.787 controls. P1 included: 81.547 cases and 325.722 controls, P2: 140.638 cases and 561.943 control and P3: 134.924 cases and 539.122 controls. Female cases were less employed than female controls (P1: 23.0 % vs 36.1%), (P2: 31.8% vs 53.6%) and (P3: 37.5% vs 64.4%). The adjusted odds ratio (aOR) for being unemployed increased during the three periods (P1: aOR = 1.77; 95%CI 1.62-1.94), (P2: aOR = 2.12; 95%CI 2.01-2.23) and (P3: aOR = 3.08; 95%CI 2.92-3.25). Male cases were less employed than the male controls (P1: 34.8% vs 50.5%), (P2: 39.8% vs 61.1%) and (P3: 40.0% vs 67.7%). The aOR for being unemployed increased during the three periods (P1: aOR = 1.74 95%CI 1.62-1.88), (P2: aOR = 2.38 95%CI 2.26-2.50) and (P3: aOR = 3.57 95%CI 3.40-3.75). <bold>Conclusion:</bold> Female and male cases had higher unemployment rates and the employment rates for cases compared with controls increased for both genders during the study period.