Costs of Workplace Productivity Loss in Patients with Connective Tissue Disease Associated Interstitial Lung Disease.

Algamdi, Mohmmed; Sadatsafavi, Mohsen; Fisher, Jolene H; Morisset, Julie; Johannson, Kerri A; Fell, Charlene D; Kolb, Martin; Manganas, Hélène; Cox, Gerry; Gershon, Andrea S; Halayko, Andrew J; Hambly, Nathan; Khalil, Nasreen; Shapera, Shane; To, Teresa; Wilcox, Pearce G; Guler, Sabina; Ryerson, Christopher J (2020). Costs of Workplace Productivity Loss in Patients with Connective Tissue Disease Associated Interstitial Lung Disease. Annals of the American Thoracic Society, 17(9), pp. 1077-1084. American Thoracic Society 10.1513/AnnalsATS.201911-822OC

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Interstitial lung disease (ILD) develops in a large percentage of patients with connective tissue disease (CTD) and is associated with increased morbidity and mortality. Patients with CTD-associated ILD (CTD-ILD) often present at a young age, suggesting that ILD likely impacts workplace productivity.


We aimed to determine the employment rate and workplace productivity loss, its associated factors, and its estimated costs in patients with fibrotic CTD-ILD.


Patients with fibrotic CTD-ILD from the six centres of the CAnadian REgistry for Pulmonary Fibrosis were eligible. Health-related productivity loss was assessed using the Work Productivity and Activity Impairment questionnaire. Proposed factors associated with low workplace productivity were forced into a multivariable regression model. Average productivity loss in hours/week were used to calculate the costs of productivity loss based on hourly wage obtained from national census data matched for age and sex. Workplace productivity loss outcomes in CTD-ILD patients were compared to patients with a non-CTD fibrotic ILD.


Of 375 eligible patients with fibrotic CTD-ILD, 113 (30%) were employed. Productivity loss was reported by 59% of employed patients with mean loss of 9.4±1.2 hours/week, including 3.9±0.9 hours/week from absenteeism and 5.5±0.7 hours/week from presenteeism. Employment among patients with fibrotic CTD-ILD 25-54 years old was 27% lower than the matched general Canadian population (56% vs. 83%, p<0.001). Employment in CTD-ILD patients ≥55 years old was 17% lower than the matched population (19% vs. 36%, p<0.001). Workplace productivity loss was not associated with respiratory symptoms or lung physiology. Annual costs of productivity loss were calculated at 13,593 Canadian Dollars per employee with fibrotic CTD-ILD. Workplace productivity loss was similar in patients with fibrotic CTD-ILD and non-CTD fibrotic ILD.


Patients with fibrotic CTD-ILD frequently report workplace productivity loss, which is unexplained by respiratory symptoms or lung physiology and is associated with significant costs.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology

UniBE Contributor:

Guler, Sabina Anna


600 Technology > 610 Medicine & health




American Thoracic Society




Heidi Lobsiger

Date Deposited:

27 May 2020 16:21

Last Modified:

02 Mar 2023 23:33

Publisher DOI:


PubMed ID:



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