Productivity benefits of chronic obstructive pulmonary disease prevention in China

Although COPD places a significant health and economic burden on Chinese society, its associated productivity losses among working-age adults have not been estimated at the population level.

Dynamic life table models, utilizing country-specific data from published literature and public datasets, estimated the gains in productivity-adjusted life-years (PALYs), and associated cost savings from preventing incident COPD among China's working-age population (20-63 years in men and 20-58 years in women) from 2021 to 2030. Productivity losses, encompassing excess mortality, reduced labor force participation, presenteeism, and absenteeism, were aggregated to determine PALYs lost. Comparing model outputs with and without COPD incidence yielded the potential benefits of prevention. To evaluate the labor saved from preventing smoking and PM_2.5 exposure, two additional analyses were conducted to estimate the productivity gains if China achieved its 2030 smoking reduction targets and if PM_2.5 levels aligned with WHO guidelines.

From 2021 to 2030, the projected elimination of incident COPD among China's working-age population would yield an estimated 2.13 million PALYs gained (95% confidence interval [CI]: 1.80-2.42 million), translating to a $104.38 billion (95% CI: $88.35 - $119.03 billion) contribution to China's GDP. For both sexes, the saved productivity derived from controlling incident COPD was consistently highest within the 55-59 age bracket, and lowest within the 25-29 age bracket. Independently, achieving recommended 2030 targets for smoking prevalence and PM_2.5 levels was estimated to result in gains of 456,158 (95% CI: 439,031-472,576) and 1,091,622 (95% CI:1,057,836-1,121,879) PALYs, respectively, with corresponding economic savings of $24.33 billion (95% CI: $23.44-$25.20 billion) and $58.10 billion (95% CI: $56.36-$59.65 billion).

COPD prevention extends productive life years and enhances workforce productivity across all working-age groups. Policymakers should recognize COPD's substantial impact on labor output and implement targeted interventions to mitigate these economic losses.