COPD (chronic obstructive pulmonary disease) is an umbrella term for lung conditions which cause breathing problems. It includes emphysema (damage to the air sac in the lungs) and chronic bronchitis (inflammation of the airways). It mostly affects older smokers and is typically degenerative. Around 3 million people in the UK are thought to have COPD.
What are the signs and symptoms of COPD?
- Breathlessness, particularly at night (this may be the first sign of COPD to develop)
- Tight chest
- Coughing with phlegm
- Chest infections
Other symptoms (less common and usually indicative of advanced COPD) include:
- Weight loss
- Swollen ankles from fluid build-up (known as oedema)
- Coughing up blood (which requires urgent attention as it may indicate cancer)
How is COPD diagnosed and treated?
The NHS recommends that anyone experiencing symptoms consistent with COPD over a long period and who is over the age of 35 and a smoker or ex-smoker see their GP. This is also the case for people who have been exposed to chemicals and fumes in the workplace, including coal dust.
Since symptoms are shared by other conditions such as asthma and anaemia, a breathing test to calculate lung output will be carried out to confirm the COPD diagnosis. Blood tests or a chest x-ray can also help rule out other conditions. The sooner a diagnosis is reached, the better, as it will improve the person’s chances of living a full life with the condition for longer.
There is no cure but treatments to improve quality of life (often for decades) can include:
- Stopping smoking to prevent worsening of COPD
- Antibiotics to treat chest conditions
- Breathing exercises to clear airways
- Help from an occupational therapist who can monitor the pulmonary exercises and provide additional lifestyle recommendations
- Regular exercise to improve lung health and breathing
- Inhalers, such as bronchodilators to widen airways and steroid inhalers to treat flare-ups
- Mucolytic medicines to thin mucus
- Lung transplants in severe cases, or operations to remove part of the damaged lung(s).
There are a few ways to confirm what sort of reasonable adjustments should be made for an employee with COPD:
- An employer can enquire sensitively as to the sorts of reasonable adjustments that the employee with COPD may have had in the past, such as relocation of their work station away from an open window if the air outside is particularly polluted.
- Even if the employee does not wish to disclose their COPD, an employer can focus on making reasonable adjustments, rather than seeking to determine the precise disability their employee has.
- Given that COPD can evolve over time, with certain symptoms worsening as the person ages, it is important to maintain regular communication with the employee who has COPD so that the reasonable adjustments remain appropriate.
What reasonable adjustments are possible for employees with COPD?
Employers have a legal duty to make reasonable adjustments for employees with COPD if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has COPD. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.
If the employee does not disclose a health issue or disability which may affect their performance up front, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of COPD:
- Relocating the employee’s workstation for example, allowing the employee to have a private space in the office if they are struggling with coughing and do not wish to be disruptive, etc.
- Additional breaks to allow the employee to do breathing exercises
- Time off to attend appointments, receive treatment and to rehabilitate, particularly after a surgical procedure, or during a flare-up
- Adjustments to duties depending on the severity of their symptoms, which may be variable and improve or deteriorate from one week to the next. Work outdoors in the cold may exacerbate symptoms, so an employee with COPD may be better off only performing indoor duties, for example.
- Raising awareness so that colleagues understand the employee’s COPD and can help ensure the employee feels comfortable at work. This is particularly important as the employee with COPD may experience regular coughing fits, wheezing and other symptoms that may otherwise draw unwanted attention.
British Lung Foundation – charity dedicated to improving lung health in the UK through campaigning for cleaner air, researching treatment for lung conditions and providing advice and support for people living with lung conditions such as COPD (03000 030 555).
NARA The Breathing Charity – charity providing medical equipment, advice and support to all people living with apnoea and other breathing difficulties, including breathing problems caused by COPD. They have a community care programme which aims to improve care in the community for people with breathing problems, as well as various fundraising appeals (01604 494960).
Breathing Matters – charity set up to raise funds for research into lung conditions carried out by University College London which also campaigns for cleaner air as a preventative measure against lung infections and other conditions.
Other Research Resources