We aimed to examine associations between chronic airflow obstruction (CAO) and unemployment across the world. Cross-sectional data from 26 sites in the Burden of Obstructive Lung Disease (BOLD) study were used to analyse effects of CAO on unemployment. Odds ratios for unemployment in subjects aged 40–65 years were estimated using a multilevel mixed-effects generalised linear model with study site as random effect. Site-by-site heterogeneity was assessed using individual participant data meta-analyses. Out of 18 710 participants, 11.3% had CAO. The ratio of unemployed subjects with CAO divided by subjects without CAO showed large site discrepancies, although these were no longer significant after adjusting for age, sex, smoking and education. The site-adjusted odds ratio (95% CI) for unemployment was 1.79 (1.41–2.27) for CAO cases, decreasing to 1.43 (1.14–1.79) after adjusting for sociodemographic factors, comorbidities and forced vital capacity. Of other covariates that were associated with unemployment, age and education were important risk factors in high-income sites (4.02 (3.53–4.57) and 3.86 (2.80–5.30), respectively), while female sex was important in low- to middle-income sites (3.23 (2.66–3.91)). In the global BOLD study, CAO was associated with increased levels of unemployment, even after adjusting for sociodemographic factors, comorbidities and lung function. Chronic airflow obstruction increases risk of unemployment, and is a burden to welfare systems worldwide http://ow.ly/cxzv30cQ17A

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世界各地慢性气流阻塞的失业：BOLD 研究的结果

我们旨在研究全球慢性气流阻塞 (CAO) 与失业之间的关联。阻塞性肺疾病负担 (BOLD) 研究中 26 个地点的横断面数据用于分析 CAO 对失业的影响。使用研究地点作为随机效应的多级混合效应广义线性模型估计 40-65 岁受试者失业的优势比。使用个体参与者数据荟萃分析评估站点间异质性。在 18 710 名参与者中，11.3% 有 CAO。有 CAO 的失业受试者除以没有 CAO 的受试者的比率显示出很大的地点差异，尽管在调整了年龄、性别、吸烟和教育后这些差异不再显着。CAO 病例的现场调整优势比 (95% CI) 为 1.79 (1.41-2.27)，降至 1。43 (1.14–1.79) 在调整了社会人口因素、合并症和用力肺活量后。在与失业相关的其他协变量中，年龄和教育是高收入地区的重要风险因素（分别为 4.02（3.53-4.57）和 3.86（2.80-5.30）），而女性在中低收入地区很重要。收入网站 (3.23 (2.66–3.91))。在全球 BOLD 研究中，即使在调整了社会人口学因素、合并症和肺功能后，CAO 与失业率增加有关。慢性气流阻塞会增加失业风险，是全球福利系统的负担 http://ow.ly/cxzv30cQ17A 年龄和教育是高收入地区的重要风险因素（分别为 4.02（3.53-4.57）和 3.86（2.80-5.30）），而女性在中低收入地区很重要（3.23（2.66-3.91） ）。在全球 BOLD 研究中，即使在调整了社会人口学因素、合并症和肺功能后，CAO 与失业率增加有关。慢性气流阻塞会增加失业风险，是全球福利系统的负担 http://ow.ly/cxzv30cQ17A 年龄和教育是高收入地区的重要风险因素（分别为 4.02（3.53-4.57）和 3.86（2.80-5.30）），而女性在中低收入地区很重要（3.23（2.66-3.91） ）。在全球 BOLD 研究中，即使在调整了社会人口学因素、合并症和肺功能后，CAO 与失业率增加有关。慢性气流阻塞会增加失业风险，是全球福利系统的负担 http://ow.ly/cxzv30cQ17A