Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death around the world [1]. Chronic airflow obstruction (CAO), measured by spirometry, is the most commonly used objective characteristic of COPD [2]. Epidemiological research has provided researchers and clinicians with critical information about the burden of COPD and its risk factors; [3–9]; however, very few studies have investigated the productivity-related burden of COPD [10–12]. The Burden of Obstructive Lung Disease (BOLD) study is one of the best designed epidemiological studies investigating prevalence and risk factors for COPD, and has been vital in improving our understanding of COPD around the world [3, 13]. In this issue of the European Respiratory Journal, Grønseth et al. [14] estimate the association between CAO and unemployment at 26 BOLD sites. The study demonstrates that there is greater unemployment in participants with CAO, which was partially confounded by socioeconomic factors. Importantly, the study reports no association in low and middle income countries (LMIC), which emphasises the diversity of risk factors and burden of COPD in different parts of the world. The causal association between chronic airflow obstruction and unemployment is complex and requires further study http://ow.ly/INtD30eqgJJ

中文翻译：

---

流行病学研究能否确定 COPD 的生产力相关负担？

慢性阻塞性肺疾病 (COPD) 是全球主要的死亡原因之一 [1]。通过肺活量测定法测量的慢性气流阻塞 (CAO) 是 COPD 最常用的客观特征 [2]。流行病学研究为研究人员和临床医生提供了关于 COPD 负担及其危险因素的重要信息；[3-9]; 然而，很少有研究调查 COPD 的生产力相关负担 [10-12]。阻塞性肺疾病负担 (BOLD) 研究是调查 COPD 患病率和危险因素的最佳设计的流行病学研究之一，对于提高我们对世界各地 COPD 的了解至关重要 [3, 13]。在本期欧洲呼吸杂志中，Grønseth 等人。[14] 在 26 个 BOLD 站点估计 CAO 与失业之间的关联。该研究表明，CAO 参与者的失业率更高，这部分受到社会经济因素的影响。重要的是，该研究报告在低收入和中等收入国家 (LMIC) 中没有关联，这强调了世界不同地区 COPD 风险因素和负担的多样性。慢性气流阻塞与失业之间的因果关系很复杂，需要进一步研究 http://ow.ly/INtD30eqgJJ