Unemployment in chronic airflow obstruction (CAO) around the world: results from the Burden of Obstructive Lung Disease (BOLD) study
File(s)
Accepted version
Author(s)
Type
Conference Paper
Abstract
Objectives: We aimed to examine associations between CAO and unemployment across the world.
Methods: Cross-sectional data from 26 sites in the Burden of Obstructive Lung Disease (BOLD) Study were used to analyze effects of CAO on unemployment. Odds ratios (OR) for unemployment in subjects 40-65 years old were estimated with multilevel mixed-effects generalized linear model with study site as random effect. Site-by-site heterogeneity was assessed using individual participant data meta-analyses.
Results: Of 18710 participants, 11.3% had CAO. Ratio of unemployed subjects with CAO divided by unemployed subjects without CAO showed large discrepancies between sites, particularly in low-to-middle income countries with ratio from 0.5 (lower unemployment among CAO cases) in the Philippines to 5.8 (higher unemployment among CAO cases) in India. Site-adjusted OR for unemployment (95% confidence interval) was 1.79 (1.41, 2.27) for participants with CAO, decreasing to 1.43 (1.14, 1.79) after adjusting for gender, age, smoking, comorbidities, education and forced vital capacity (FVC). Risk factors for unemployment in high-income sites were age (OR (95%CI) 4.02 (3.53, 4.57), and primary education vs university education 3.86 (2.80, 5.30). Female gender was the most important factor for unemployment in low-to-middle-income sites (OR 3.23 (2.66, 3.91).
Conclusions: CAO was associated with unemployment even after adjusting for sociodemographic factors, comorbidities and FVC. We observed that the association was particularly strong in high-income sites.
Methods: Cross-sectional data from 26 sites in the Burden of Obstructive Lung Disease (BOLD) Study were used to analyze effects of CAO on unemployment. Odds ratios (OR) for unemployment in subjects 40-65 years old were estimated with multilevel mixed-effects generalized linear model with study site as random effect. Site-by-site heterogeneity was assessed using individual participant data meta-analyses.
Results: Of 18710 participants, 11.3% had CAO. Ratio of unemployed subjects with CAO divided by unemployed subjects without CAO showed large discrepancies between sites, particularly in low-to-middle income countries with ratio from 0.5 (lower unemployment among CAO cases) in the Philippines to 5.8 (higher unemployment among CAO cases) in India. Site-adjusted OR for unemployment (95% confidence interval) was 1.79 (1.41, 2.27) for participants with CAO, decreasing to 1.43 (1.14, 1.79) after adjusting for gender, age, smoking, comorbidities, education and forced vital capacity (FVC). Risk factors for unemployment in high-income sites were age (OR (95%CI) 4.02 (3.53, 4.57), and primary education vs university education 3.86 (2.80, 5.30). Female gender was the most important factor for unemployment in low-to-middle-income sites (OR 3.23 (2.66, 3.91).
Conclusions: CAO was associated with unemployment even after adjusting for sociodemographic factors, comorbidities and FVC. We observed that the association was particularly strong in high-income sites.
Date Issued
2017-09-01
Date Acceptance
2017-09-01
Citation
European Respiratory Journal, 2017, 50 (suppl 61)
ISSN
0903-1936
Publisher
European Respiratory Society
Journal / Book Title
European Respiratory Journal
Volume
50
Issue
suppl 61
Copyright Statement
© the authors 2017. Published by European Respiratory Society.
Sponsor
Wellcome Trust
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000431748901305&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
085790/Z/08/Z
Source
European Respiratory Society (ERS) International Congress
Subjects
Science & Technology
Life Sciences & Biomedicine
Respiratory System
Publication Status
Published
Start Date
2017-09-09
Finish Date
2017-09-13
Coverage Spatial
Milan, Italy
Date Publish Online
2017-12-06