biostudies-literatureGronseth RMedical Research CouncilWellcome Trust1700499https://www.ebi.ac.uk/biostudies/studies/S-EPMC5898950biostudies-literatureUnknown50(3)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.The European respiratory journalUnemployment in chronic airflow obstruction around the world: results from the BOLD study.PMC5898950085790/2/08/2MR/P022006/1085790Dias HPingale SBalanag VMNastalek PZgaoula IGhit MRodrigues FKoopman MCopeland RBurney PGJVollmer WMTambe MSooronbaev TMLawin HJohannessen ALondhe JTabyshova AReyes TAlmeda RHlengwa SWelte TMkandawire SMatos MJLamprecht BArgade RKuleci SJenkins CKatkar SMwangoka EGeldmacher HLill TJDoloriel ETurkyilmaz ASJohannisen CFanuncio RNyapigoti WWouters EFMMethvin JBarbara CBostonova EBondre SElsadig HAReyes MTNSantos MOsman NBEd Elhassan NMElsony ACain JBird TMcLean FNikolla JKhalifa WBMohamed MAKazasi RSvendsen LNisser KShetye VBodemann IBurney PFrancisco NABenedikdtsdottir BAlorainy HKoul PARoa CCKhatun LLouw IUmap AResearch teams at centresHirve SAgodokpessi GAyuyao FGKhan UHHassan MChaudhary SEl Zain AMUmut SStorbeck JNoory BSAtoui FAmor CUl-Haque MHaddad TKpangon AIdolor LFAl Ghobain MWesseling GJDaldoul HElhadi MAyan HIslam AEndresen TKadam MDas SCSalvi SZhong NUlst KBardhi DBeishekeeva GDawes TGulsvik APajak AIslam MErhabor GAlmeida JDantes RBBarnes EIslam NEstebesova BMIslam SAdewole OBanda JLiu SDenguezli MBanda GHayes AZheng Jde Guia TSMannino DMAkmatalieva MTadvi RGawhane ARoubhia ARan PChowdhury TRMalik SBenali RRashid AChipeta MToelle BTeferici ATafa HAzilova TSholehah SAbdelmonam DMarks GChatterjee SKBerratio LUAl Hajjaj MBengrait AFayomi BMortimer KKambwili MCardoso JOsman HAAAIslam QSGudmundsdottir LSafia LMarajapov NErdal MJanson CSanchez MFEl Rhazi KSchweda-Linow AFrey JEspinel PHarat RWalke STan WCObaseki DSzczeklik AAyelo PFernandez LCTawde MBoukheroufa ZMezini AGudmundsdottir SHarrabi IAmaral AFSRaphael JBateman EUsenbaeva SKocabas ADela RAhmed SMEl-Hamad EBuist ASKydyrova JStudnicka MFerreira RSambhudas SDononbaeva NBoudra SMadas SMia DAdams DPotts JZhou YBenjelloun MCTan DTSkucha WGhurup UParvin MBanal-Yang SGaikwad VTwardowska MOlckers ASimpao LPWang DLaja HUnalan THafizi HChaidhary BMejza FSpetz-Nystrom UWang WSapkal ANizankowska-Mogilnicka EGarcia GSFreeman JHazen DBrashier BZobel VOlafsdottir ISThanasi NAit-Khaled NKhalifa SRahman MTabka ZDevchakke SLoh LCCherkaski HHJuvekar SKBencheikh ALu JAliko ATumilty MLund GMElbiaze MRyck JAmarillo LMohamaden MMTady CZEmilov BHanta IYakoubi RHagg GHancioglu AGronseth RToktogulova NChouikha FJuvekar SLudick IChowgule RKpossou KJorundsdottir KGundmundsson GHakim NASchirhofer LSheraliev UKhan AAObaseki DOUddin SGislason THardaker KSimao PJogi RMarciano INaval SSTodri DJithoo ANejjari CAwopeju OShelar NDhanawade RfalseUnemployment in chronic airflow obstruction around the world: results from the BOLD study.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.2017-01-01T00:00:00Z2017 Sep2026-06-11T05:33:56.354Z2026-06-11T03:08:14.115ZS-EPMC58989502893166110.1183/13993003.00499-2017