8284705 Precarious employment and its impact on chronic obstructive pulmonary disease in the Swedish working population – a longitudinal register-based study

<h3>Objective</h3> Chronic Obstructive Pulmonary Disease (COPD) is a common respiratory disorder. In developed countries, occupational exposures are considered the second most important risk factor for developing COPD, after tobacco smoking. While precarious employment (PE) has been associated in public health research with common mental-health disorders and other diseases, evidence is currently lacking regarding the association with COPD. PE could increase the risk of COPD by higher occupational exposure to particles and through poorer lifestyle behaviors, especially related to tobacco use. This study investigates if PE is associated with the risk of developing COPD in the Swedish working population, and whether the association differs depending on gender and other socioeconomic factors and smoking. <h3>Material and Methods</h3> Using nationwide Swedish registers, a large cohort (N = 1,984,081) was followed over a 14-year period, from 2003 to 2007. Five indicators of PE were used to measure level of precarity (contractual employment insecurity, temporariness, multiple jobholding, income level, and coverage under collective bargaining agreements). Cases were identified as being diagnosed with COPD between 2004-2017. <h3>Results</h3> The adjusted RR of developing COPD for the PE group was 1.5 (95% CI 1.4 – 1.6). The key dimensions of PE contributing to the increased risk of COPD were low-income levels (increased the risk of COPD by over 40%) and unstable employment (increased the risk of COPD by 15%). Men were found to have a higher risk of developing COPD than women. <h3>Conclusion</h3> This study suggests that that individuals in higher levels of PE does have a higher risk of developing COPD compared with individuals in standard employment. Our findings emphasize the need for further research on the health impacts of PE, being aligned with earlier findings regarding the harmful effects of PE on workers’ health and well-being.