OR (95% CI) for unemployment for chronic airflow obstruction (CAO) and other risk factors, stratified by country income category, with increasing degree of adjustment (demographic characteristics, comorbidities and forced vital capacity (FVC))
| Model 2 | Model 3 | Model 4 | ||||
| High income | Low to middle income | High income | Low to middle income | High income | Low to middle income | |
| Spirometric CAO | 1.71 (1.17–2.49) | 1.16 (0.78–1.73) | 1.63 (1.16–2.28) | 1.18 (0.79–1.76) | 1.68 (1.16–2.45) | 1.15 (0.77–1.71) |
| FVC 10 percentage points decrease in % pred | 1.09 (1.03–1.15) | 1.08 (1.02–1.14) | ||||
| Female | 1.36 (1.16–1.59) | 3.34 (2.76–4.04) | 1.43 (1.23–1.68) | 3.25 (2.68–3.94) | 1.44 (1.23–1.68) | 3.23 (2.66–3.91) |
| Age 10-year increment | 4.28 (3.77–4.86) | 2.31 (2.06–2.59) | 4.04 (3.55–4.59) | 2.21 (1.96–2.48) | 4.02 (3.53–4.57) | 2.20 (1.96–2.47) |
| Smoking status | ||||||
| Current smoker | 1.34 (1.09–1.65) | 0.88 (0.72–1.09) | 1.36 (1.11–1.68) | 0.89 (0.72–1.10) | 1.36 (1.10–1.67) | 0.89 (0.72–1.10) |
| Ex-smoker | 1.31 (1.09–1.56) | 1.15 (0.90–1.47) | 1.28 (1.07–1.53) | 1.13 (0.88–1.44) | 1.29 (1.08–1.54) | 1.12 (0.88–1.43) |
| Education | ||||||
| Some college | 1.85 (1.45–2.38) | 0.96 (0.60–1.52) | 1.83 (1.43–2.36) | 0.95 (0.60–1.52) | 1.83 (1.42–2.35) | 0.97 (0.61–1.54) |
| High school | 2.30 (1.84–2.88) | 1.26 (0.92–1.73) | 2.27 (1.81–2.84) | 1.28 (0.93–1.76) | 2.24 (1.79–2.81) | 1.30 (0.94–1.78) |
| Middle school | 3.65 (2.73–4.87) | 1.23 (0.89–1.70) | 3.54 (2.64–4.74) | 1.26 (0.91–1.74) | 3.49 (2.60–4.67) | 1.26 (0.91–1.75) |
| Primary school | 4.14 (3.02–5.66) | 1.52 (1.10–2.10) | 3.90 (2.84–5.37) | 1.56 (1.13–2.16) | 3.86 (2.80–5.30) | 1.56 (1.13–2.16) |
| No education | 1.96 (0.61–6.32) | 1.61 (1.13–2.30) | 2.01 (0.62–6.43) | 1.64 (1.15–2.34) | 1.98 (0.61–6.43) | 1.65 (1.15–2.35) |
| Comorbidities | ||||||
| Hypertension | 1.25 (1.05–1.49) | 1.25 (1.02–1.53) | 1.22 (1.02–1.45) | 1.22 (0.99–1.50) | ||
| Heart disease | 1.56 (1.22–2.00) | 1.20 (0.86–1.67) | 1.53 (1.19–1.96) | 1.18 (0.85–1.64) | ||
| Diabetes | 1.53 (1.14–2.04) | 1.39 (1.01–1.92) | 1.46 (1.09–1.95) | 1.38 (1.00–1.91) | ||
| Stroke | 2.17 (1.14–4.13) | 1.58 (0.83–3.02) | 2.15 (1.13–4.10) | 1.56 (0.82–2.99) | ||
| Lung cancer | 2.87 (0.89–9.30) | 1.01 (0.04–28.54) | 2.86 (0.89–9.26) | 1.03 (0.04–28.37) | ||
Adjustment variables: no fixed effects (model 1); age, sex, education and smoking (model 2); model 2 adjustment + comorbidities (model 3); model 3 adjustment + FVC (model 4). All five models were fit using a multilevel mixed-effects generalised linear model with study site included as random effect to account for within-site clustering. Separate analyses were performed for high-income countries and low- to middle-income countries. Reference values for categorical variables: no CAO, male, never-smoker, university education, no hypertension, no heart disease, no diabetes, no stroke and no lung cancer. n=11 675. Retirees (age limit defined as ≥65 years) and homemakers/caregivers were excluded from the analysis.