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Prevalence, progression and impact of chronic cough on employment in Northern Europe

Henrik Johansson, Ane Johannessen, Mathias Holm, Bertil Forsberg, Vivi Schlünssen, Rain Jõgi, Michael Clausen, Eva Lindberg, Andrei Malinovschi, Össur Ingi Emilsson
European Respiratory Journal 2021 57: 2003344; DOI: 10.1183/13993003.03344-2020
Henrik Johansson
1Dept of Neuroscience, Uppsala University, Uppsala, Sweden
2Clinical Physiology, Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
3Respiratory, Allergy and Sleep Research, Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
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  • ORCID record for Henrik Johansson
Ane Johannessen
4Centre for International Health, Dept of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Mathias Holm
5Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Bertil Forsberg
6Sustainable Health, Dept of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Vivi Schlünssen
7Dept of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
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Rain Jõgi
8Lung Clinic, Tartu University Hospital, Tartu, Estonia
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Michael Clausen
9Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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Eva Lindberg
3Respiratory, Allergy and Sleep Research, Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
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Andrei Malinovschi
2Clinical Physiology, Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
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Össur Ingi Emilsson
3Respiratory, Allergy and Sleep Research, Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
9Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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  • For correspondence: ossur.emilsson@medsci.uu.se
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Abstract

We investigated the prevalence of chronic cough and its association with work ability and sick leave in the general population.

Data were analysed from the Respiratory Health In Northern Europe (RHINE) III cohort (n=13 500), of which 11 252 participants had also participated in RHINE II 10 years earlier, a multicentre study in Northern Europe. Participants answered a questionnaire on chronic cough, employment factors, smoking and respiratory comorbidities.

Nonproductive chronic cough was found in 7% and productive chronic cough in 9% of the participants. Participants with nonproductive cough were more often female and participants with productive cough were more often smokers and had a higher body mass index (BMI) than those without cough. Participants with chronic cough more often reported >7 days of sick leave in the preceding year than those without cough (“nonproductive cough” 21% and “productive cough” 24%; p<0.001 for comparisons with “no cough” 13%). This pattern was consistent after adjusting for age, sex, BMI, education level, smoking status and comorbidities. Participants with chronic cough at baseline reported lower work ability and more often had >7 days of sick leave at follow-up than those without cough. These associations remained significant after adjusting for cough at follow-up and other confounding factors.

Chronic cough was found in around one in six participants and was associated with more sick leave. Chronic cough 10 years earlier was associated with lower work ability and sick leave at follow-up. These associations were not explained by studied comorbidities. This indication of negative effects on employment from chronic cough needs to be recognised.

Abstract

In an adult general population, one in six reports chronic cough. Chronic cough, current and a decade earlier, is associated with increased sick leave days and decreased work ability in middle-aged adults from the general Northern European population. https://bit.ly/35Iz694

Footnotes

  • Author contributions: H. Johansson, Ö.I. Emilsson, A. Malinovschi and A. Johannessen contributed significantly to the conception of this study. Ö.I. Emilsson performed the statistical analysis. All authors participated in discussions for the development of the study and contributed to the data interpretation. All authors read, contributed to and approved the final manuscript.

  • Conflict of interest: A. Johannessen has nothing to disclose.

  • Conflict of interest: M. Holm has nothing to disclose.

  • Conflict of interest: B. Forsberg has nothing to disclose.

  • Conflict of interest: V. Schlünssen has nothing to disclose.

  • Conflict of interest: R. Jõgi has nothing to disclose.

  • Conflict of interest: M. Clausen has nothing to disclose.

  • Conflict of interest: E. Lindberg has nothing to disclose.

  • Conflict of interest: A. Malinovschi has nothing to disclose.

  • Conflict of interest: Ö.I. Emilsson has nothing to disclose.

  • Conflict of interest: H. Johansson has nothing to disclose.

  • Support statement: RHINE was supported financially by the Norwegian Research Council, Bergen Medical Research Foundation, Western Norwegian Regional Health Authorities, Norwegian Labour Inspection, Norwegian Asthma and Allergy Association, Faculty of Health of Aarhus University, Wood Dust Foundation, Danish Lung Association, Swedish Heart and Lung Foundation, Vårdal Foundation for Health Care Science and Allergy Research, Swedish Council for Working Life and Social Research, Bror Hjerpstedt Foundation, Swedish Asthma and Allergy Association, Icelandic Research Council, and Estonian Science Foundation. Funding information for this article has been deposited with the Crossref Funder Registry.

  • Received September 1, 2020.
  • Accepted November 12, 2020.
  • Copyright ©ERS 2021
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Prevalence, progression and impact of chronic cough on employment in Northern Europe
Henrik Johansson, Ane Johannessen, Mathias Holm, Bertil Forsberg, Vivi Schlünssen, Rain Jõgi, Michael Clausen, Eva Lindberg, Andrei Malinovschi, Össur Ingi Emilsson
European Respiratory Journal Jun 2021, 57 (6) 2003344; DOI: 10.1183/13993003.03344-2020

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Prevalence, progression and impact of chronic cough on employment in Northern Europe
Henrik Johansson, Ane Johannessen, Mathias Holm, Bertil Forsberg, Vivi Schlünssen, Rain Jõgi, Michael Clausen, Eva Lindberg, Andrei Malinovschi, Össur Ingi Emilsson
European Respiratory Journal Jun 2021, 57 (6) 2003344; DOI: 10.1183/13993003.03344-2020
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