TY - JOUR T1 - Job strain and COPD exacerbations: an individual-participant meta-analysis JF - European Respiratory Journal JO - Eur Respir J SP - 247 LP - 251 DO - 10.1183/09031936.00205113 VL - 44 IS - 1 AU - Katriina Heikkilä AU - Ida E.H. Madsen AU - Solja T. Nyberg AU - Eleonor I. Fransson AU - Kirsi Ahola AU - Lars Alfredsson AU - Jakob B. Bjorner AU - Marianne Borritz AU - Hermann Burr AU - Anders Knutsson AU - Markku Koskenvuo AU - Aki Koskinen AU - Martin L. Nielsen AU - Maria Nordin AU - Krista Pahkin AU - Jaana Pentti AU - Reiner Rugulies AU - Paula Salo AU - Martin J. Shipley AU - Sakari B. Suominen AU - Töres Theorell AU - Ari Väänänen AU - Jussi Vahtera AU - Marianna Virtanen AU - Peter J.M. Westerholm AU - G. David Batty AU - Archana Singh-Manoux AU - Mika Kivimäki Y1 - 2014/07/01 UR - http://erj.ersjournals.com/content/44/1/247.abstract N2 - To the Editor:Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and disability worldwide [1]. The clinical course of COPD is characterised by exacerbations, which can be minor and manageable at home or in primary care, or severe, leading to hospitalisation or even death. Known causes of exacerbations include tobacco smoke, air pollution, dusts and fumes, and respiratory infections [1], [2]. One less well understood risk factor is stress, which could plausibly lead to COPD exacerbations as it can trigger inflammation [3], [4] and is associated with increased smoking [5], which are both implicated in COPD pathology [2]. Work is an important source of stress in the age groups in which COPD is typically diagnosed [1], [6]. However, we are not aware of previous investigations of work-related stress and the risk of COPD exacerbations.In this study, we examined the associations between job strain (the most widely studied conceptualisation of work-related stress) and severe COPD exacerbations using individual-level data from 10 prospective cohort studies from the Individual Participant Data Meta-analysis in Working Populations (IPD-Work) Consortium [7]. Job strain is defined as a combination of high demands (excessive amounts of work) and low control (having little influence on what tasks to do and how to carry them out) at work.We ascertained job strain from the participants’ responses to questions on demands and control aspects of their work at study baseline. The responses were scored and for each participant, and mean scores were calculated for job-demand items and job-control items. Based on these, participants’ job … ER -