{
  "abstract": "Objective: Chronic obstructive pulmonary disease (COPD) is a respiratory disorder, and – after tobacco smoking – occupational exposures are among the most important risk factors. Precarious employment (PE) has been linked to a range of adverse mental and physical health outcomes; however, evidence regarding its potential association with COPD remains limited. PE may contribute to COPD risk through both greater exposure to occupational hazards and health-related behaviors, particularly smoking. This study aimed to examine whether PE is associated with COPD in the Swedish working population and assess whether these associations differ by gender.\n\nMethods: A nationwide register-based cohort of 1 984 081 working-age individuals in Sweden was followed for 14 years (2003–2017). PE was operationalized multidimensionally: contractual employment insecurity, temporariness, multiple jobholding, income level, and coverage by collective bargaining agreements. Cumulative incidence of COPD (2004–2017) was identified through register-based diagnoses. Risk ratios (RR) were estimated using generalized linear models with a log link function, adjusting for sociodemographic factors, occupational exposures, and smoking where available.\n\nResults: PE was associated with a graded increase in COPD risk, ranging from substandard employment [adjusted RR (RRadj) 1.18, 95% confidence interval (CI) 1.14–1.22] to PE (RRadj 1.39, 95% CI 1.31–1.47). Among the dimensions of PE, low income was the strongest contributor (RR 1.44, 95% CI 1.39–1.50), while unstable employment had a modest effect (RR 1.16, 95% CI 1.12–1.20).\n\nConclusion: PE is associated with elevated risk of COPD in the Swedish workforce. These findings emphasize the role of employment conditions as a social determinant of respiratory health.",
  "abstract_shown": true,
  "affiliations": [
    "Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .",
    "School of Nursing, Cape Breton University, Nova Scotia, Canada .",
    "Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark .",
    "Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden .",
    "Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden ."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Filippa Lundh"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Virginia Gunn"
    },
    {
      "affs": [
        2
      ],
      "name": "Bertina Kreshpaj"
    },
    {
      "affs": [
        0
      ],
      "name": "Signild Kvart"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Theo Bodin"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Maria Albin"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Jenny Selander"
    },
    {
      "affs": [
        0,
        3,
        4
      ],
      "name": "Sandra Ekström"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Pernilla Wiebert"
    },
    {
      "affs": [
        0
      ],
      "name": "Nuria Matilla-Santander"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/266ygn6vjryzt.bib",
  "cited_by": 0,
  "doi": "10.5271/sjweh.4319",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13738666/",
  "id": "266ygn6vjryzt",
  "issns": [
    "0355-3140",
    "1795-990X"
  ],
  "landing_url": "https://doi.org/10.5271/sjweh.4319",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2739|Employment and Welfare Studies"
    ]
  ],
  "openalex": "W4414964506",
  "pdf_url": "https://www.sjweh.fi/download.php?abstract_id=4319&file_nro=1",
  "pmcid": "PMC13738666",
  "pmid": "42610780",
  "published": "2026-11-01",
  "publisher": "Nordic Association of Occupational Safety and Health",
  "ris": "https://research.draconitic.com/paper/266ygn6vjryzt.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:23:37Z",
      "native_id": "PMC13738666",
      "source": "pmc",
      "url": "https://doi.org/10.5271/sjweh.4319"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Employment and Welfare Studies",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Precarious employment and its impact on chronic obstructive pulmonary disease in the Swedish working population – a longitudinal register-based study",
  "title_text": "Precarious employment and its impact on chronic obstructive pulmonary disease in the Swedish working population – a longitudinal register-based study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:23:37Z",
  "url": "https://research.draconitic.com/paper/266ygn6vjryzt",
  "venue": "Scandinavian Journal of Work, Environment & Health",
  "versions": []
}