The relationship between dyspnoea and main lifetime occupation in the elderly.

PAQUID is a prospective epidemiological study of mental and functional ageing. Based on the data collected during the baseline screening of this cohort, the present paper will examine the relationship between main lifetime occupation and the presence of dyspnoea in a representative sample of 3777 subjects aged > or = 65 years; living at home in the south-west of France. Subjects were considered dyspnoeic if they had a dyspnoea level 3, 4 or 5 according to the Fletcher classification. Occupational categories were determined according to the classification of the French 'Institut National de la Statistique et des Etudes Economiques,' and to the type of occupation for blue-collar workers. The proportion of dyspnoeic subjects varied significantly according to the occupational categories (from 13% for teachers to 37% for farm workers) and to the type of work (from 18% for printing workers to 41% for building workers). When age, sex, weight, smoking history, place of residence, educational level and some concurrent diseases were adjusted for, former farm workers (odds ratio [OR] = 3.3, 95% confidence interval [CI]: 2.0-5.6), farm managers (OR = 2.1, 95% CI: 1.3-3.5), domestic service employees (OR = 1.9, 95% CI: 1.2-3.6) and blue-collar workers (OR = 1.9, 95% CI: 1.3-3.0), had a higher risk of dyspnoea than subjects who used to have an intellectual occupation. The risk was not significant for other professional categories. These results demonstrate the important long-term effect of previous professional activities on respiratory health in the elderly.