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Occupational exposure to vapors, gases, dusts or fumes (VGDF) has been described as a relevant risk factor for chronic obstructive pulmonary disease (COPD) and mortality, but the corresponding studies are limited to detect these effects. The aim was to investigate if occupational exposure to VGDF was associated with COPD and mortality. We linked two Swiss datasets (LuftiBus and Swiss National Cohort) (N=30,198 adults, ≥25 years) and thereby obtained information about the current job in 2000 and/or learned profession, lung function data (2002-2012) and all-cause mortality up to 2014. Job coding and VGDF exposure assignment was done using the Airborne Chemical Exposure Job Exposure Matrix (ACE JEM) (Sadhra, SS. et al. Occup Med 2016:66:358-364). To study the association of VGDF with lung function, COPD and mortality we used linear, logistic and proportional hazard regression and adjusted for age, sex, smoking, height or body mass index, medication and residential proximity to main roads. We found lower forced expiratory volume in 1 second (FEV1) (-18.81mL, 95% CI -35.57 to -2.05, p=0.03), forced vital capacity (FVC) (-20.29mL, -40.51 to -0.07, p This cohort indicates that occupational exposure to VGDF is associated with lung function, the association with COPD and mortality however remains unclear.

Rationale A 3 month tele-coaching (TC) program is effective to increase physical activity (PA) in patients with COPD, but the impact of contact time between patient and coach has never been assessed. Methods 140 patients with COPD, allocated to TC as part of a multicenter RCT (NCT02158065), were analysed. The TC consisted of patients interacting with a stepcounter and a smartphone application. Telephone contact was initiated if patients did not increase their PA goal or in case of health/technical issues. PA was measured by Actigraph GT3x at baseline and week 12. Results Total median[IQR] contact time per patient was 50[30-100] minutes in 6[4-9] contacts with the coach. These contacts were mainly related to not increasing PA goal (39.5%) and to technical issues (58.3%). In a tertile analysis, patients with a low/medium contact time had more PA improvement (steps) compared to those with high contact time (p=0.01). High contact time patients were older and had a worse baseline FEV 1 and functional exercise capacity. Conclusion Older and more severe patients need more interaction with their coach and have less improvement in PA compared to patients with a lower contact time. Such patients may not be ideal candidates for telecoaching only. Funding:IMU-JU#115011.

Rationale: Increasing physical activity (PA) is a desired outcome in patients with COPD. We aimed to investigate the effectiveness of a 3 month tele-coaching program on the PA level of patients with COPD in a multicenter European trial (NCT02158065). Methods: In this RCT 344 patients (64% male, FEV 1 %pred 56(21), age 66(8)y, 6MWD 443(106)m, BMI 26(5) kg.m- 2 , 4890(2778)steps.day -1 , 488(200)VMU.min -1 ) from 6 centers were allocated to a usual care group (UCG) or an intervention group (IG) receiving a tele-coaching program, including a step counter providing direct feedback, an exercise booklet, a dedicated smartphone application (Linkcare), text messages and occasional telephone contacts with investigators. A daily goal (number of steps) was sent and revised every week. PA was measured using accelerometry during 1 week preceding randomization and during week 12. Mean daily step count and vector magnitude units (VMU) were chosen as outcome. Results: Both groups were comparable at baseline, for all variables except VMU [UCG vs IG respectively 512(207) vs 465(190)VMU.min -1 ]. 40% of patients in the intervention group vs 12% of control patients (p -1 (p -1 and 55(148) vs -39(122)VMU.min -1 . Conclusion: Physical activity can be significantly increased in patients with COPD using a step counter and a smartphone based, semi-automated tele-coaching program.