{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T03:45:00Z","timestamp":1792122300833,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Liver cirrhosis is often diagnosed in working\u2010age adults and carries a poor prognosis. A better understanding of variation by employment status and occupation may support earlier and more targeted diagnostic evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the odds of liver cirrhosis across labor\u2010market status and occupations in working\u2010age adults and whether these patterns differed by etiology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this nationwide case\u2013control study, individuals aged 35\u201365 years with cirrhosis during 2002\u20132021 were identified from Swedish national registries and matched to up to four controls on age, sex, and municipality. Labor\u2010market status in the year before diagnosis was classified as employed, unemployed, disability\/activity benefit, long\u2010term sick leave, or other. Employed individuals were classified into occupations. Conditional logistic regression was used to estimate odds ratios and 95% confidence intervals, with physical and engineering professionals as the reference group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 23,033 cases and 92,106 controls. Cases were less often employed than controls (25.7% vs. 66.2%) and more often belonged to labor\u2010market strata associated with a lower socioeconomic status. In analyses, including employed and unemployed individuals (7485 cases; 63,747 controls), unemployment was associated with the highest odds of cirrhosis. Among employed individuals, food preparation workers and refuse and recycling workers had the highest odds. Stratified by etiologies, associations were strongest for alcohol\u2010related cirrhosis. Patterns across sex strata were similar, with generally larger effect sizes in men.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among working\u2010age adults, unemployment and selected occupations were strongly associated with incident cirrhosis. Routinely collected employment information may help identify groups who could benefit from earlier liver evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/joim.70166","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:59:23Z","timestamp":1791367163000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Employment status and occupation are associated with liver cirrhosis: A nationwide Swedish case\u2013control study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9245-915X","authenticated-orcid":false,"given":"Marie","family":"Zalesiak","sequence":"first","affiliation":[{"name":"Department of Medicine, Huddinge Karolinska Institutet  Stockholm Sweden"},{"name":"Boehringer Ingelheim Pharma GmbH &amp; Co. KG  Ingelheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7232-8000","authenticated-orcid":false,"given":"Juan","family":"Vaz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Huddinge Karolinska Institutet  Stockholm Sweden"},{"name":"School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Internal Medicine Halland Hospital Halmstad  Halmstad Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7329-6194","authenticated-orcid":false,"given":"Eralda","family":"Asllanaj","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim B.V.  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1699-3185","authenticated-orcid":false,"given":"Martin","family":"Henriksson","sequence":"additional","affiliation":[{"name":"Centre for Medical Technology Assessment, Department of Medical, Health and Caring Sciences Link\u00f6ping University  Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8474-1759","authenticated-orcid":false,"given":"Hannes","family":"Hagstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Medicine, Huddinge Karolinska Institutet  Stockholm Sweden"},{"name":"Unit of Hepatology, Department of Upper GI Diseases Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1496-1799","authenticated-orcid":false,"given":"Ying","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Huddinge Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.03.017"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(25)00228-2"},{"key":"e_1_2_11_4_1","article-title":"Trends and the course of liver cirrhosis and its complications in Germany: nationwide population\u2010based study (2005 to 2018)","volume":"12","author":"Gu W","year":"2022","journal-title":"Lancet Reg 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