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We recorded coughing, sputum production and the degree of dyspnoea according to the New York Heart Association (NYHA) classification.15 Factors for stains development We documented any mental disorders diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria and antidepressant, benzodiazepine, neuroleptic or mood stabiliser use.16 We considered harmful alcohol use when high alcohol intakemore than 14 standard drinks/week for women and more than 21 standard drinks/week for men (140 and 210 g of alcohol, respectively)was associated with documented withdrawal, medical consequences (neurological, cardiac, hepatic or pancreatic) or erythrocyte macrocytosis (mean corpuscular volume (MCV) greater than 98 fL) not otherwise explained.17 Occupations were classified according to the six-class version of the National Statistics Socio-Economic Classification.18 Previous occupation was considered for retired individuals

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