A platform for collaborations in respiratory research in Sweden
Anchor: intro


The BOLD started 2006 and the purpose was to measure the prevalence and burden of chronic obstructive pulmonary disease (COPD) around the world. In Northern Europe four centres: Uppsala, Bergen, Reykjavik and Tartu are participating. 2020 the participants were reinvestigated in order to study change in lung function and the incidence of chronic airflow obstruction and COPD. The investigation in BOLD I included questionnaires, spirometry and blood sampling for assessment of inflammatory markers. The BOLD II protocol was similar to BOLD I but in the Nordic centres sleep recordings and collection of fecal samples for microbiota analyses were added.

BOLD is not divided in different subprojects but different aspects of respiratory health are examines such as associations to: health status, inflammatory markers, exposure and sleep. Ideas for analyses are circulated with the PIs for each centre as well as the coordination centre at Imperial College in London.

Anchor: Investigators and study personnel


• Christer Janson, Andrei Malinovschi, and Eva Lindberg, Uppsala University
• Rune Nielsen, University of Bergen
• Thorarinn Gislason, Bryndis Benediktsdottir, University of Iceland
• Rain Jõgi, Tartu University

Anchor: Responsible university or institution

Responsible university or institution

Uppsala University
University of Bergen
University of Iceland
Tartu University

Anchor: Collaborators


The ECRHS study
The GA2LEN study
Thermo Fisher Scientific
Astra Zeneca

Anchor: Funders


Swedish Heart and Lung Foundation
• Swedish Association against Heart and Lung Disease
• The Bror Hjerpstedt Foundation
Astra Zeneca
Glaxo Smith Kline
• The Landspitali University Science Fund

Anchor: Collaborate with BOLD

How to collaborate with BOLD

Contact one of the contact persons below with proposals.

Anchor: contacts

Contact information

Christer Janson

Andrei Malinovschi

Rune Nielsen

Thorarinn Gislason

Rain Jögi

Anchor: publications

Key publications

Thorleifsson SJ, Margretardottir OB, Gudmundsson G,Olafsson I, Benediktsdottir B, Janson C, Buist AS, Gislason T. Chronic airflow obstruction and markers of systemic inflammation: Results from the BOLD study in Iceland. Respir Med 2009; 103:1548-1553.

Margretardottir OB, Thorleifsson SJ, Gudmundsson G, Olafsson I, Benediktsdottir B, Janson C, Buist AS, Gislason T. Hypertension, systemic inflammation and body weight in relation to lung function impairment – an epidemiological study. COPD 2009; 6:250–255.

Benediktsdottir B, Janson C, Lindberg E, Arnardóttir ES, Olafsson I, Cook E, Thorarinsdottir EH, Gislason T. Prevalence of Restless Legs Syndrome Among Adults in Iceland and Sweden – Lung function, Comorbidity, Ferritin, Biomarkers and Quality of Life. Sleep Med 2010; 11:1043-1048.

Fjalldal SB, Janson C,  Benediktsdóttir B, Gudmundsson G, Burney P, Buist AS, Vollmer WM, Gislason T. Smoking, stages of change and decisional balance in Iceland and Sweden. Clin Respir J 2011; 5:76-83.

Danielsson P, Ólafsdóttir IS, Benediktsdóttir B, Gíslason T,Janson C. The prevalence of COPD in Uppsala, Sweden – The Burden of Obstructive Lung Disease (BOLD) study: Cross-sectional Population-based study. Clin Respir J 2012; 6: 120–127.

Kato B, Gulsvik A,Vollmer V, Janson C, Studnika M, Buist S, Burney P,. Can spirometric norms be set using pre- or post-bronchodilator test results in older people? Respir Res 2012;13:102.

Lamprecht B, Vanfleteren LE, Studnicka M, Allison M, McBurnie MA, Vollmer WM, Tan WC, Nielsen R, Nastalek P, Gnatiuc L, Kaiser B, Janson C, Wouters EFM, Burney P, Buist AS. Gender-related differences in respiratory symptoms: results from the BOLD Study. Eur Respir J 2013;42:858-60.

Janson C, Marks G, Buist S, Gnatiuc L, Gislason T, McBurnie MA, Nielsen R, Studnicka M, Toelle B, Benediktsdottir B, Burney P. The impact of COPD on health status: findings from the BOLD study. Eur Respir J 2013;42:1472-1483.

Burney P, Jithoo A, Kato B, Janson C, Mannino D, Nizankowska-Mogilnicka E, Studnicka M, Tan W, Bateman E, Koçabas A, Vollmer WM, Gislason T, Marks G, Koul PA, Harrabi I, Gnatiuc L, Buist S. Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty–a BOLD analysis. Thorax 2014; 69:465-473.

Gnatiuc L, Buist AS, Kato B, Janson C, Ait-Khaled N, Nielsen R, Koul PA, Nizankowska-Mogilnicka E, Obaseki D, Idolor LF, Harrabi I, Burney PGJ. The gap in use of bronchodilators, inhaled corticosteroids and influenza vaccine among 23 high and low income sites. Int J Tubercul Lung Dis 2015; 19:21-30.

Amaral AFS, Jithoo A, Coton S, Kato B, Tan WC, Studnicka M, Janson C, Gislason T, Mannino D, Bateman ED, Buist S, Burney PGJ. Tuberculosis associates with both airflow obstruction and low lung function: BOLD results. Eur Respir J 2015; 46:1104-1112.

Coton S, Vollmer WM, Bateman E, Marks GB, Tan W, Mejza F, Juvekar S, Janson C, Mortimer K, Mahesh PA, Buist S, Burney PGJ. Severity of airflow obstruction in Chronic Obstructive Pulmonary Disease (COPD): Proposal for a new classification. COPD 2017; 14:469-475.

Broström E, Jögi R, Gislason T, Benediktsdottir B, Burney PGJ, Janson C. The prevalence of chronic airflow obstruction in three cities in the Nordic-Baltic region. Respir Med 2018; 143: 8-13.

Thorarinsdottir EH, Arnardottir ES, Benediktsdottir B, Janson C, Olafsson I, Pack A, Gislason T, Keenan BT. Serum ferritin and obstructive sleep apnea-epidemiological study. Sleep Breath 2018; 22:663–672.

Thorarinsdottir EH, Bjornsdottir E, Benediktsdottir B, Janson C, Gislason T, Aspelund T, Kuna ST, Pack AI, Arnardottir ES. Definition of excessive daytime sleepiness in the general population: feeling sleepy relates better with sleep related symptoms and quality of life than the Epworth Sleepiness Scale score. Results from an epidemiological study. J Sleep Res 2019;28:e12852.

Sator L, Horner A, Studnicka M, Lamprecht B, Kaiser B, McBurnie MA, Buist AS, Gnatiuc L, Mannino DM, Janson C, Bateman ED, Burney P; BOLD Collaborative Research Group. Overdiagnosis of COPD in subjects with unobstructed spirometry – a BOLD analysis. Chest 2019; 156:277-288.

Janson C, Malinovschi A, Amaral AFS, Accordini S, Bousquet J, Sonia Buist A, Canonica GW, Dahlén B, Garcia-Aymerich J, Gnatiuc L, Kowalski ML, Patel J, Tan W, Torén K, Zuberbier T, Burney P, Jarvis D. Bronchodilator reversibility in asthma and COPD: Findings from three large population studies. Eur Respir J 2019;54: pii: 1900561.

Amaral A, Amaral AFS, Burney PGJ, Patel J, Minelli C, Mejza F, Mannino DM, Seemungal TAR, Mahesh PA, Lo LC, Janson C, Juvekar S, Denguezli M, Harrabi I, Wouters EFM, Cherkaski H, Mortimer K, Jogi R, Bateman ED, Fuertes E, Al Ghobain M, Tan W, Obaseki DO, El Sony A, Studnicka M, Aquart-Stewart A, Koul P, Lawin H, Nafees AA, Awopeju O, Erhabor GE, Gislason T, Welte T, Gulsvik A, Nielsen R, Gnatiuc L, Kocabas A, Marks GB, Sooronbaev T, Mbatchou Ngahane BH, Barbara C, Buist AS. Chronic airflow obstruction and ambient particulate air pollution. Thorax 2021 76:1236-1241.

Burney P, Patel J, Minelli C, Gnatiuc L, Amaral AFS, Kocabaş A, Cherkaski HH, Gulsvik A, Nielsen R, Bateman E, Jithoo A, Mortimer K, Sooronbaev TM, Lawin H, Nejjari C, Elbiaze M, El Rhazi K, Zheng JP, Ran P, Welte T, Obaseki D, Erhabor G, Elsony A, Osman NB, Ahmed R, Nizankowska-Mogilnicka E, Mejza F, Mannino DM, Bárbara C, Wouters EFM, Idolor LF, Loh LC, Rashid A, Juvekar S, Gislason T, Al Ghobain M, Studnicka M, Harrabi I, Denguezli M, Koul PA, Jenkins C, Marks G, Jõgi R, Hafizi H, Janson C, Tan WC, Aquart-Stewart A, Mbatchou B, Nafees A, Gunasekera K, Seemungal T, Padukudru Anand M, Enright P, Vollmer WM, Blangiardo M, Elfadaly FG, Buist AS. Prevalence and population attributable risk for chronic airflow obstruction in a large multinational study. Am J Respir Crit Care Med 2021;203: 1353–1365.

Knox-Brown B, Patel J, Potts J, Ahmed R, Aquart-Stewart A, Cherkaski HH, Denguezli M, Elbiaze M, Elsony A, Franssen FME, Ghobain MA, Harrabi I, Janson C, Jõgi R, Juvekar S, Lawin H, Mannino D, Mortimer K, Nafees AA, Nielsen R, Obaseki D, Paraguas SNM, Rashid A, Loh LC, Salvi S, Seemungal T, Studnicka M, Tan WC, Wouters EEFM, Barbara C, Gislason T, Gunasekera K, Burney P, Amaral AFS; BOLD Collaborative Research Group. Prevalence of small airways obstruction and its risk factors in the multinational Burden of Obstructive Lung Disease (BOLD) study. Lancet Global Health 2023; 11:e69-e82.

Anchor: links


WSAS – West Sweden Asthma Study at the University of Gothenburg
Krefting Research Centre