In a large COPD cohort study (SPIROMICS), analysis of occupational exposure data in 2736 participants (1809 with COPD and 927 without airflow limitation) showed that those with VDGF exposure in their longest held job (49%) had significantly greater airway wall thickness, expressed as Pi10, as well as higher odds of emphysema and large and small airways disease [27]. Here, SERPINB10 is linked to pulmonary emphysema.