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Keywords COVID-19; Furlough; Unemployment; Longitudinal studies; Meta-analysis; Temporary unemployment; Mental health; Wellbeing Highlights * The relationship between furlough and mental health and wellbeing is not well known. * We use 9 UK studies to assess this relationship at the early stage of the pandemic. * Furlough is associated with a slight decline in mental and social wellbeing. * However, the excess risk is smaller than for those no longer being employed. * Furlough occupies an intermediary position between employment and unemployment. Abstract Background The COVID-19 pandemic has led to major economic disruptions. In March 2020, the UK implemented the Coronavirus Job Retention Scheme -- known as furlough -- to minimize the impact of job losses. We investigate associations between change in employment status and mental and social wellbeing during the early stages of the pandemic. Methods Data were from 25,670 respondents, aged 17--66, across nine UK longitudinal studies. Furlough and other employment changes were defined using employment status pre-pandemic and during the first lockdown (April--June 2020). Mental and social wellbeing outcomes included psychological distress, life satisfaction, self-rated health, social contact, and loneliness. Study-specific modified Poisson regression estimates, adjusting for socio-demographic characteristics and pre-pandemic mental and social wellbeing, were pooled using meta-analysis. Associations were also stratified by sex, age, education, and household composition. Results Compared to those who remained working, furloughed workers were at greater risk of psychological distress (adjusted risk ratio, ARR = 1.12; 95%CI: 0.97, 1.29), low life satisfaction (ARR = 1.14; 95%CI: 1.07, 1.22), loneliness (ARR = 1.12; 95%CI: 1.01, 1.23), and poor self-rated health (ARR = 1.26; 95%CI: 1.05, 1.50). Nevertheless, compared to furloughed workers, those who became unemployed had greater risk of psychological distress (ARR = 1.30; 95%CI: 1.12, 1.52), low life satisfaction (ARR = 1.16; 95%CI: 0.98, 1.38), and loneliness (ARR = 1.67; 95%CI: 1.08, 2.59). Effects were not uniform across all sub-groups. Conclusions During the early stages of the pandemic, those furloughed had increased risk of poor mental and social wellbeing, but furloughed workers fared better than those who became unemployed, suggesting that furlough may have partly mitigated poorer outcomes. Author Affiliation: (a) MRC Unit for Lifelong Health and Ageing, University College London, UK (b) Centre for Longitudinal Studies, Social Research Institute, University College London, UK (c) MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, UK (d) Institute of Epidemiology and Health Care, University College London, UK (e) Centre for Genomic and Experimental Medicine, University of Edinburgh, UK (f) MRC Integrative Epidemiology Unit, University of Bristol, UK (g) Department of Twin Research & Genetic Epidemiology, King's College London, UK * Corresponding author. University College London, MRC Unit for Lifelong Health and Ageing Floor 5, MRC LHA at UCL, 1 -- 19 Torrington Place, London, WC1E 7HB, UK. Article History: Received 26 February 2022; Revised 15 July 2022; Accepted 15 July 2022 (footnote)1 joint first authors. Byline: Jacques Wels [w.jacques@ucl.ac.uk] (a,*,1), Charlotte Booth (b,1), Bozena Wielgoszewska (b,1), Michael J. Green (c,1), Giorgio Di Gessa (d,1), Charlotte F. Huggins (e), Gareth J. Griffith (f), Alex S.F. Kwong (f), Ruth C.E. Bowyer (g), Jane Maddock (a), Praveetha Patalay (a,b), Richard J. Silverwood (b), Emla Fitzsimons (b), Richard Shaw (c), Ellen J. Thompson (g), Andrew Steptoe (d), Alun Hughes (a), Nishi Chaturvedi (a), Claire J. Steves (g), Srinivasa Vittal Katikireddi (c), George B. Ploubidis (b)

Proton pump inhibitors (PPIs) are among the most used drugs in the UK. PPI use has been associated with decreased bone mineral density (BMD) and increased fracture risk, although these results have been inconsistent. We hypothesized that PPI could modulate BMD by altering gut and/or host systemic metabolic environments. Using data from more than 5000 British male and female individuals, we confirmed that PPI use is associated with decreased lumbar spine and total hip BMD. This effect was not mediated through the gut microbiome. We suggest here that PPI use may influence total hip BMD, both directly and indirectly, via plasma metabolites involved in the sex hormone pathway. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR). [ABSTRACT FROM AUTHOR]