Work-related stress, inability to relax after work and risk of adult asthma: a population-based cohort study

Authors

  • A. Loerbroks,

    1. Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim
    2. Competence Center for Social Medicine and Occupational Health Promotion, Heidelberg University, Mannheim
    3. Cluster of Excellence “Asia and Europe in a Global Context”, Heidelberg University, Heidelberg, Germany
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  • M. C. Gadinger,

    1. Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim
    2. Competence Center for Social Medicine and Occupational Health Promotion, Heidelberg University, Mannheim
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  • J. A. Bosch,

    1. Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim
    2. School of Sport and Exercise Sciences, University of Birmingham, Birmingham, UK
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  • T. Stürmer,

    1. Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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  • M. Amelang

    1. Institute of Psychology, Heidelberg University, Heidelberg, Germany
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  • Edited by: Anthony Frew

Dr Adrian Loerbroks, MSc, MSc, Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Strasse 7-11, 68167 Mannheim, Germany.
Tel.: +49 621 383 9600
Fax: +49 621 383 9920
E-mail: adrian.loerbroks@medma.uni-heidelberg.de

Abstract

To cite this article: Loerbroks A, Gadinger MC, Bosch JA, Stürmer T, Amelang M. Work-related stress, inability to relax after work and risk of adult asthma: a population-based cohort study. Allergy 2010; 65: 1298–1305.

Abstract

Background:  There is an extensive literature linking stressful work conditions to adverse health outcomes. Notwithstanding, the relationship with asthma has not been examined, although various other measures of psychological stress have been associated with asthma. Therefore, we aimed to investigate the relation between work stress and asthma prevalence and incidence.

Methods:  We used data from a population-based cohort study (n = 5114 at baseline in 1992–1995 and n = 4010 at follow-up in 2002/2003). Asthma was measured by self-reports. Two scales that assessed psychologically adverse work conditions were extracted from a list of work-condition items by factor analysis (these scales were termed ‘work stress’ and ‘inability to relax after work’). For each scale, the derived score was employed both as continuous z-score and as categorized variable in analyses. Associations with asthma were estimated by prevalence ratios (PRs) and risk ratios (RRs) using Poisson regression with a log-link function adjusting for demographics, health-related lifestyles, body mass index and family history of asthma. Analyses were restricted to those in employment (n = 3341).

Results:  Work stress and inability to relax z-scores were positively associated with asthma prevalence (PR = 1.15, 95%CI = 0.97, 1.36 and PR = 1.43, 95%CI = 1.12, 1.83, respectively). Prospective analyses using z-scores showed that for each 1 standard deviation increase in work stress and inability to relax, the risk of asthma increased by approximately 40% (RR for work stress = 1.46, 95%CI = 1.06, 2.00; RR for inability to relax = 1.39, 95%CI = 1.01, 1.91). Similar patterns of associations were observed in analyses of categorized exposures.

Conclusions:  This is the first study to show a cross-sectional and longitudinal association of work stress with asthma.

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