Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Allergy. 2010 Oct;65(10):1298-305. doi: 10.1111/j.1398-9995.2010.02375.x. Epub 2010 Apr 27.
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.
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).
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.
This is the first study to show a cross-sectional and longitudinal association of work stress with asthma.
有大量文献将紧张的工作条件与不良健康结果联系起来。尽管如此，与哮喘的关系尚未得到检验，尽管其他各种心理压力测量指标与哮喘有关。因此，我们旨在调查工作压力与哮喘患病率和发病率之间的关系。
我们使用了一项基于人群的队列研究的数据（1992-1995 年基线时为 5114 人，2002-2003 年随访时为 4010 人）。哮喘通过自我报告进行测量。通过因子分析从一系列工作条件项目中提取出两个评估心理不良工作条件的量表（这些量表称为“工作压力”和“工作后无法放松”）。对于每个量表，采用衍生得分作为连续 z 分数和分类变量进行分析。使用泊松回归和对数链接函数，根据人口统计学、健康相关生活方式、体重指数和哮喘家族史，对哮喘的关联进行了患病率比（PR）和风险比（RR）的估计。分析仅限于在职人员（n=3341）。
工作压力和无法放松 z 分数与哮喘患病率呈正相关（PR=1.15，95%CI=0.97，1.36 和 PR=1.43，95%CI=1.12，1.83）。使用 z 分数进行的前瞻性分析表明，工作压力和无法放松每增加 1 个标准差，哮喘的风险增加约 40%（工作压力的 RR=1.46，95%CI=1.06，2.00；无法放松的 RR=1.39，95%CI=1.01，1.91）。在分析分类暴露时也观察到了类似的关联模式。
这是第一项显示工作压力与哮喘之间存在横断面和纵向关联的研究。
