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因工作不稳定感以及空气和噪音污染带来的烦恼会预示自评健康状况不佳吗?一项使用德国全国代表性队列研究对独立关联和联合关联进行的前瞻性分析。

Do perceived job insecurity and annoyance due to air and noise pollution predict incident self-rated poor health? A prospective analysis of independent and joint associations using a German national representative cohort study.

作者信息

Riedel Natalie, Loerbroks Adrian, Bolte Gabriele, Li Jian

机构信息

Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany.

Institute for Occupational, Social, and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.

出版信息

BMJ Open. 2017 Jan 23;7(1):e012815. doi: 10.1136/bmjopen-2016-012815.

Abstract

BACKGROUND

Current economic and social change has contributed to increasing job insecurity and traffic-related pollution in residential areas. Both job insecurity and exposure to noise and air pollution are known determinants of population health and can concur in peoples' lives. This may hold true particularly for socially disadvantaged subpopulations. Nevertheless, the potential independent and joint links of those exposures to health have been rarely examined so far. We aimed to contribute to the scarce body of evidence.

METHODS

Information on perceived job insecurity and exposures to noise and air pollution as expressed by annoyance as well as on self-rated health were gathered from 2 waves of the population-based German Socio-Economic Panel (2009 and 2011, N=6544). We performed multivariable Poisson regression to examine the independent and joint risk of poor health in 2011 by perceived job insecurity and annoyance due to noise and air pollution in 2009.

RESULTS

After the 2-year follow-up in 2011, 571 (8.7%) participants rated their health as poor. The risk of reporting incident poor health was increased by roughly 40% in employees reporting high versus low perceived job insecurity and annoyance due to noise and air pollution, respectively. This risk increased when both exposures were present at higher levels (risk ratio=1.95 (1.49 to 2.55)).

CONCLUSIONS

Work-related and environmental exposures may accumulate and have a joint health impact. Elaboration on the link between occupational and residential exposures is warranted in the light of their concurrence and their implications for health inequities.

摘要

背景

当前的经济和社会变革导致工作不安全感增加以及居民区与交通相关的污染加剧。工作不安全感以及接触噪音和空气污染都是已知的影响人群健康的因素,且可能在人们的生活中同时存在。这可能尤其适用于社会弱势群体。然而,到目前为止,这些暴露因素与健康之间潜在的独立及联合关联很少被研究。我们旨在为这一稀缺的证据体系做出贡献。

方法

从基于人群的德国社会经济面板的两轮调查(2009年和2011年,N = 6544)中收集有关感知到的工作不安全感、因烦恼而表达出的对噪音和空气污染的暴露情况以及自我评估健康状况的信息。我们进行了多变量泊松回归分析,以研究2009年感知到的工作不安全感以及因噪音和空气污染而产生的烦恼与2011年健康状况不佳的独立及联合风险。

结果

在2011年进行为期两年的随访后,571名(8.7%)参与者将自己的健康状况评为不佳。报告出现健康状况不佳的风险在报告高工作不安全感以及分别因噪音和空气污染而烦恼程度高的员工中分别增加了约40%。当两种暴露水平都较高时,这种风险会增加(风险比 = 1.95(1.49至2.55))。

结论

与工作相关的和环境暴露可能会累积并对健康产生联合影响。鉴于职业暴露和居住暴露的同时存在及其对健康不平等的影响,有必要详细阐述它们之间的联系。

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