Guillaume Airagnes is with AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry and Addictology, Université Paris Descartes, UMS011, UMR1168, Inserm, Villejuif, France. Cédric Lemogne, Nicolas Hoertel, and Frédéric Limosin are with AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry and Addictology, Université Paris Descartes, U894, Inserm, Paris, France. Romain Olekhnovitch is with UMS011, UMR1168, Inserm. Yves Roquelaure is with UMR1085, Inserm Irest, Université d'Angers, Angers, France. Marcel Goldberg is with Université Paris Descartes, UMS011, Inserm. Marie Zins is with Université Paris Descartes, UMS011, UMR1168, Inserm.
Am J Public Health. 2019 Jan;109(1):119-125. doi: 10.2105/AJPH.2018.304734. Epub 2018 Nov 29.
To examine whether stressful job exposure to the public could be associated with having long-term benzodiazepine use. From the participants included between 2012 and 2016 in the French population-based CONSTANCES cohort, 13 934 men and 19 261 women declared a daily job exposure to the public and rated the frequency of stressful exposure. We examined benzodiazepine long-term use by using drug reimbursement administrative registries. Logistic regressions provided odds ratios (ORs) of benzodiazepine long-term use, with stratification for gender and adjustment for age, education, and area deprivation index. Occupational grade, job strain, depression, self-rated health, and alcohol use disorder were additional stratification variables. Benzodiazepine long-term use was positively associated with stressful exposure to the public ("often or always" vs "rarely or never") in men (OR = 2.2; 95% confidence interval [CI] = 1.8, 2.8) and women (OR = 1.6; 95% CI = 1.4, 1.9), with dose-dependent relationships ( trends < .001). Adjustments and analyses in subgroups without other individual or environmental vulnerability factors led to similar results. Stressful job exposure to the public increases the risk of benzodiazepine long-term use. Prevention programs aiming at reducing the burden of benzodiazepine long-term use would benefit in targeting this specific population.
为了检验公共环境压力工作暴露是否与长期使用苯二氮䓬类药物有关。本研究纳入了 2012 年至 2016 年间法国人群队列 CONSTANCES 中的 13934 名男性和 19261 名女性,这些参与者报告了每天的公共环境工作暴露情况,并对压力暴露的频率进行了评级。我们通过药物报销行政登记处来检查长期使用苯二氮䓬类药物的情况。逻辑回归提供了苯二氮䓬类药物长期使用的比值比(OR),并按性别分层,同时调整了年龄、教育程度和地区贫困指数。职业等级、工作压力、抑郁、自我评估健康状况和酒精使用障碍是额外的分层变量。在男性(OR=2.2;95%置信区间[CI]:1.8,2.8)和女性(OR=1.6;95%CI:1.4,1.9)中,与公共环境压力暴露(“经常或总是”与“很少或从不”)相关的苯二氮䓬类药物长期使用呈阳性关联,且存在剂量依赖性关系(趋势<.001)。在没有其他个体或环境脆弱性因素的亚组中进行调整和分析,结果相似。公共环境压力工作暴露增加了长期使用苯二氮䓬类药物的风险。旨在减少长期使用苯二氮䓬类药物负担的预防计划将受益于针对这一特定人群。