Departamento de Salud Pública, Universidad de Concepción, Concepción, Chile.
Department of Public Health, Regis College, Weston MA, USA.
Ann Work Expo Health. 2019 Apr 19;63(4):426-436. doi: 10.1093/annweh/wxz017.
Irritable bowel syndrome (IBS) is a stress-related disease linked to psychosocial factors, though knowledge about its occupational psychosocial aspects is scarce.
A cross-sectional study of the prevalence of IBS and its association with occupational psychosocial factors in Chilean workers was conducted.
IBS prevalence, using the IBS-Rome IV criteria, in the working population was estimated using data from the National Health Survey of 2009. Data on occupational psychosocial aspects were drawn from the Chilean Survey of Employment, Health, and Work of 2009, and allocated to individual survey participants at the occupation-region level. Data on family and community stressors were available at the individual level. Prevalence ratios (PR) for IBS were computed using generalized linear mixed models to account for variability at the group level.
The IBS prevalence in the overall working population (weighted n = 5 435 253) was 18.4%, but varied substantially by industry sector. Compared with 'professionals' (IBS prevalence = 7.3%), jobs with high prevalence of IBS included 'health and social work activities' [PR = 4.9; 95% confidence interval (CI) = 1.4-16.7], 'household employment' (PR = 4.8; 95% CI = 1.5-15.9), and 'manufacturing' (PR = 3.5; 95% CI = 1.0-11.8). With Karasek Job Demand Control scores assigned to occupations within regions, high job demand doubled the prevalence of IBS (PR = 2.0; 95% CI = 1.4-2.9), whereas high-skill discretion was associated with lower prevalence of IBS (PR = 0.6; 95% CI = 0.4-0.8). There was also evidence that these two factors were not independent; high-skill discretion appeared to buffer the effect of high job demand on IBS prevalence (P < 0.001).
Occupational factors were associated with IBS prevalence, showing effects as important as those for non-occupational stresses such as civic insecurity or having health problems. High job skill discretion appeared to reduce the prevalence of IBS in the presence of high job demands. Given its high overall prevalence and poorly understood risk factors, further research on occupational psychosocial factors of IBS is warranted.
肠易激综合征（IBS）是一种与心理社会因素相关的应激相关疾病，尽管人们对其职业心理社会方面的知识知之甚少。
在智利工人中进行了一项 IBS 患病率及其与职业心理社会因素相关性的横断面研究。
使用 2009 年全国健康调查的数据，估计了工作人群中 IBS 的患病率，并采用罗马 IV 标准进行了 IBS 诊断。职业心理社会方面的数据来自 2009 年智利就业、健康和工作调查，并在职业-地区层面分配给个别调查参与者。家庭和社区应激源的数据可在个人层面获得。使用广义线性混合模型计算 IBS 的患病率比（PR），以解释群体水平的变异性。
总体工作人群（加权 n = 5435253）中 IBS 的患病率为 18.4%，但因行业部门而异。与“专业人员”（IBS 患病率=7.3%）相比，IBS 患病率较高的职业包括“卫生和社会活动”[PR=4.9；95%置信区间（CI）=1.4-16.7]、“家庭佣工”（PR=4.8；95%CI=1.5-15.9）和“制造业”（PR=3.5；95%CI=1.0-11.8）。根据区域内职业的 Karasek 工作需求控制评分，高工作需求使 IBS 的患病率增加一倍（PR=2.0；95%CI=1.4-2.9），而高技能自主权与较低的 IBS 患病率相关（PR=0.6；95%CI=0.4-0.8）。还有证据表明，这两个因素并非相互独立；高技能自主权似乎减轻了高工作需求对 IBS 患病率的影响（P<0.001）。
职业因素与 IBS 患病率相关，其影响与公民不安全或健康问题等非职业压力同样重要。在高工作需求的情况下，高工作技能自主权似乎降低了 IBS 的患病率。鉴于其总体患病率较高且风险因素尚未得到充分理解，有必要对 IBS 的职业心理社会因素进行进一步研究。
