Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milano, Italy.
Occup Environ Med. 2020 Oct;77(10):681-690. doi: 10.1136/oemed-2020-106489. Epub 2020 Jun 23.
Psychological stress may influence both susceptibility and severity of infections. Although work-related stress is a widespread concern among many employees, few studies have been conducted with the focus on work stressors and infections. We therefore aimed to investigate this association in a prospective cohort study.
Our study included 25 029 employed individuals who filled-out a questionnaire in September 1997 and were followed through record linkages until retirement or December 2016. Work stress was assessed at baseline using a Swedish version of the Demand-Control Questionnaire, whereas hospital contacts related to infections were identified from the National Patient Register. We fitted extensions of the standard Cox model to account for recurrent infections.
In total, we observed 8257 infections. Individuals in the third tertile of job demand had a 13% higher hazard of infections (HR=1.13; 95% CI=1.03 to 1.24) compared with individuals in the first tertile, specifically an increased incidence of upper respiratory tract infections (HR=1.15; 95% CI=1.00 to 1.33) and urinary tract infections (HR=1.31; 95% CI=1.09 to 1.57) was found. Employees with the highest job control (third tertile) had no lower risk of infections than individuals in the lowest tertile (HR=1.02; 95% CI=0.92 to 1.13). When combining the demand and control dimensions into job strain scale, no association between high job strain and infections was observed (HR=1.08; 95% CI=0.97 to 1.21).
High job demand, but not low job control, is associated with an increased occurrence of infections. No difference was observed in workers with high strain jobs compared with those with low strain jobs.
心理压力可能会影响感染的易感性和严重程度。虽然工作相关的压力是许多员工普遍关注的问题，但很少有研究关注工作压力源与感染之间的关系。因此，我们旨在前瞻性队列研究中调查这种关联。
我们的研究纳入了 25029 名在职人员，他们于 1997 年 9 月填写了一份问卷，并通过记录链接进行随访，直至退休或 2016 年 12 月。工作压力在基线时使用瑞典版的需求-控制问卷进行评估，而感染相关的医院接触则从国家患者登记处确定。我们拟合了标准 Cox 模型的扩展来解释复发性感染。
总共有 8257 例感染。与处于第一 tertile 的人相比，工作需求处于第三 tertile 的人感染的风险高出 13%（HR=1.13；95%CI=1.03 至 1.24），特别是上呼吸道感染（HR=1.15；95%CI=1.00 至 1.33）和尿路感染（HR=1.31；95%CI=1.09 至 1.57）的发病率增加。工作控制（第三 tertile）最高的员工感染的风险并不低于最低 tertile 的员工（HR=1.02；95%CI=0.92 至 1.13）。当将需求和控制维度结合到工作压力量表中时，没有观察到高工作压力与感染之间的关联（HR=1.08；95%CI=0.97 至 1.21）。
高工作需求，但不是低工作控制，与感染的发生增加有关。与低压力工作的工人相比，高压力工作的工人没有观察到差异。
