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Job strain and the risk of severe asthma exacerbations: a meta-analysis of individual-participant data from 100 000 European men and women
Finnish Institute of Occupational Health, Helsinki, Finland.
National Research Centre for the Working Environment, Copenhagen, Denmark.
Finnish Institute of Occupational Health, Helsinki, Finland.
Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. ADULT. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Stress Research Institute, Stockholm University, Stockholm, Sweden.ORCID iD: 0000-0001-9042-4832
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2014 (English)In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 69, no 6, 775-783 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Many patients and healthcare professionals believe that work-related psychosocial stress, such as job strain, can make asthma worse, but this is not corroborated by empirical evidence. We investigated the associations between job strain and the incidence of severe asthma exacerbations in working-age European men and women.

METHODS: We analysed individual-level data, collected between 1985 and 2010, from 102 175 working-age men and women in 11 prospective European studies. Job strain (a combination of high demands and low control at work) was self-reported at baseline. Incident severe asthma exacerbations were ascertained from national hospitalization and death registries. Associations between job strain and asthma exacerbations were modelled using Cox regression and the study-specific findings combined using random-effects meta-analyses.

RESULTS: During a median follow-up of 10 years, 1 109 individuals experienced a severe asthma exacerbation (430 with asthma as the primary diagnostic code). In the age- and sex-adjusted analyses, job strain was associated with an increased risk of severe asthma exacerbations defined using the primary diagnostic code (hazard ratio, HR: 1.27, 95% confidence interval, CI: 1.00, 1.61). This association attenuated towards the null after adjustment for potential confounders (HR: 1.22, 95% CI: 0.96, 1.55). No association was observed in the analyses with asthma defined using any diagnostic code (HR: 1.01, 95% CI: 0.86, 1.19).

CONCLUSIONS: Our findings suggest that job strain is probably not an important risk factor for severe asthma exacerbations leading to hospitalization or death.

Place, publisher, year, edition, pages
2014. Vol. 69, no 6, 775-783 p.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:hj:diva-23706DOI: 10.1111/all.12381ISI: 000335362600010PubMedID: 24725175Scopus ID: 2-s2.0-84899897594Local ID: HHJADULTISOAI: oai:DiVA.org:hj-23706DiVA: diva2:712399
Available from: 2014-04-15 Created: 2014-04-15 Last updated: 2016-06-30Bibliographically approved

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CiteExportLink to record
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