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  • 1.
    Heikkilä, K
    et al.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Madsen, I E H
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Nyberg, S T
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Fransson, Eleonor
    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.
    Westerlund, H
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Westerholm, P. J. M.
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
    Virtanen, M.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Vahtera, J.
    Finnish Institute of Occupational Health, Turku, Finland; Department of Public Health, University of Turku, Turku, Finland.
    Väänänen, A.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Theorell, T.
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Suominen, S. B.
    Department of Public Health, University of Turku, Turku, Finland; Folkhälsan Research Center, Helsinki, Finland; Nordic School of Public Health, Göteborg, Sweden .
    Shipley, M. J.
    Department of Epidemiology and Public Health, University College London, London, UK.
    Salo, P.
    Department of Public Health and Department of Psychology, University of Turku, Turku, Finland.
    Rugulies, R.
    National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Public Health, Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
    Pentti, J.
    Department of Public Health, University of Turku, Turku, Finland.
    Pejtersen, J. H.
    The Danish National Centre for Social Research, Copenhagen, Denmark.
    Oksanen, T.
    Finnish Institute of Occupational Health, Turku, Finland.
    Nordin, M.
    Department of Psychology, Umeå University, Umeå, Sweden.
    Nielsen, M. L.
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
    Kouvonen, A.
    School of Sociology, Social Policy & Social Work, Queen's University Belfast, Belfast, UK.
    Koskinen, A.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Koskenvuo, M.
    Department of Public Health, University of Helsinki, Helsinki, Finland.
    Knutsson, A.
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Ferrie, J. E.
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden; Social and Community Medicine, University of Bristol, Bristol, UK.
    Dragano, N.
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Burr, H.
    Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany.
    Borritz, M.
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
    Bjorner, J. B.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Alfredsson, L.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Batty, G. D.
    Department of Epidemiology and Public Health, University College London, London, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK .
    Singh-Manoux, A.
    Department of Epidemiology and Public Health, University College London, London, UK; Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France.
    Kivimäki, M.
    Finnish Institute of Occupational Health, Helsinki, Finland; Department of Epidemiology and Public Health, University College London, London, UK.
    Job strain and the risk of severe asthma exacerbations: a meta-analysis of individual-participant data from 100 000 European men and women2014In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 69, no 6, p. 775-783Article in journal (Refereed)
    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.

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