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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.

Identifieur interne : 000E84 ( Main/Exploration ); précédent : 000E83; suivant : 000E85

Job strain and the risk of severe asthma exacerbations: a meta-analysis of individual-participant data from 100 000 European men and women.

Auteurs : Katriina Heikkil [Finlande] ; Ida Madsen [Danemark] ; Solja Nyberg [Finlande] ; Eleonor Fransson [Suède] ; Hugo Westerlund [Royaume-Uni] ; Peter Westerholm [Suède] ; Marianna Virtanen [Finlande] ; Jussi Vahtera [Finlande] ; Ari V N Nen [Finlande] ; Töres Theorell [Suède] ; Sakari Suominen [Finlande] ; Martin Shipley [Royaume-Uni] ; Paula Salo [Finlande] ; Reiner Rugulies [Danemark] ; Jaana Pentti [Finlande] ; Jan Pejtersen [Danemark] ; Tuula Oksanen [Finlande] ; Maria Nordin [Suède] ; Martin Nielsen [Allemagne] ; Anne Kouvonen [Royaume-Uni] ; Aki Koskinen [Finlande] ; Markku Koskenvuo [Finlande] ; Anders Knutsson [Suède] ; Jane Ferrie [Royaume-Uni] ; Nico Dragano [Allemagne] ; Hermann Burr [Allemagne] ; Marianne Borritz [Danemark] ; Jakob Bjorner [Danemark] ; Lars Alfredsson [Suède] ; David Batty [Royaume-Uni] ; Archana Singh-Manoux [Royaume-Uni] ; Mika Kivim Ki [Royaume-Uni]

Source :

RBID : Hal:inserm-01151643

English descriptors

Abstract

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


Url:
DOI: 10.1111/all.12381


Affiliations:


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<country>Royaume-Uni</country>
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<name sortKey="Singh Manoux, Archana" sort="Singh Manoux, Archana" uniqKey="Singh Manoux A" first="Archana" last="Singh-Manoux">Archana Singh-Manoux</name>
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<name sortKey="Kivim Ki, Mika" sort="Kivim Ki, Mika" uniqKey="Kivim Ki M" first="Mika" last="Kivim Ki">Mika Kivim Ki</name>
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<orgName>Department of Epidemiology and Public Health</orgName>
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<idno type="DOI">10.1111/all.12381</idno>
<series>
<title level="j">Allergy</title>
<idno type="ISSN">0105-4538</idno>
<imprint>
<date type="datePub">2014-05-31</date>
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<keywords scheme="mix" xml:lang="en">
<term>Asthma</term>
<term>exacerbation</term>
<term>job strain</term>
<term>psychosocial</term>
<term>work stress</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<p>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. 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. 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). Our findings suggest that job strain is probably not an important risk factor for severe asthma exacerbations leading to hospitalization or death.</p>
</div>
</front>
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<li>Allemagne</li>
<li>Danemark</li>
<li>Finlande</li>
<li>Royaume-Uni</li>
<li>Suède</li>
</country>
<region>
<li>Comté de Stockholm</li>
<li>East Middle Sweden</li>
<li>Finlande occidentale</li>
<li>Svealand</li>
</region>
<settlement>
<li>Stockholm</li>
<li>Turku</li>
<li>Uppsala</li>
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<li>Université de Stockholm</li>
<li>Université de Turku</li>
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<name sortKey="Koskinen, Aki" sort="Koskinen, Aki" uniqKey="Koskinen A" first="Aki" last="Koskinen">Aki Koskinen</name>
<name sortKey="Nyberg, Solja" sort="Nyberg, Solja" uniqKey="Nyberg S" first="Solja" last="Nyberg">Solja Nyberg</name>
<name sortKey="Oksanen, Tuula" sort="Oksanen, Tuula" uniqKey="Oksanen T" first="Tuula" last="Oksanen">Tuula Oksanen</name>
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<name sortKey="Suominen, Sakari" sort="Suominen, Sakari" uniqKey="Suominen S" first="Sakari" last="Suominen">Sakari Suominen</name>
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<name sortKey="Rugulies, Reiner" sort="Rugulies, Reiner" uniqKey="Rugulies " first=" Reiner" last="Rugulies"> Reiner Rugulies</name>
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<name sortKey="Fransson, Eleonor" sort="Fransson, Eleonor" uniqKey="Fransson E" first="Eleonor" last="Fransson">Eleonor Fransson</name>
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<name sortKey="Theorell, Tores" sort="Theorell, Tores" uniqKey="Theorell T" first="Töres" last="Theorell">Töres Theorell</name>
<name sortKey="Westerholm, Peter" sort="Westerholm, Peter" uniqKey="Westerholm P" first="Peter" last="Westerholm">Peter Westerholm</name>
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<name sortKey="Westerlund, Hugo" sort="Westerlund, Hugo" uniqKey="Westerlund H" first="Hugo" last="Westerlund">Hugo Westerlund</name>
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<name sortKey="Kivim Ki, Mika" sort="Kivim Ki, Mika" uniqKey="Kivim Ki M" first="Mika" last="Kivim Ki">Mika Kivim Ki</name>
<name sortKey="Kouvonen, Anne" sort="Kouvonen, Anne" uniqKey="Kouvonen A" first="Anne" last="Kouvonen">Anne Kouvonen</name>
<name sortKey="Shipley, Martin" sort="Shipley, Martin" uniqKey="Shipley M" first="Martin" last="Shipley">Martin Shipley</name>
<name sortKey="Singh Manoux, Archana" sort="Singh Manoux, Archana" uniqKey="Singh Manoux A" first="Archana" last="Singh-Manoux">Archana Singh-Manoux</name>
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