title: Work-related stress, inability to relax after work and risk of adult asthma: a population-based cohort study.
abstract: BACKGROUND
  There is an extensive literature linking stressful work conditions to adverse health outcomes. Notwithstanding, the relationship with asthma has not been examined, although various other measures of psychological stress have been associated with asthma. Therefore, we aimed to investigate the relation between work stress and asthma prevalence and incidence.
  
  
  METHODS
  We used data from a population-based cohort study (n = 5114 at baseline in 1992-1995 and n = 4010 at follow-up in 2002/2003). Asthma was measured by self-reports. Two scales that assessed psychologically adverse work conditions were extracted from a list of work-condition items by factor analysis (these scales were termed 'work stress' and 'inability to relax after work'). For each scale, the derived score was employed both as continuous z-score and as categorized variable in analyses. Associations with asthma were estimated by prevalence ratios (PRs) and risk ratios (RRs) using Poisson regression with a log-link function adjusting for demographics, health-related lifestyles, body mass index and family history of asthma. Analyses were restricted to those in employment (n = 3341).
  
  
  RESULTS
  Work stress and inability to relax z-scores were positively associated with asthma prevalence (PR = 1.15, 95%CI = 0.97, 1.36 and PR = 1.43, 95%CI = 1.12, 1.83, respectively). Prospective analyses using z-scores showed that for each 1 standard deviation increase in work stress and inability to relax, the risk of asthma increased by approximately 40% (RR for work stress = 1.46, 95%CI = 1.06, 2.00; RR for inability to relax = 1.39, 95%CI = 1.01, 1.91). Similar patterns of associations were observed in analyses of categorized exposures.
  
  
  CONCLUSIONS
  This is the first study to show a cross-sectional and longitudinal association of work stress with asthma.
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. adrian.loerbroks@medma.uni-heidelberg.de
authors.forename: A
authors.initials: A
authors.lastname: Loerbroks
authors.forename: M C
authors.initials: MC
authors.lastname: Gadinger
authors.forename: J A
authors.initials: JA
authors.lastname: Bosch
authors.forename: T
authors.initials: T
authors.lastname: Stürmer
authors.forename: M
authors.initials: M
authors.lastname: Amelang
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003625:Data Collection; D006801:Humans; D015994:Incidence; D007588:Job Satisfaction; D008137:Longitudinal Studies; D015995:Prevalence; D012063:Relaxation; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*; D014937:Work / Q000523:psychology*; D055815:Young Adult