title: Is a single item stress measure independently associated with subsequent severe injury: a prospective cohort study of 16,385 forest industry employees.
abstract: BACKGROUND
  A previous review showed that high stress increases the risk of occupational injury by three- to five-fold. However, most of the prior studies have relied on short follow-ups. In this prospective cohort study we examined the effect of stress on recorded hospitalised injuries in an 8-year follow-up.
  
  
  METHODS
  A total of 16,385 employees of a Finnish forest company responded to the questionnaire. Perceived stress was measured with a validated single-item measure, and analysed in relation recorded hospitalised injuries from 1986 to 2008. We used Cox proportional hazard regression models to examine the prospective associations between work stress, injuries and confounding factors.
  
  
  RESULTS
  Highly stressed participants were approximately 40% more likely to be hospitalised due to injury over the follow-up period than participants with low stress. This association remained significant after adjustment for age, gender, marital status, occupational status, educational level, and physical work environment.
  
  
  CONCLUSIONS
  High stress is associated with an increased risk of severe injury.
authors.forename: Simo
authors.initials: S
authors.lastname: Salminen
authors.affiliation: UKCRC Centre of Excellence for Public Health (NI), Queen's University, Belfast, UK. anne.kouvonen@helsinki.fi.
authors.forename: Anne
authors.initials: A
authors.lastname: Kouvonen
authors.forename: Aki
authors.initials: A
authors.lastname: Koskinen
authors.forename: Matti
authors.initials: M
authors.lastname: Joensuu
authors.forename: Ari
authors.initials: A
authors.lastname: Väänänen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005387:Finland; D065928:Forests; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009786:Occupational Health Services; D060051:Occupational Injuries / Q000453:epidemiology* / Q000473:pathology / Q000523:psychology; D011446:Prospective Studies; D012307:Risk Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D017132:Workplace