title: Job insecurity is associated with adult asthma in Germany during Europe's recent economic crisis: a prospective cohort study.
abstract: BACKGROUND
  Job insecurity has been identified as a risk factor for adverse health outcomes. Perceptions of job insecurity steeply increased during Europe's recent economic downturn, which commenced in 2008. The current study assessed whether job insecurity was associated with incident asthma in Germany during this period.
  
  
  METHODS
  We used prospective data from the German Socio-Economic Panel for the period 2009-2011 (follow-up rate=77.5%, n=7031). Job insecurity was defined by respondents' ratings of the probability of losing their job within the next 2 years and asthma as self-reports of physician-diagnosed asthma. Associations between job insecurity in 2009 (continuous z-scores or categorised variables) and incident asthma by 2011 were assessed using multivariable Poisson regression.
  
  
  RESULTS
  The risk of asthma increased significantly by 24% with every one SD increase of the job insecurity variable. In dichotomised analyses, a probability of job loss of ≥50% (vs <50%) was associated with a 61% excess risk of asthma. A trichotomous categorisation of job insecurity confirmed this finding.
  
  
  CONCLUSIONS
  This study has shown, for the first time, that perceived job insecurity may increase the risk of new onset asthma. Further prospective studies may examine the generalisability of our findings and determine the underlying mechanisms.
authors.affiliation: Institute of Occupational and Social Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Adrian
authors.initials: A
authors.lastname: Loerbroks
authors.affiliation: Department of Clinical Psychology, University of Amsterdam, The Netherlands.
authors.forename: Jos A
authors.initials: JA
authors.lastname: Bosch
authors.affiliation: Centre for Public Health Research, Massey University, Wellington, New Zealand.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Douwes
authors.affiliation: Institute of Occupational and Social Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Angerer
authors.affiliation: Institute of Occupational and Social Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology*; D057172:Economic Recession; D004651:Employment / Q000523:psychology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D036301:Qualitative Research; D014478:Unemployment / Q000523:psychology
keywords: ASTHMA; EPIDEMIOLOGY; OCCUPATIONAL HEALTH; PSYCHOLOGICAL STRESS; Work stress