title: Job strain, bullying and violence at work and asthma in Peruvian cleaners-a cross-sectional analysis.
abstract: An increased asthma prevalence was found in cleaners. Many of them work in precarious employment conditions, potentially leading to stress, a known risk factor for asthma. We aimed to analyze whether asthma in cleaners might partly be explained by psychosocial working conditions.
  
  
  
  The study population of this cross-sectional study included 199 cleaners employed at regional public health services in Puno Province (Peru). They were compared to 79 unexposed workers from Lima, Peru (response 83%). Both groups answered the short version of the European Working Condition Survey and a modified version of the European Community Respiratory Health screening questionnaire. After multiple imputation, the association between psychosocial working conditions and asthma (wheeze without cold or use of asthma medication) was assessed.
  
  
  
  The 12-months prevalence of asthma was 22% among cleaners versus 5% among unexposed workers (pChi(2) = .001). Cleaners were more likely than unexposed workers to work with temporary or sub-contracts, have a high employment insecurity, high strain working conditions and low social support (all pChi(2) < .05). Twenty-six percent vs. 10% reported a high bullying score; 39% vs. 8% had experienced violence at work (both pChi(2) < .001). High bullying score (adjusted Odds Ratio 5.6; 95% Confidence Interval 1.5-21.4) and violence (2.4; 1.1-5.4) were the main predictors of asthma. Taking these factors into account, being a cleaner was not statistically significantly associated with the outcome (3.5; 0.9-13.8).
  
  
  
  Poor psychosocial working conditions of cleaners may partly explain the high prevalence of asthma. The underlying mechanism might be a stress-induced inflammatory immune response.
authors.affiliation: a Center for International Health at the Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Member of DZL, German Centre for Lung Research , Munich , Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Radon
authors.affiliation: b Social Health Insurance , Care Net Puno, Center for Prevention of Work-related Risks , Puno , Perú
authors.forename: Uriel
authors.initials: U
authors.lastname: Llanqui
authors.affiliation: c Cardioclinic , Occupational and Preventive Health Center , San Borja, Lima , Perú
authors.forename: Andrés
authors.initials: A
authors.lastname: Arce
authors.affiliation: a Center for International Health at the Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Member of DZL, German Centre for Lung Research , Munich , Germany.
authors.forename: Ronald
authors.initials: R
authors.lastname: Herrera
authors.affiliation: d Research Unit Applied Medicine and Psychology at Work , Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU) , Munich , Germany.
authors.forename: Britta
authors.initials: B
authors.lastname: Herbig
authors.affiliation: a Center for International Health at the Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Member of DZL, German Centre for Lung Research , Munich , Germany.
authors.forename: Dennis
authors.initials: D
authors.lastname: Nowak
authors.affiliation: a Center for International Health at the Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Member of DZL, German Centre for Lung Research , Munich , Germany.|e Consultant in Occupational Health and Health Promotion , Providencia, Santiago , Chile.
authors.forename: Manuel
authors.initials: M
authors.lastname: Parra
mesh_terms: D001249:Asthma / Q000453:epidemiology*; D058445:Bullying; D005260:Female; D006796:Household Work / Q000706:statistics & numerical data*; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D016017:Odds Ratio; D010568:Peru / Q000453:epidemiology; D013315:Stress, Psychological; D017132:Workplace; D064450:Workplace Violence; D055815:Young Adult
keywords: Asthma; Peru; developing country; occupational; social support; workplace violence