Work stress, asthma control and asthma-specific quality of life: initial evidence from a cross-sectional study

Background: Research has suggested that psychological stress is positively associated with asthma morbidity. One prominent and prevalent source of stress in adulthood is one's occupation. However, to date, potential links of work stress with asthma control or asthma-specific quality of life have not been examined.

Objective: To address the above-mentioned knowledge gap.

Methods: In 2014/2015, we conducted a cross-sectional study among adults with asthma in Germany (n = 362). For the current analyses that sample was restricted to participants in employment and reporting to have never been diagnosed with chronic obstructive pulmonary disease (n = 94). Work stress was operationalized by the 16-item effort-reward-imbalance (ERI) questionnaire, which measures the subcomponents “effort”, “reward” and “overcommitment”. Participants further completed the Asthma Control Test and the Asthma Quality of Life Questionnaire-Sydney. Multivariable associations were quantified by linear regression and logistic regression.

Results: Effort, reward and their ratio (i.e. ERI ratio) did not show meaningful associations with asthma morbidity. By contrast, increasing levels of overcommitment were associated with poorer asthma control and worse quality of life according to both linear regression (ß=-0.24 with p = 0.02 and ß= 0.39 with p = 0.01, respectively) and logistic regression (odds ration [OR]= 1.76 with 95% confidence interval [CI]= 1.08 – 2.86 and OR = 1.97, 95% CI = 1.15 – 3.36, respectively).

Conclusion: The present study provides initial evidence of a positive relationship of work-related overcommitment with asthma control and asthma-specific quality of life. Longitudinal studies with larger samples are needed to confirm our findings and to disentangle potential causality of associations.