Psychosocial working conditions—in terms of job decision authority, among others—may influence asthma self-management at work and in leisure time, as recent qualitative research has shown. We sought to statistically investigate potential relationships between job decision authority and two types of self-management behaviours: physical activity (PA) and visits to the general practitioner (GP).
We combined data from waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe (SHARE) for cross-sectional analyses. The sample was restricted to participants who were employed and reported asthma but no other chronic lung disease (n = 387). The three key variables were each measured by one item. We estimated the prevalence ratios of adequate PA (i.e., more than once a week) and regular GP visits (i.e., ≥ 4 per year) according to job decision authority (low vs. high) using Poisson regression with the robust variance.
We found no evidence of a relationship between job decision authority and PA. However, employees with low levels of job decision authority had a higher prevalence of reporting that they consulted their GP at least four times per year (prevalence ratio = 1.30; 95% confidence interval = 1.03–1.65).
This study was the first to quantitatively investigate the relationship between job decision authority and PA specifically among individuals with asthma. Our results contradict prior epidemiological studies among general working populations, which reported a positive relationship between job decision authority and PA. Our results concerning the association between low job decision authority and more GP visits are inconsistent with our qualitative findings but supported by epidemiological studies among general occupational samples.
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Barros AJ, Hirakata VN (2003) Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol 3:21. https://doi.org/10.1186/1471-2288-3-21
Bean CG, Winefield HR, Sargent C, Hutchinson AD (2015) Differential associations of job control components with both waist circumference and body mass index. Soc Sci Med 143:1–8. https://doi.org/10.1016/j.socscimed.2015.08.034
Bíró A (2016) Outpatient visits after retirement in Europe and the US. Int J Health Econ Manag 16:363–385. https://doi.org/10.1007/s10754-016-9191-7
Börsch-Supan A, Brandt M, Hunkler C et al (2013) Data resource profile: the Survey of Health, Ageing and Retirement in Europe (SHARE). Int J Epidemiol 42:992–1001. https://doi.org/10.1093/ije/dyt088
Carson KV, Chandratilleke MG, Picot J, Brinn MP, Esterman AJ, Smith BJ (2013) Physical training for asthma. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD001116.pub4
Cheval B, Sieber S, Guessous I et al (2017) Effect of early-and adult-life socioeconomic circumstances on physical inactivity. Med Sci Sports Exerc. https://doi.org/10.1249/MSS.0000000000001472
Choi B, Schnall P, Haiou Y et al (2010) Psychosocial working conditions and active leisure-time physical activity in middle-aged US workers. Int J Occup Med Environ Health 23:239–253. https://doi.org/10.2478/v10001-010-0029-0
Dumas O, Le Moual N, Siroux V et al (2013) Work related asthma. A causal analysis controlling the healthy worker effect. Occup Environ Med 70:603–610. https://doi.org/10.1136/oemed-2013-101362
Durand M-J, Vézina N, Baril R, Loisel P, Richard M-C, Ngomo S (2009) Margin of manoeuvre indicators in the workplace during the rehabilitation process: a qualitative analysis. J Occup Rehabil 19:194–202. https://doi.org/10.1007/s10926-009-9173-4
Eichenberger PA, Diener SN, Kofmehl R, Spengler CM (2013) Effects of exercise training on airway hyperreactivity in asthma: a systematic review and meta-analysis. Sports Med 43:1157–1170. https://doi.org/10.1007/s40279-013-0077-2
Ferrario MM, Roncaioli M, Veronesi G et al (2018) Differing associations for sport versus occupational physical activity and cardiovascular risk. Heart 104:1165–1172. https://doi.org/10.1136/heartjnl-2017-312594
Global Initiative for Asthma (2018) Pocket Guide for asthma management and prevention (updated 2018). https://ginasthma.org/download/836/. Accessed 23 Oct 2018
Grover H, Higgins B (2016) GPs have key role in improving outcomes in acute asthma. Pract 260:15–19
Heinrichs K, Vu-Eickmann P, Hummel S, Gholami J, Loerbroks A (2018) What are the perceived influences on asthma self-management at the workplace? A qualitative study. BMJ Open 8:e022126. https://doi.org/10.1136/bmjopen-2018-022126
Holtermann A, Krause N, Van Der Beek AJ, Straker L (2018) The physical activity paradox: six reasons why occupational physical activity (OPA) does not confer the cardiovascular health benefits that leisure time physical activity does. BMJ Publ Group Ltd Br Assoc Sport Exer Med 1:1. https://doi.org/10.1136/bjsports-2017-097965
Joensuu M, Kivimäki M, Koskinen A et al (2012) Differential associations of job control components with mortality: a cohort study, 1986–2005. Am J Epidemiol 175:609–619
Johansson G, Lundberg I (2004) Adjustment latitude and attendance requirements as determinants of sickness absence or attendance. Empirical tests of the illness flexibility model. Soc Sci Med 58:1857–1868. https://doi.org/10.1016/S0277-9536(03)00407-6
Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B (1998) The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol 3:322
Kotses H, Creer T (2010) Asthma self-management. In: Harver A, Kotses H (eds) Asthma, health and society. Springer, New York, pp 117–139
Kouvonen A, Kivimäki M, Elovainio M, Virtanen M, Linna A, Vahtera J (2005) Job strain and leisure-time physical activity in female and male public sector employees. Prev Med 41:532–539. https://doi.org/10.1016/j.ypmed.2005.01.004
Kouvonen A, Vahtera J, Oksanen T et al (2012) Chronic workplace stress and insufficient physical activity: a cohort study. Occup Environ Med 70:3–8. https://doi.org/10.1136/oemed-2012-100808
Li J, Loerbroks A, Angerer P (2013) Physical activity and risk of cardiovascular disease: what does the new epidemiological evidence show? Curr Opin Cardiol 28:575–583. https://doi.org/10.1097/HCO.0b013e328364289c
Loerbroks A, Herr RM, Subramanian S, Bosch JA (2012) The association of asthma and wheezing with major depressive episodes: an analysis of 245 727 women and men from 57 countries. Int J Epidemiol 41:1436–1444. https://doi.org/10.1093/ije/dys123
Loerbroks A, Karrasch S, Lunau T (2017) The longitudinal relationship of work stress with peak expiratory flow: a cohort study. Int Arch Occup Environ Health 90:695–701. https://doi.org/10.1007/s00420-017-1232-0
Loerbroks A, Bosch JA, Sheikh A, Yamamoto S, Herr RM (2018) Reports of wheezing and of diagnosed asthma are associated with impaired social functioning: secondary analysis of the cross-sectional World Health Survey data. J Psychosom Res 105:52–57. https://doi.org/10.1016/j.jpsychores.2017.12.008
Mäcken J (2019) Work stress among older employees in Germany: effects on health and retirement age. PLoS One 14:e0211487. https://doi.org/10.1371/journal.pone.0211487
Mammen J, Rhee H (2012) Adolescent asthma self-management: a concept analysis and operational definition. Pediatr Allergy Immunol Pulmonol 25:180–189. https://doi.org/10.1089/ped.2012.0150
Marques A, Peralta M, Sarmento H, Martins J, González Valeiro M (2018) Associations between vigorous physical activity and chronic diseases in older adults: a study in 13 European countries. Eur J Public Health. https://doi.org/10.1093/eurpub/cky086
Memel M, Bourassa K, Woolverton C, Sbarra DA (2016) Body mass and physical activity uniquely predict change in cognition for aging adults. Ann Behav Med 50:397–408. https://doi.org/10.1007/s12160-015-9768-2
Mirabelli MC, Beavers SF, Flanders WD, Chatterjee AB (2014) Reliability in reporting asthma history and age at asthma onset. J Asthma 51:956–963. https://doi.org/10.3109/02770903.2014.930480
Parslow RA, Jorm AF, Christensen H, Broom DH, Strazdins L, Souza R (2004) The impact of employee level and work stress on mental health and GP service use: an analysis of a sample of Australian government employees. BMC Public Health 4:41. https://doi.org/10.1186/1471-2458-4-41
Steenbeek R (2012) The importance of job characteristics in determining medical care-seeking in the Dutch working population, a longitudinal survey study. BMC Health Serv Res 12:294. https://doi.org/10.1186/1472-6963-12-294
The global asthma report 2018 (2018) Auckland, New Zealand: Global Asthma Network. http://globalasthmareport.org/Global%20Asthma%20Report%202018.pdf. Accessed 23 Oct 2018
Tinkelman DG, Price DB, Nordyke RJ, Halbert R (2006) Misdiagnosis of COPD and asthma in primary care patients 40 years of age and over. J Asthma 43:75–80. https://doi.org/10.1080/02770900500448738
The SHARE data collection has been primarily funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), and FP7 (SHARE-PREP: No. 211909, SHARE-LEAP: No. 227822, SHARE M4: No. 261982). Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the U.S. National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C), and from various national funding sources is gratefully acknowledged (see www.share-project.org). Our work was supported by refonet—Rehabilitation Research Network of the German Pension Fund Rhineland, grant number 14006.
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Waves 1 and 2 received ethical approval by the ethics committee of the University of Mannheim, Germany.
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Heinrichs, K., Li, J. & Loerbroks, A. General practitioner visits and physical activity with asthma—the role of job decision authority: a cross-sectional study. Int Arch Occup Environ Health 92, 1173–1178 (2019). https://doi.org/10.1007/s00420-019-01456-x
- Health care utilization
- Job decision authority
- Physical activity
- Survey of Health, Ageing and Retirement in Europe