How do job decision latitude and social support at work relate to asthma self-management at work and asthma morbidity? A cross-sectional study

Adverse psychosocial working conditions-in particular poor job decision latitude (JDL) and poor social support at work-may impair the effective implementation of asthma self-management behaviour (SMB) at work and may be associated with more pronounced asthma morbidity. In this study, we investigate for the first time the association of JDL and social support at work with i) different asthma-specific SMBs at work (i.e., physical activity, trigger avoidance, acute symptom management, and communication) and with ii) asthma control and asthma-related quality of life (QoL).

A total of 221 employees with asthma recruited through three rehabilitation clinics completed questionnaires (response rate = 29.3%). JDL and social support were measured using items from the Copenhagen Psychosocial Questionnaire. The four domains of asthma SMB were mainly assessed by self-developed items. We used the Asthma Control Test and the Marks Asthma QoL Questionnaire to measure asthma morbidity. We dichotomized all variables and conducted logistic regressions to calculate odds ratios (ORs) with 95% confidence intervals.

Low JDL and low social support were significantly associated with poorer trigger avoidance (ORs≥2.05), low JDL also with poorer acute symptom management (OR = 6.32), low social support additionally with significantly less communication (OR = 2.95). Low JDL and low social support were significantly associated with poorer asthma control (ORs≥1.94), low social support also with poorer asthma-related QoL (OR = 2.26). The relationships with asthma morbidity were attenuated after adjustment for asthma SMBs (ORs ranging from 1.1 – 1.9).

Adverse psychosocial working conditions may contribute to poorer asthma SMB at work and to increased asthma morbidity. The latter association may be mediated by asthma SMB.