Job strain, bullying and violence at work and asthma in Peruvian cleaners—a cross-sectional analysis

Abstract

Objectives: 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. Methods: 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. Results: The 12-months prevalence of asthma was 22% among cleaners versus 5% among unexposed workers (p_Chi² = .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 p_Chi² < .05). Twenty-six percent vs. 10% reported a high bullying score; 39% vs. 8% had experienced violence at work (both p_Chi² < .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). Conclusions: 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.

Keywords:

• Asthma
• occupational
• social support
• workplace violence
• developing country
• Peru

Acknowledgements

The authors thank Alberto Ramírez, Wilbert Bueno and Pamela Ramos for the fieldwork in Puno (Peru). We acknowledge the participation of the study population, which made this analysis possible.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Funding

The Center for International Health at the Ludwig-Maximilians-University is supported by the German Academic Exchange Service (DAAD) via the Exceed Program funded by the German Federal Ministry of Economic Collaboration and Development (BMZ). Uriel Llanqui received a scholarship from MAN Studienstiftung. Ronald Herrera received a scholarship for doctoral studies from Colciencias (Departamento Administrativo de Ciencia, Tecnología e Innovación de Colombia). The Cardioclinic (Lima, Perú) supported the study. The funders had no role in the study design, data collection, analysis, conclusions, the writing of the article or the decision to submit for publication.