BACKGROUND: Psychological stress can affect airway inflammatory response to irritants and allergens, but the importance of stress in the etiology of adult-onset respiratory and dermatologic allergic disorders remains unclear. We aim to address the relationship between perceived stress and the risk of adult-onset asthma, allergic rhinitis, atopic dermatitis, and asthma/bronchitis medication. METHODS: Participants (n = 9785) from the Copenhagen City Heart Study, Denmark, free of atopic disorders at baseline in 1981-1983 were asked questions on stress intensity and frequency. They were followed for first-time asthma hospitalization in nationwide registers until 2010, with < 0.1% loss to follow-up. Objective measures of lung function allowed for thorough adjustment for confounding and prevented ambiguity between diagnosis of asthma and chronic obstructive lung disease. Daily intake of asthma/bronchitis medication and incidence of asthma, allergic rhinitis, and atopic dermatitis were assessed by self-report after 10 years of follow-up in 5648 persons. RESULTS: Perceived stress was associated with atopic disorders in a dose-dependent manner (P(trend) < 0.001). High vs low stress was associated with higher risk of self-reported asthma incidence (OR = 2.32; 95% CI: 1.47-3.65), daily intake of asthma/bronchitis medication (OR = 2.26; 95% CI: 1.42-3.58), first-time asthma hospitalization (HR = 2.01; 95% CI: 1.41-2.86), allergic rhinitis (OR = 1.64; 95% CI: 0.99-2.72), and atopic dermatitis (OR = 1.75; 95% CI: 1.11-2.77). The associations were similar for smokers and nonsmokers. CONCLUSIONS: Stress is strongly associated with asthma incidence and hospitalization, use of asthma medication as well as with allergic rhinitis and atopic dermatitis in adults.
BACKGROUND: Psychological stress can affect airway inflammatory response to irritants and allergens, but the importance of stress in the etiology of adult-onset respiratory and dermatologic allergic disorders remains unclear. We aim to address the relationship between perceived stress and the risk of adult-onset asthma, allergic rhinitis, atopic dermatitis, and asthma/bronchitis medication. METHODS:Participants (n = 9785) from the Copenhagen City Heart Study, Denmark, free of atopic disorders at baseline in 1981-1983 were asked questions on stress intensity and frequency. They were followed for first-time asthma hospitalization in nationwide registers until 2010, with < 0.1% loss to follow-up. Objective measures of lung function allowed for thorough adjustment for confounding and prevented ambiguity between diagnosis of asthma and chronic obstructive lung disease. Daily intake of asthma/bronchitis medication and incidence of asthma, allergic rhinitis, and atopic dermatitis were assessed by self-report after 10 years of follow-up in 5648 persons. RESULTS: Perceived stress was associated with atopic disorders in a dose-dependent manner (P(trend) < 0.001). High vs low stress was associated with higher risk of self-reported asthma incidence (OR = 2.32; 95% CI: 1.47-3.65), daily intake of asthma/bronchitis medication (OR = 2.26; 95% CI: 1.42-3.58), first-time asthma hospitalization (HR = 2.01; 95% CI: 1.41-2.86), allergic rhinitis (OR = 1.64; 95% CI: 0.99-2.72), and atopic dermatitis (OR = 1.75; 95% CI: 1.11-2.77). The associations were similar for smokers and nonsmokers. CONCLUSIONS: Stress is strongly associated with asthma incidence and hospitalization, use of asthma medication as well as with allergic rhinitis and atopic dermatitis in adults.
Authors: Felix Forster; Tobias Weinmann; Jessica Gerlich; Wolff Schlotz; Gudrun Weinmayr; Jon Genuneit; Doris Windstetter; Christian Vogelberg; Erika von Mutius; Dennis Nowak; Katja Radon Journal: Int Arch Occup Environ Health Date: 2019-01-18 Impact factor: 3.015
Authors: Patricia F Coogan; Jeffrey Yu; George T O'Connor; Timothy A Brown; Julie R Palmer; Lynn Rosenberg Journal: Ann Allergy Asthma Immunol Date: 2014-01-17 Impact factor: 6.347
Authors: Patricia F Coogan; Jeffrey Yu; George T O'Connor; Timothy A Brown; Yvette C Cozier; Julie R Palmer; Lynn Rosenberg Journal: Chest Date: 2014-03-01 Impact factor: 9.410
Authors: Kathi L Heffner; Janice K Kiecolt-Glaser; Ronald Glaser; William B Malarkey; Gailen D Marshall Journal: Ann Allergy Asthma Immunol Date: 2014-04-13 Impact factor: 6.347