Common infections and the role of burnout in a Dutch working population

Objective: To determine if burnout is a risk factor for common cold, flu-like illness and gastroenteritis. Methods: We conducted a prospective cohort study among 12,140 employees at baseline, using three consecutive self-administered questionnaires. The Maslach Burnout Inventory-General Survey (MBI-GS) was used to define employees with burnout complaints (Level 1) and clinical burnout (Level 2). The cross-sectional relationship between burnout and the occurrence of common infections was assessed at baseline, using logistic regression analysis. Survival analysis with Cox regression was performed to study the longitudinal relationship between burnout and the subscales of the MBI-GS as risk factors for common infections. Results: For both levels of burnout, an increased incidence of common infections was found at baseline. The largest effect was found for the relationship between burnout and gastroenteritis (OR: 1.86, Cl: 1.57-2.21 for Level 1 and OR: 3.59, Cl: 2.09-6.17 for Level 2). The longitudinal analyses showed comparable results, although less pronounced. The largest effect was again found for gastroenteritis (RR: 1.55, CL 1.28-1.86 for Level 1 and RR: 2.09, Cl: 1.09-3.98 for Level 2). For flu-like illness and common cold, we found smaller but significant effects at Level 1, but not at Level 2. The subscale Exhaustion was found to be the strongest predictor for infections at both levels of burnout. Conclusions: This study provides evidence for burnout as a risk factor for common infections in a large heterogeneous population. Taking into account that burnout or its subscales are not primary etiological agents for these common infections, the observed effects are large. (C) 2003 Elsevier Inc. All rights reserved.