267676 Occupational disparities in physiologic stress among U.S. workers

Sunday, October 28, 2012

Alberto Caban-Martinez, PhD, DO, MPH, CPH , Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, FL
Frank C. Bandiera, MPH , Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, FL
Tainya C. Clarke, MPH, MS , Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine, Miami, FL
Manuel Ocasio, BA , Department of Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, FL
Diana Kachan, BS , Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, FL
Brittny Major, BS , Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, FL
Kristopher L. Arheart, EdD , Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine - NIOSH Research Group, Miami, FL
Lora E. Fleming, MD, PhD , OHH Center & Red Tide Research Group, University of Miami, Key Biscayne, FL
David Lee, PhD , Epidemiology & Public Health, University of Miami, Miami, FL
Introduction: Occupational stress, associated with increased rates of morbidity and possibly mortality, has become a serious US worker health issue. As a conceptual framework for the cumulative wear and tear on the body caused by physiological responses to stressors, "Allostatic Load (AL)" may serve as an objective global stress measure. We examined US data for average AL scores and the proportion of high scores by employment type, 40 specific occupational groups, and four broad-based sectors; and describe the association between job type and AL.

Methods: We used data from the 2003-2004 National Health and Nutrition Examination Survey (NHANES) for adults (≥ 17 years old) participating in both a comprehensive medical examination and questionnaire that reported on their occupational status and job type (n=5,328). We developed an AL index guided by the literature that included 10 biomarkers. We further categorized participants by employment status into one of 40 specific occupational groups and by socio-demographic characteristics.

Results: Blue-collar workers had a higher proportion (39.1%) experiencing greater physiological stress (with AL index score of ≥3) than white-collar (37.4%), farm (36.8%) or service (33.6%) workers. Adults employed as construction laborers (47.0%) and protective service occupations (51.3%) had the two highest mean AL scores. After adjustment for socio-demographic indicators, blue-collar workers were significantly more likely to experience higher physiologic stress than white-collar workers (adjusted odds ratio= 1.44; 95%CI [1.09ĘC1.91])

Discussion: Given that stress is a modifiable risk factor, workplace intervention efforts at preventing high stress levels among occupations at risk may be warranted.

Learning Areas:
Basic medical science applied in public health
Epidemiology
Occupational health and safety
Public health biology

Learning Objectives:
Explain the use of Allostatic Load to measure stress. List which worker groups have the highest levels of physiologic stress. Describe the relationship between physiologic stress, employment and specific occupation type.

Keywords: Epidemiology, Occupational Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceived this study and lead the analysis phase. I am board certified in public health and hold a doctoral degree in epidemiology.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.