A streamlined approach for assessing the Allostatic Load Index in industrial employees

Stress. 2015;18(4):475-83. doi: 10.3109/10253890.2015.1040987. Epub 2015 May 15.

Abstract

Work stress is common and can lead to various bodily dysfunctions. The Allostatic Load Index (ALI) is a tool to measure the wear and tear of the body caused by chronic stress. This cross-sectional study aimed to explore the association of work-related stress and ALI in German industrial employees. A short form ALI should be developed for practical use of company physicians. In this exploration of an industrial cohort (n = 3797; 79.3% male), work stress was measured by the effort-reward imbalance (ERI) questionnaire in 2009-2011. ALI was calculated using 15 variables including anthropometric data, heart rate variability, as well as blood and urine samples based on predefined subclinical cut-off values. Differences in ALI related to low (≤1) and high (>1) ERI categories were tested. Logistic regression models estimated odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the association between ALI and work stress controlling for multiple confounders. Employees exposed to high work stress showed higher ALI scores (p < 0.001) compared to those with low stress levels. In multivariable models, ALI was associated with work stress (OR 1.19 [95% CI: 1.00, 1.42]; p < 0.05) following adjustment for a range of potential confounders. By reducing ALI parameters to five variables this association increased modestly and remained statistically significant (OR 1.27 [95% CI: 1.05, 1.54]; p < 0.05). The results indicate that work stress is associated with ALI in German industrial employees. A short form index seems to be a promising approach for occupational health practitioners. The results should be validated in further longitudinal explorations defining a standard set of variables including gender-related thresholds.

Keywords: Allostatic load; corporate health management; effort–reward imbalance; employees; heart rate variability; psychosocial load; work stress.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aircraft
  • Albuminuria
  • Allostasis*
  • Blood Glucose / metabolism
  • Blood Pressure
  • Body Mass Index
  • C-Reactive Protein / metabolism
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Creatinine / blood
  • Cross-Sectional Studies
  • Engineering
  • Female
  • Glycated Hemoglobin / metabolism
  • Heart Rate*
  • Humans
  • Leukocyte Count
  • Logistic Models
  • Male
  • Manufacturing Industry
  • Middle Aged
  • Occupational Health*
  • Odds Ratio
  • Reward
  • Stress, Psychological / metabolism
  • Stress, Psychological / physiopathology*
  • Surveys and Questionnaires
  • Triglycerides / blood
  • Waist Circumference
  • Waist-Hip Ratio
  • Young Adult

Substances

  • Blood Glucose
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Glycated Hemoglobin A
  • Triglycerides
  • hemoglobin A1c protein, human
  • C-Reactive Protein
  • Cholesterol
  • Creatinine