Work Stress and Metabolic Syndrome in Police Officers. A Prospective Study

Physical exercise behavior characteristics and influencing factors for participation in police officers

Objective

The purpose of this study was to analyze police officers' exercise participation behavior and influencing factors in order to better promote physical exercise participation and improve the health status of the police force.

Methods

Police officers (n = 3,682) were recruited from 16 district public security substations in a city in eastern China to investigate their physical exercise participation and influencing factors, and logistic regression analysis was used to investigate three aspects: exercise behavior, health cognition, and influencing factors.

Findings

The physical exercise behavior of police officers showed long duration of time, but low frequency and intensity. The exercise programs were diverse but mainly involved running. The exercise motivation was mainly to keep fit and for stress relief. Logistic regression analysis indicated that source of police entry (OR = 1.467, 95% CI: 1.338-1.609), exercise conditions in the workplace (OR = 1.069, 95% CI: 1.051-1.088), exercise conditions near home (OR = 1.123, 95% CI: 1.047-1.205), high volume physical labor during work resulting in little time for exercise (OR = 1.372, 95% CI: 1.038-1.813), lack of organization (OR = 1.415, 95% CI: 1.164-1.720), economic condition constraints (OR = 1.439, 95% CI: 1.114-1.858), and weather restrictions (OR = 2.929, 95% CI: 2.418-3.548) were the main factors influencing police physical exercise behavior.

Conclusion

Various influencing factors and the nature of actual police work presented barriers to police officers' participation in physical exercise. Interventions to increase physical exercise participation would promote the physical health of police officers.

Proposal of a workplace classification model for heart attack accidents from the field of occupational safety and health engineering

Research on occupational accidents is a key factor in improving working conditions and sustainability. Fatal accidents incur significant human and economic costs. Therefore, it is essential to examine fatal accidents to identify the factors that contribute to their occurrence. This study presents an overview of fatal heart attack accidents at work in Spain over the period 2009-2021. Descriptive analysis was conducted considering 13 variables classified into five groups. These variables were selected as predictors to determine the occurrence of this type of accident using a machine learning technique. Thirteen Naïve Bayes prediction models were developed using an unbalanced dataset of 15,616 valid samples from the Spanish Delta@database, employing a two-stage algorithm. The final model was retained using a General Performance Score index. The model selected for this study used a 70:30 distribution for the training and test datasets. A sample was classified as a fatal heart attack if its posterior probability exceeded 0.25. This model is assumed to be a compromise between the confusion matrix values of each model. Sectors with the highest number of heart attacks are 'Health and social work', 'Transport and storage', 'Manufacturing', and 'Construction'. The incidence of heart attacks and fatal heart attack accidents is higher in men than in women and higher in private sector employees. The findings and model development may assist in the formulation of surveillance strategies and preventive measures to reduce the incidence of heart attacks in the workplace.

Correlation analysis of occupational stress and metabolic syndrome among employees of a power grid enterprise in China

BACKGROUND

Being in a state of high occupational stress may disrupt the metabolic balance of the body, thus increasing the risk of metabolic diseases. However, the evidence about the relationship between occupational stress and metabolic syndrome was limited.

OBJECTIVES

To explore the association between occupational stress and metabolic syndrome (MetS) in employees of a power grid enterprise.

METHODS

A total of 1091 employees were recruited from a power grid enterprise in China. Excluding those who failed to complete the questionnaire and those who had incomplete health check-ups, 945 subjects were included in the study. Assessment of occupational stress was used by job demand-control (JDC) and effort-reward imbalance (ERI) questionnaires, respectively. The information on body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were collected. The levels of high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and fasting blood glucose (FBG) in the fasting venous blood samples were measured. Logistic regression analysis and multiple linear regression methods were used to analyze the correlation between JDC and ERI models of occupational stress, metabolic syndrome, and its components, respectively.

RESULTS

The prevalence of MetS was 8.4% and 9.9% in JDC and ERI model high occupational stress employees, respectively. ERI model occupational stress and smoking are significantly associated with the risk of MetS. ERI ratio was significantly associated with lower HDL-C levels. Gender, age, marital status, smoking, high-temperature and high-altitude work were significantly associated with metabolic component levels.

CONCLUSION

Our study revealed a high detection rate of occupational stress in both JDC and ERI models among employees of a power grid enterprise. ERI model occupational stress, demanding more attention, was associated with the risk of MetS as well as its components such as HDL-C.

A comparative analysis of sleep quality and time management skills between shift and non-shift police officers

PURPOSE

The sleep quality of police officers working in shifts is negatively affected due to long working hours and sleeping less during the day. In our study, we aimed to examine the differences in sleep quality and time management skills in police officers working with shift and non-shift system.

METHODS

106 police officers, 46 of whom worked in the shift system, 60 of whom worked in the non-shift system, and whose mean age was 27.6 ± 0.9 [min 20, max 40] were included in the study. Sleep quality was assessed with the Pittsburgh Sleep Quality Index[PSQI] and time management skills with the Time Management Questionnaire[TMQ].

RESULTS

While the TMQ total score was 80.91 ± 12.61 for police officers working in shifts, it was 72.41 ± 12.62 for police officers working non-shift. The PSQI total score was 5 in both groups. There was a difference between the TMQ time planning, TMQ time attitudes sub-dimensions, and TMQ total scores of police officers working in the shift system and those working in the non-shift system[p < 0.05]. While poor sleep quality was observed between both groups, there was no difference in sleep quality[p > 0.05].

CONCLUSION

There was no difference in sleep quality between police officers working in shifts and non-shifts. However, the time management skills of police officers working in shifts were better than those of police officers working in non-shifts. We believe that training programs to improve sleep health and time management skills in police officers are needed for both the sleep quality and well-being of police officers and public safety.

Correlation analysis between occupational stress and metabolic syndrome in workers of a petrochemical enterprise: based on two assessment models of occupational stress

BACKGROUND

Occupational stress is becoming a common phenomenon around the world. Being in a high occupational stress state for a long time may destroy the metabolic balance of the body, thereby increasing the risk of metabolic diseases. There is limited evidence regarding the correlation between occupational stress and metabolic syndrome (MetS), particularly in the petrochemical workers.

METHODS

A total of 1683 workers of a petrochemical enterprise in China were included in the survey by cluster sampling method. The occupational stress assessment was carried out by the Job Content Questionnaire and the Effort-Reward Imbalance Questionnaire, and the general demographic characteristics, work characteristics, occupational hazards, lifestyle and health examination data of the participants were collected. Logistic regression and multiple linear regression were used to analyze the correlations and influencing factors between occupational stress and its dimensions with MetS and its components.

RESULTS

A total of 1683 questionnaires were sent out, and 1608 were effectively collected, with an effective recovery rate of 95.54%. The detection rates of occupational stress in Job Demand-Control (JDC) and Effort-Reward Imbalance (ERI) models were 28.4% and 27.2%, respectively. In this study, 257 participants (16.0%) were diagnosed with MetS. Compared with the non-MetS group, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG) and fasting blood-glucose (FBG) levels were significantly higher in the MetS group, and high density lipoprotein-cholesterol (HDL-C) levels were significantly lower (P < 0.001). The results of multiple linear regression showed that after adjusting for nation, marital status, education, work system, smoking and drinking, and further adjusting for occupational hazards, the D/C ratio was significantly negatively correlated with SBP in the JDC model. Social support was negatively correlated with WC. In the ERI model, there was a significant positive correlation between over-commitment and FBG.

CONCLUSIONS

The detection rates of occupational stress and MetS were high in workers of a petrochemical enterprise. In the JDC model, occupational stress was negatively correlated with SBP, and social support was negatively correlated with WC. In the ERI model, there was a significantly positive correlation between over-commitment and FBG.

Cardiovascular risk, social vigilance, and stress profiles of male law enforcement officers versus civilians

This study examined the cardiovascular disease (CVD) risk profiles of male law enforcement officers (LEOs) and civilians. CVD risk profiles were based on data collected using traditional objective (e.g., resting BP, cholesterol), novel objective (e.g., ambulatory BP) and self-report measures (e.g., EMA social vigilance). A subset of male LEOs (n = 30, M age = 41.47, SD = 8.03) and male civilians (n = 120, M age = 40.73, SD = 13.52) from a larger study were included in analyses. Results indicated LEOs had significantly higher body mass index [BMI], 31.17 kg/m2 versus 28.87 kg/m2, and exhibited significantly higher trait and state social vigilance across multiple measures, whereas perceived stress was higher among civilians. Findings highlight the need for future research examining CVD risk associated with occupational health disparities, including attributes of individuals entering certain professions as well as experiential and environmental demands of the work.

Interactive associations of smoking and physical activity with metabolic syndrome in adult men in Korea

Introduction

This study aimed to investigate the association of smoking and physical activity (PA) with metabolic syndrome (MetS) in adult men in Korea.

Methods

This study analyzed data of 7,229 adult men aged 19-64 years obtained from the 2014-2021 Korea National Health and Nutrition Examination Survey (KNHANES). Information on smoking habits was obtained using KNHANES data, while that on total PA (TPA), leisure-time PA (LTPA), and occupational PA (OPA) was collected using the Global Physical Activity Questionnaire. Smoking status was classified into non-smokers and smokers, and PA was categorized into three groups (total, leisure time, and occupational) according to the time spent engaging in moderate or high-intensity PA areas. The diagnosis of MetS was based on the Adult Treatment Program III of the National Cholesterol Education Program and Koreans' waist circumference criteria.

Results

Logistic regression revealed that the risk of MetS was significantly lower in non-smokers than in smokers, even after adjusting for all covariates. The risk of MetS was significantly lower in individuals who engaged in at least 150 min of moderate- and high-intensity TPA or LTPA per week than in those who did not engage in PA. Furthermore, smokers who engaged in at least 150 min of moderate- to high-intensity TPA and LTPA per week had a significantly lower risk of MetS than those who did not engage in PA. Meanwhile, OPA was not associated with MetS.

Conclusion

The findings suggest that engaging in moderate- to high-intensity TPA or LTPA for at least 150 min per week attenuates the risk of MetS caused by smoking.

Acute and long-term sleep measurements produce opposing results on sleep quality in 8 and 12 hour shift patterns in law enforcement officers

The occupational demands of law enforcement increase the risk of poor-quality sleep, putting officers at risk of adverse physical and mental health. This cross-sectional study aimed to characterise sleep quality in day workers, 8 and 12 h rotating shift pattern workers. One hundred eighty-six officers volunteered for the study (37 female, age: 41 ± 7). Sleep quality was assessed using the Pittsburgh sleep quality index, actigraphy and the Leeds sleep evaluation questionnaire. The maximal aerobic capacity (VO2max ) was measured on a treadmill via breath-by-breath analysis. There was a 70% overall prevalence of poor sleepers based on Pittsburgh sleep quality index scores, where 8 h shifts exhibited the worst prevalence (92%, p = 0.029), however, there was no difference between age, gender, or role. In contrast, 12 h shifts exhibited the poorest short-term measures, including awakening from sleep (p = 0.039) and behaviour following wakefulness (p = 0.033) from subjective measures, and poorer total sleep time (p = 0.024) and sleep efficiency (p = 0.024) from the actigraphy. High VO2max predicted poorer wake after sleep onset (Rsq = 0.07, p = 0.05) and poorer sleep latency (p = 0.028). There was no relationship between the Pittsburgh sleep quality index scores and any of the short-term measures. The prevalence of poor sleepers in this cohort was substantially higher than in the general population, regardless of shift pattern. The results obtained from the long- and short-term measures of sleep quality yielded opposing results, where long-term perceptions favoured the 12 h pattern, but short-term subjective and objective measures both favoured the 8 h pattern.

Validation and Psychometric Properties of the German Operational and Organizational Police Stress Questionnaires

CONTEXT

Working in the police force is an operationally and organizationally stressful job. Suitable psychometric tools are needed to detect and study the psychosocial risks of these professionals. The original version contains 40 items, which may be too long for clinical use or as a research control measure. The main aim of this study is to validate the Police Stress Questionnaire (PSQ) in German. The secondary objective is to validate a shorter version.

METHOD

After translation and counter translation of the PSQ-G by a committee of experts, 10 participants pre-tested the comprehension of an intermediate version, allowing the development of a final version that was submitted to a psychometric validation plan with 2314 German-speaking officers. Structure, reliability, and convergent, divergent, and discriminant validities were tested for each sample.

RESULTS

The German version of the PSQ performed well psychometrically. We have created a short version of 14 items with good psychometric properties, 7 items for each subscale: operational stressors and organizational stressors.

CONCLUSION

This study validated a German version of the PSQ and provides a reliable measure of stress processes in the police force. A short version is now available.

Contributions from incumbent police officer's physical activity and body composition to occupational assessment performance

Introduction

Police officers must perform various tasks in unpredictable work environments and potentially volatile situations. This study aimed to determine if cardiovascular fitness, body composition, and physical activity levels could predict performance in a Midwest Police Department's Physical Readiness Assessment (PRA).

Methods

Researchers collected data from thirty incumbent police officers (33.9 ± 8.3 years, female = 5). Anthropometric data included height, body mass, body fat percentage (BF%), fat-free mass (FFM), and maximal hand grip strength. The police officers also completed a physical activity rating (PA-R) scale to estimate maximal oxygen consumption (V ˙ O2max) and the International Physical Activity Questionnaire (IPAQ). Police officers then conducted their department's PRA. Stepwise linear regression analyses were used to determine the relationship between predictor variables and PRA performance. Pearson's product-moment correlations investigated relationships between anthropometric, physical fitness, and physical activity variables and PRA performance using SPSS (v.28). The significance level was set at p < 0.05.

Results

Descriptive data for the sample includes BF%: 27.85 ± 7.57%, FFM: 65.73 ± 10.72 kg, hand grip strength: 55.51 ± 11.07 kg, weekday sedentary time (WST): 328 ± 28.26 min, weekend day sedentary time (WDST): 310 ± 28.92 min, daily moderate-to-vigorous physical activity (MVPA): 29.02 ± 39.41 min, PRA: 273.6 ± 51.4 s and estimated V ˙ O2max: 43.26 ± 6.35 mL kg-1 min-1. The stepwise regression analyses indicated that BF% was predictive of PRA time (R2 = 0.32, p < 0.01); estimated V ˙ O2max predictive of PRA time (R2 = 0.45, p < 0.001). There were significant correlations between BF % and PRA time (r = 0.57, p < 0.001), PA-R and MVPA (r = 0.71, p < 0.001), %BF % and WDST (r = -0.606, p < 0.001), hand grip and FFM (r = 0.602, p < 0.001) and PA-R and PRA time (r = -0.36, p < 0.05).

Discussion

The results of this exploratory study highlight that higher estimated V ˙ O2max and lower BF% were the best predictors for faster PRA completion times, accounting for 45% and 32% of the variance, respectively. The findings of this study support the need for wellness and fitness initiatives in law enforcement agencies focused on increasing cardiovascular fitness and physical activity while decreasing BF% to ensure optimal performance in policing and overall health.

The association between perceived stress, acculturation, and non-alcoholic fatty liver disease in Mexican-origin adults in Southern Arizona

Although available evidence indicates that Mexican-origin (MO) adults experience unique stressful life events, little is known about how stress may influence risk for developing non-alcoholic fatty liver disease (NAFLD) for this high-risk group. This study investigated the association between perceived stress and NAFLD and explored how this relationship varied by acculturation levels. In a cross-sectional study, a total of 307 MO adults from a community-based sample in the U.S-Mexico Southern Arizona border region completed self-reported measures of perceived stress and acculturation. NAFLD was identified as having a continuous attenuation parameter (CAP) score of ≥ 288 dB/m determined by FibroScan®. Logistic regression models were fitted to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) for NAFLD. The prevalence of NAFLD was 50 % (n = 155). Overall, perceived stress was high (Mean = 15.9) for the total sample. There were no differences by NAFLD status (No NAFLD: Mean = 16.6; NAFLD: Mean = 15.3; p = 0.11). Neither perceived stress nor acculturation were associated with NAFLD status. However, the association between perceived stress and NAFLD was moderated by acculturation levels. Specifically with each point increase in perceived stress, the odds of having NAFLD were 5.5 % higher for MO adults with an Anglo orientation and 1.2 % higher for bicultural MO adults. In contrast, the odds of NAFLD for MO adults with a Mexican cultural orientation were 9.3 % lower with each point increase in perceived stress. In conclusion, results highlight the need for additional efforts to fully understand the pathways through which stress and acculturation may influence the prevalence of NAFLD in MO adults.

Attitudes toward organizational change and their association with exhaustion in a sample of Italian police workers

Introduction

Change management is an important topic for organizations and some personal characteristics may help or hinder coping with change.

Methods

The aim of the present study was to find out whether attitudes toward organizational change can predict work-related exhaustion in a sample of police workers (N = 532) in northern Italy. Differences between groups in relation to role (police officers vs. other roles) and gender were also considered.

Results

The results of hierarchical regression showed that change beliefs were negatively associated to exhaustion, while resistance to change was positively related to exhaustion; role and gender were also significantly and positive associated with the dependent variable. Regarding differences between groups, police officers had lower positive change beliefs and higher levels of exhaustion compared to workers in other roles. Regarding gender, women reported higher levels of exhaustion than men.

Discussion

The results of the present study provide further insights into what aspects should be considered when promoting organizational change in the police work context.

Assessment of the Body Composition and Bone Calcification of Students of Police Schools and Police Training Centers in Poland-A Cross-Sectional Study

The 21st century is considered the age of malnutrition resulting in the unprecedented frequency of civilization diseases. Among these disorders, obesity is particularly distinguished and considered an epidemic-scale disease. For this reason, conducting studies on obesity and counteracting this phenomenon is essential. Research from recent years indicates a problem of excessive body weight among officers of uniformed services, who should be characterized by good health and fitness level due to the specificity of the work. As the problem of obesity affects every fourth Pole, research in uniformed services seems to be essential from health and national security perspectives. The presented study aimed to determine the elements of nutritional status in 289 students of Polish police schools and police training centers. Body composition was determined by bioelectrical impedance analysis, and bone calcification assessment was conducted by the DXA densitometric method. Based on BMI and body fat content, body weight disorders were found in 31.8% of all examined students. Densitometric test results showed changes in bone calcification of varying severity in 26.6% of the total number of respondents. The presence of obesity in students of police schools and training centers proves that the present nutrition model is energetically unbalanced, while the demonstrated disorders of bone calcification indicate an improper condition of mineral nutrition.

Age, Sex, and Profession Difference Among Health Care Workers With Burnout and Metabolic Syndrome in Taiwan Tertiary Hospital-A Cross-Section Study

Background

This cross-sectional study aimed to analyze the association between burnout, work-related factors and metabolic syndrome (MetS) among various health-care workers (HCWs) at a tertiary hospital in Taiwan.

Methods

Relevant demographic data were obtained through written questionnaires. Information about psychosocial and work conditions, including assigned department, working hours, shifts, and sleep condition, was obtained. Burnout was evaluated according to the Chinese version of Maslach Burnout Inventory-Health Services Survey. MetS was analyzed according to the criteria of the National Cholesterol Education Program of Taiwan-Treatment Panel for Adults III.

Results

A total of 1,055 non-doctor/nurse and 2,078 doctor/nurse staff with a median age of 45.2 and 36.1 years participated in this study. The incidence of burnout was nearly 6.42 and 6.68% and that of MetS was 31.4 and 13.5% in non-doctor/nurse and doctor/nurse staff, respectively. The results showed that burnout induced a higher Odds ratio (OR) of MetS in the doctor/nurse group (OR = 1.96, p = 0.01). Other factors, such as night shift and seniority (>10 years), led to a higher OR of MetS, but a decreased risk was observed based on seniority (2-4 years). Further, young female participants and young doctors/nurses with burnout had a higher OR of MetS compare to other groups (OR = 2.43 and 2.32, p < 0.05).

Conclusion

The study results suggested positive relationship between burnout and MetS in young female staffs and young doctors/nurses. For doctor/nurse staff with higher seniority or more night shifts, strategies are needed to prevent burnout and MetS.

Identifying Organizational Stressors That Could Be a Source of Discomfort in Police Officers: A Thematic Review

The aim of this paper is to highlight the organizational factors that might influence perceived discomfort in police officers. The studies included in the thematic review referred to specific factors, not the general terms “organizational stressors” or “workplace stressors”. It is important to emphasize this distinction because most studies use the general term “organizational stressor” (referring to context) to distinguish from “operational stressor” (referring to content, such as exposure to danger, threat, and trauma). For our purposes, we selected the studies that examined specific organizational factors. The results indicate that organizational social support, organizational culture, leadership, and bureaucracy are the organizational factors associated with police officers’ perceived discomfort. These organizational factors could have negative impacts on individuals, perceptions of stigma when contacting support services, anxiety and depressive symptoms, burnout, PTSD, and suicidal thoughts, among others.

Effects of a Yoga-Based Stress Intervention Program on the Blood Pressure of Young Police Officers: A Randomized Controlled Trial

Objectives: Despite improvements in health education and treatment, arterial hypertension remains a major health problem of increasing epidemiological importance. The purpose of this randomized controlled trial was to determine the impact of regular yoga breathing exercises on blood pressure, work-related stress, and the prevalence of arterial hypertension in young police academy trainees with no existing comorbidities. Design: A single-center, prospective, randomized controlled trial. Subjects: The study included 120 healthy trainees aged between 18 and 39 years who practiced weekly yoga exercises with an emphasis on breathing (prāṇāyāma) over an observation period of 6 months. Results: These regular exercises lowered the blood pressure of the participants by 1.34 mmHg (right arm, p = 0.007), increased their regenerative capacity (Recovery Experience Questionnaire [REQ] scale +2.77, p < 0.001) and resilience (Resilience Scale [RS] +4.6, p = 0.001), and concomitantly reduced the level of perceived stress (Perceived Stress Scale [PSS] -0.9, p < 0.001). In contrast, blood pressure in the control group had slightly increased over the study period by 0.1 mmHg (right arm, p < 0.001) and 1.0 mmHg (left arm, p = 0.03), and subjective scores had significantly worsened (REQ scale -3.4, p < 0.001; RS -2.29, p = 0.001; PSS +0.88, p < 0.001). Conclusions: The results point to a significant correlation between blood pressure and both regenerative capacity and stress level. Thus, the study confirms the hypothesis that yoga exercises reduce perceived stress and exert positive effects on blood pressure. Clinical Trial Registration Number: DRKS00025921.

Acceptability of a real-time notification of stress and access to self-help therapies among law enforcement officers

BACKGROUND

Law enforcement officers (LEOs) are exposed to chronic stress throughout the course of their shift, which increases the risk of adverse events. Although there have been studies targeting LEO safety through enhanced training or expanded equipment provisions, there has been little attempt to leverage personal technology in the field to provide real-time notification of LEO stress. This study tests the acceptability of implementing of a brief, smart watch intervention to alleviate stress among LEOs.

METHODS

We assigned smart watches to 22 patrol LEOs across two police departments: one suburban department and one large, urban department. At baseline, we measured participants' resting heart rates (RHR), activated their watches, and educated them on brief wellness interventions in the field. LEOs were instructed to wear the watch during the entirety of their shift for 30 calendar days. When LEO's heart rate or stress continuum reached the predetermined threshold for more than 10 min, the watch notified LEOs, in real time, of two stress reduction interventions: [1] a 1-min, guided breathing exercise; and [2] A Calm app, which provided a mix of guided meditations and mindfulness exercises for LEOs needing a longer decompression period. After the study period, participants were invited for semi-structured interviews to elucidate intervention components. Qualitative data were analyzed using an immersion-crystallization approach.

RESULTS

LEOs reported three particularly useful intervention components: 1) a vibration notification when hearts rates remained high, although receipt of a notification was highly variable; 2) visualization of their heart rate and stress continuum in real time; and, 3) breathing exercises. The most frequently reported type of call for service when the watch vibrated was when a weapon was involved or when a LEO was in pursuit of a murder suspect/hostage. LEOs also recollected that their watch vibrated while reading dispatch notes or while on their way to work.

CONCLUSIONS

A smart watch can deliver access to brief wellness interventions in the field in a manner that is both feasible and acceptable to LEOs.

Aspectos de saúde mental investigados em policiais: uma revisão integrativa

Resumo Esta revisão integrativa teve por objetivo identificar quais aspectos de saúde mental dos policiais têm sido mais investigados na literatura, considerando o período de 2012 a 2018. Foram realizadas buscas nas bases de dados PubMed, LILACS, SciELO e PePSIC. Foram analisados 84 artigos, quanto a 4 categorias: características dos estudos; saúde mental dos policiais; fatores de risco para problemas mentais; e fatores protetivos e para desenvolvimento da saúde. A análise dos artigos mostrou que Estados Unidos e Brasil produziram mais sobre o tema e que depressão, estresse e transtornos de ansiedade foram as patologias mais frequentes nos artigos analisados. Fatores individuais e do trabalho associaram-se ao adoecimento e fatores protetivos e intervenções foram pouco investigados. Estudos futuros poderão abordar essas lacunas.

The relationship between occupational stress, mental health and work ability of coal chemical workers in Xinjiang

OBJECTIVE

To understand the current working ability of coal chemical workers in Xinjiang, and analyze the impact of occupational stress, mental disorders, and their interaction on work ability. To provide a scientific basis for improving the working ability and quality of life of coal chemical workers.

METHODS

In this study, a stratified random sampling method was used to conduct a questionnaire survey of 1,400 workers in six coal mining enterprises from June to December 2019. The Effort-Reward Imbalance Questionnaire (ERI), the Symptoms Checklist 90 (SCL-90), and the Work Ability Index Scale (WAI) were used to evaluate the level of occupational stress, mental disorders, and the ability to work as coal chemical workers.

RESULTS

The results showed that WAI scores had statistically significant differences between gender, age, length of service, shift, education, marital status, and monthly income (P < 0.05). The ability to work and its dimensions were inversely correlated with occupational stress, and mental disorders (P < 0.001). Occupational stress and mental disorders are risk factors affecting the ability to work. Workers with high occupational stress^* mental disorders (OR = 10.666, 95% CI: 6.443-17.658) are 10.666 times more likely to be at risk for developing poor work ability than low occupational stress^* no mental disorders. Structural equation models show that occupational stress and mental health conditions had a direct impact on work ability, and mental health conditions were the mediators of the relationship between occupational stress and work ability.

CONCLUSION

Occupational stress, mental disorders, and their interaction are risk factors affecting the ability of coal chemical workers to work. Occupational stress can indirectly affect the ability to work through mental health conditions.

Psychometric Properties of the Serbian Version of the Operational and Organizational Police Stress Questionnaires

The Police Operational Stress Questionnaire (PSQ-Op) and Police Organizational Stress Questionnaire (PSQ-Org) have been used to assess operational and organizational sources of police officers’ occupational stress. Considering that different cultural and socio-economic environments could affect officers’ perception of operational and organizational stress, country specific psychometric properties and cut-off values should be defined. Therefore, this study aimed to investigate the psychometric properties of the Serbian version of the PSQ-Op and PSQ-Org (i.e., translated in Serbian and adjusted to Serbian culture) and to establish cut-off values for low, moderate and high stress. Methods: The PSQ-Op and PSQ-Org were administered to police officers through the Ministry of Interior of the Republic of Serbia. Participants included 1220 police officers (19.0% female) who correctly completed both questionnaires. Cronbach’s α was used to determine the reliability of instruments. Cut-off values for low, moderate and high stress were defined based on the mean and standard deviation of the sample and using percentile analysis. Prevalence of low, moderate and high stress was calculated according to already established cut-off values as well as those calculated based on the study sample. Results: Both instruments showed high reliability (Cronbach’s α = 0.963 [95% Confidence Interval = 0.957–0.964]). Occupational stress levels (low, moderate and high) were distributed differently (p < 0.001) when categorized according to the cut-off values defined in literature and cut-off values based on the study sample. The cut-off values by mean and standard deviation could be used for PSQ-Op, while cut-off values by percentile analysis could be used for PSQ-Org.

Associations of work-related stress and total sleep time with cholesterol levels in an occupational cohort of Japanese office workers

OBJECTIVE

The aim of the study was to investigate the associations of total sleep time (TST) and occupational stress based on the Brief Job Stress Questionnaire (BJSQ) with cholesterol levels in an occupational cohort of Japanese office workers.

METHODS

The present study is a secondary analysis of a subset of participants from a randomized controlled trial. Participants were 179 employees from 5 companies in Tokyo who participated as the intervention group in a 3-month lifestyle intervention study among office workers with metabolic syndrome or at risk of metabolic syndrome. All intervention-group participants used a mobile app and a wearable device. The final population for analysis in the present study were 173 participants. Cholesterol measures were derived from participants' annual health check-up data in the fiscal year preceding their inclusion in the study. Multiple linear regression models were used to determine the association between exposures and outcome.

RESULTS

Overall, stress levels were significantly and inversely associated with LDL-C (-7.12 mg/dl; 95% CI: -11.78, -2.45) and LDL-C/HDL-C ratio (-0.16 mg/dl; 95% CI: -0.27, -0.04) per standard deviation increase. Compared to average TST 5.9-7.2 hours, average TST of 4.0-5.3 hours (-4.82 mg/dl; 95% CI: -9.22, -0.43) was inversely associated with HDL-C.

CONCLUSION

Incremental increases of stress were significantly and inversely associated with LDL-C and LDL-C/HDL-C ratio. The shortest average TST was inversely associated with HDL-C. The results should be interpreted with care given certain methodological limitations.

Dying for the job: police mortality, 1950-2018

Purpose –

This study is a mortality assessment on police officers (68-years, 1950-2018) and includes all causes of death.

Design/methodology/approach –

The authors investigated 1,853 police deaths (1950-2018) using sources of mortality that included the National Death Index, NY State, and available records from the Buffalo NY police department. Standardized Mortality Ratios were calculated. Death codes were obtained from 8th and 9th International Classification of Disease revisions in accordance with the year of death.

Findings –

Compared to the US general population, white male police officers from 1950-2018 had elevated mortality rates for some causes of death, including diseases of the circulatory system, malignant neoplasms, cirrhosis of the liver, and mental disorders. Black and female officers had lower mortality rates for all causes of death compared to the general population.

Research limitations/implications –

The findings of elevated risk for chronic disease among police need to be studied in relation to stress, lifestyle, and exposure to chemical and physical agents. There is a special need to further study officers from minority populations as larger samples become available.

Practical implications –

The results of this study will provide police and occupational health practitioners with objective evidence to determine the health impact of work on law enforcement officers.

Originality/value –

This study is longest running mortality assessment on police officers ever conducted (1950-2018) and includes white, black, and female officers.

The impact of a mindfulness-based intervention on the quality of life of Spanish national police officers

PURPOSE

Police officers belong to a profession with a high risk of stress, burnout and compassion fatigue. Incorporating mindfulness practices into the health and occupational-risk prevention programs run by the national police forces in Spain could provide a new approach to reducing stress and enhancing the psychological and emotional balance of these officers.

METHODS

A 7-week mindfulness-based intervention (MBI) was conducted in a group of 20 national police officers in Mallorca (Spain). Mindfulness, self-compassion, burnout, compassion fatigue, compassion satisfaction and perceived stress were measured and compared before and after the intervention.

RESULTS

We identified significant differences in mindfulness (F(5, 14) = 7.441, p = 0.001, η²  = 0.727), compassion satisfaction (F(1, 19) = 5.929, p = 0.025, η²  = 0.238) and perceived stress levels (t(18) = 2.863, p = 0.010, d = 0.611) after the intervention; non-significant improvements were observed for the remaining variables assessed.

CONCLUSIONS

MBIs could be an effective way of reducing stress levels among police officers in Spain.

Risk factors for stress among police officers: A systematic literature review

BACKGROUND

Stress is common among police personnel leading to several negative consequences.

OBJECTIVE

We performed a systematic literature review to identify risk factors for stress among police officers.

METHODS

We searched PubMed and Scopus electronic databases through to July 2018 and we conducted this review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The Newcastle-Ottawa scale was used for studies quality assessment.

RESULTS

After selection, 29 cross-sectional studies met the inclusion criteria and included in the review. The average quality of studies was low since no study was rated as having low risk of bias, three studies (10.3%) as moderate risk and 26 studies (89.7%) were rated as having high risk of bias. Stress risk factors were summarized in the following categories: demographic characteristics; job characteristics; lifestyle factors; negative coping strategies and negative personality traits.

CONCLUSIONS

Identification of stress risk factors is the first step to create and adopt the appropriate interventions to decrease stress among police personnel. The early identification of police officers at higher risk and the appropriate screening for mental health disorders is crucial to prevent disease and promote quality of life.

Effectiveness of Psychological Support to Healthcare Workers by the Occupational Health Service: A Pilot Experience

Work-related stress is a significant risk for healthcare workers (HCWs). This study aims at evaluating the effectiveness of an individual psychological support programme for hospital workers. In all, 35 workers participated (n). A control group of 245 workers (7n) was set. Occupational distress was measured by the General Health Questionnaire, (GHQ-12), the quality of life by the Short Form-36 health survey, (SF-36), and sickness absence was recorded. Costs and benefits of the service were evaluated and the return on investment (ROI) was calculated. The level of distress was significantly reduced in the treated group at the end of the follow-up (p < 0.001). Quality of life had significantly improved (p < 0.003). A 60% reduction of sickness absence days (SADs) following the intervention was recorded. After the treatment, absenteeism in cases was significantly lower than in controls (p < 0.02). The individual improvement of mental health and quality of life was significantly correlated with the number of meetings with the psychologist (p < 0.01 and p < 0.03, respectively). The recovery of direct costs due to reduced sick leave absence was significantly higher than the costs of the programme; ROI was 2.73. The results must be examined with caution, given the very limited number of workers treated; this first study, however, encouraged us to continue the experience.

Stressful life events and serum triglyceride levels: the Cardiovascular and Metabolic Diseases Etiology Research Center cohort in Korea

OBJECTIVES

Elevated serum triglyceride levels are a risk factor for developing cardiovascular disease. A number of studies have demonstrated a positive association between psychological stress and serum triglyceride levels. However, there is limited evidence regarding the impact of stressful life events (SLEs) on serum triglyceride levels in the healthy population. Therefore, we evaluated the independent association between SLEs and serum triglyceride levels in a middle-aged Korean population.

METHODS

We analyzed a sample of 2,963 people (aged 30-64 years; 36% men) using baseline data from the Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort study. The Korean version of the Life Experience Survey questionnaire was used to measure the presence and positive/negative impact of SLEs. Hypertriglyceridemia was defined as a fasting serum triglyceride level of ≥ 150 mg/dL.

RESULTS

Of the 2,963 participants, 33.1% reported at least 1 SLE over the past 6 months and 24.8% had hypertriglyceridemia. Even after adjusting for potential confounders, the serum triglyceride level was significantly associated with the total number of SLEs in men (3.333 mg/dL per event; p= 0.001), but not in women (0.451 mg/dL per event, p= 0.338). Hypertriglyceridemia was also associated with having 4 or more SLEs with positive effects (odds ratio [OR], 2.57; 95% CI, 1.02 to 6.46) and 4 or more SLEs with negative effects (OR, 1.99; 95% CI, 1.16 to 3.41) in men.

CONCLUSIONS

Our findings suggest that SLEs may increase the risk of hypertriglyceridemia in middle-aged men.

Aerobic fitness influences cardiac autonomic modulation in police officers regardless of specific duties

PURPOSE

This study assesses whether the specific duties of a police officer or aerobic fitness influences blood pressure (BP) and cardiac autonomic modulation.

METHOD

Police officers (n = 161) were divided into administrative and operational (34.72 ± 5.98 vs. 33.95 ± 5.61 years old) groups, and subsequently divided into lower and higher aerobic fitness (35.49 ± 4.32 vs. 45.39 ± 13.10 mL·kg-1·min-1).

RESULTS

Higher SBP (125 ± 10 vs. 121 ± 10 mmHg; P = 0.02) and aerobic fitness (42.10 ± 5.57 vs. 38.51 ± 6.67 mL·kg-1·min-1; P < 0.01) were observed in the operational group. On the other hand, lower obesity indicators and higher heart rate variability (HRV) indices (SD1: 26.67 ± 14.19 vs. 20.98 ± 9.12; SD2: 54.04 ± 19.81 vs. 47.32 ± 18.85; RMSSD: 36.50 ± 18.78 vs. 29.90 ± 12.51; SDNN: 42.80 ± 16.05 vs. 36.85 ± 14.23 ms; pNN50: 17.32 ± 17.54 vs. 10.60 ± 10.77 %) were observed in the higher aerobic fitness group (P ≤ 0.05).

CONCLUSION

In summary, although the operational occupation had shown a negative influence on SBP, the HRV was not impaired in police officers. Additionally, aerobic fitness was related to differences in obesity indicators and HRV regardless of police duties. Our findings encourage the inclusion of BP and HRV measurements in routine health checks to screen for early hypertension and autonomic dysfunction.

Evaluation of the correlation between effort-reward imbalance and sleep quality among community health workers

BACKGROUND

A chronic state of imbalance between effort and reward can affect sleep quality. However, few studies have explored the relationship between variables in the work-related stress (the effort-reward imbalance model, ERI model) and sleep quality in community health workers in mainland China. We investigated the relationship between ERI and sleep quality in community health workers.

METHODS

This cross-sectional study was conducted from September to November 2018 and involved 249 registered doctors and 223 registered nurses. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep problems status of the participants. The ERI questionnaire was administered to evaluate job-related stress. Multivariate logistic regression was performed to evaluate the factors related to sleep quality.

RESULTS

The ERI ratio of the 472 health workers was 1.17 ± 0.22, and 273 health workers (57.84%) had PSQI scores > 7.There were statistically significant differences in the effort scores, overcommitment scores and ERI ratio between the health workers with and without sleep problems. The ERI ratio was an independent risk factor for sleep quality; sleep quality, race, type of work, shift work,job title, and personal monthly income were related to the ERI ratio among community health workers.

CONCLUSIONS

We found that sleep problems were prevalent, work effort was greater than reward and a positive correlation between effort-reward and sleep quality among community health workers in China. Managers should focus on the factors that influence sleep problems among community health workers, balance the efforts and rewards of work, and reduce the incidence of sleep problems.

Profiles of US Law Enforcement Officers' Diagnosed Health Conditions: Results From a Probability-Based Sample of Officers

OBJECTIVE

To assess comorbidity across five common health conditions.

METHODS

Surveys were collected from a probability-based sample of US law enforcement officers, and latent class models estimated for hypertension (HTN), high blood cholesterol (LDL), diabetes (DM), a gastrointestinal disorder (GI), and sleep apnea (SA).

RESULTS

The majority of officers (69.4%) were classified in a Healthy profile. One in four officers (23.7%) were classified in a LDL-HTN-DM profile. About 7% of officers were classified in a GI-SA-HTN profile. Age, sex, body mass index (BMI), exercise, and working a rotating shift assignment distinguished class membership.

CONCLUSION

Most officers reported good health. Law enforcement administrative or clinical assessments using readily accessible measures might be informative in identifying risk categories of need for more targeted prevention and treatment support.

Roles of effort and reward in well-being for police officers in Singapore: The effort-reward imbalance model

RATIONALE

Despite the growing body of research on the effort-reward imbalance (ERI) model, evidence is scarce for the generalizability of the model across various national and occupational contexts. Also, studies that examine a wider variety of health and well-being outcomes of ERI are warranted, especially in vocations in which effort and stress is known to be high and reward is usually limited - such as policing.

OBJECTIVE

The current study examined the relationship between the ERI perception and four employee well-being outcomes (self-reported physical health, sickness absence, job satisfaction, and work-life effectiveness) among a sample of police officers in Singapore.

METHODS

Cross-sectional survey data collected from a large representative sample of uniformed police officers from Singapore were used (N = 8729). Missing data were handled with the multiple imputation method and logistic regression analyses were used to test hypotheses.

RESULTS

In line with the theory, employees characterized by high intrinsic effort and low reward (ERI > 1) reported significantly elevated odds ratios of poor physical health (OR = 1.25), job dissatisfaction (OR = 1.53), and work-life ineffectiveness (OR = 1.31). Contrary to expectations, an unusual relationship was observed such that police officers who were overcommitted exhibited lower odds ratios of the suboptimal outcomes. Interestingly, police officers in the low effort-low reward condition exhibited the worst outcomes, whereas officers in the high effort-high reward condition reported optimal outcomes. Findings were generally consistent across genders and age groups.

CONCLUSIONS

This research bolsters the core proposition of the ERI model and emphasizes the importance of social and occupational contexts in the study of ERI.

A Behavioral-Analytic Model for Assessing Stress in Firefighters

Research has documented a number of acute and chronic stressors unique to the fire service. Due to the rise in mental health concerns in firefighters, there has been increased awareness of the negative effects of unmanaged stress. The present study employed a behavioral-analytic model to construct a brief screening measure of stress for this population: the Firefighter Assessment of Stress Test (FAST). Psychometric properties of the FAST were evaluated using data from active-duty firefighters throughout the United States. Results indicated the FAST has good internal reliability (α = 0.89), as well as good convergent and discriminant validity. Also, the factor structure of the FAST revealed three significant subscales reflective of stress associated with responding to calls, administrative difficulties, and being overworked. Scoring and interpretation guidelines were established to suggest when further assessment is warranted. The FAST offers a brief and valid method of self-assessment of current stress levels in firefighters. Information obtained from the FAST (i.e., overall stress level and domains) has the potential to facilitate more immediate identification and recognition of stress in firefighters than what has been possible to date. Moreover, heightened awareness of stress and its effects will hopefully culminate in expanded efforts directed toward stress reduction and intervention for firefighters and their families.

Exercise capacity, cardiovascular and metabolic risk of the sample of German police officers in a descriptive international comparison

Background: The police force has the mandate to protect citizens and enforce the law for public safety. Employment in the police force is recognized as a dangerous occupation and characterized by job-related physical hazards. Therefore, good health and adequate physical condition are necessary. This study aimed to determine cardiovascular, cardiorespiratory, and metabolic risk parameters of German police officers (POs) in comparison to POs from other nations. Methods: 55 male police officers from Germany participated in the survey. We examined anthropometric measurements, cardiovascular/metabolic risk factors and blood parameters. Additionally, we calculated 10-year cardiovascular risk using the Framingham Risk Score. The diagnosis of metabolic syndrome bases on the criteria of the International Diabetes Federation. We assessed cardiorespiratory status by exercise spirometry. Results: The analyzed group of POs demonstrated a high prevalence of pre obesity (BMI: 28.0±3.2 kg/m², waist circumference: 97.8±12.4 cm). 61.8 % of POs showed an increased waist circumference. POs showed high prevalence of abnormal values of triglyceride (n: 24, 43,6%), and systolic (n: 29, 52,7%) and diastolic (n: 27, 49%) blood pressure. The average 10-year cardiovascular risk (by Framingham) was classified as moderate (9.6 ± 7.4 %). 32 % (n: 18) of POs in our study group were diagnosed with metabolic syndrome. Maximal relative oxygen uptake of POs was 34.1 ± 8.0 ·ml/kg^-1 ·min^-1. Conclusions: To our knowledge, this study was one of the first to assess data on cardiovascular health, metabolic syndrome and cardiorespiratory status of police officers in Germany. The results of our study demonstrated an increased cardiovascular and metabolic risk and decreased cardiorespiratory fitness in German police officers. The present study results underline the need to implement health-promoting interventions and concepts like corporate sports activities or nutrition courses to counteract cardiovascular and metabolic risk factors. We have to reduce the subsequent development of cardiovascular and metabolic disease in this occupational group.

Burnout and metabolic syndrome among different departments of medical center nurses in Taiwan-Cross-sectional study and biomarker research

OBJECTIVES

The cross-sectional study aimed to analyze the association between burnout, work-related factors, and metabolic syndrome (Mets) in nurses from several departments of a tertiary hospital in Taiwan. Exploring biomarkers could provide for prevention.

METHODS

Demographic data were obtained through a written questionnaire and include the following information: gender, age, education level, psychosocial and work situations, such as departments, working hours, work shift, depression, and sleep time. Burnout was evaluated according to the Chinese Burnout inventory, Mets was evaluated according to the criteria of the National Cholesterol Education Program of Taiwan-Treatment Panel for Adults III (NCEP-ATP III).

RESULTS

A total of 1758 nurses participated with a median age of 35.2 years. The prevalence of burnout and Mets was 6.4% and 13.84%, respectively. The results showed that burnout induced higher risk of Mets, odds ratio (OR) 1.70 (95% confidence interval, 1.04-3.05). Other factors, such as out-patient nurses, seniority (4-10 and >10 years), working hours (51-59 h/wk), nigh shift, Brief Symptom Rating Scale-5 (score 10-14 and ≧15), poor self-rated health status, and inadequate sleep time, led to higher risk of Mets. Biomarkers research showed that Glycated hemoglobin (Hba1c) was significantly associated with burnout nurses (OR = 24.72, P < .001), but thyroid-stimulating hormone and free thyroxin were not.

CONCLUSIONS

Results suggested positive associations between burnout and Mets in nurses. For nurses with higher seniority, long hours of work, night shifts, poor physical and mental conditions, and poor lifestyle habits in different departments, strategies are needed to prevent burnout and Mets.

The Associations of Perceived and Oxidative Stress with Hypertension in a Cohort of Police Officers

PURPOSE

Associations between perceived stress and oxidative stress marker and metabolic syndrome (MetS) components were investigated in a cohort of police officers.

METHODS

Cross-sectional data from a cohort of non-diabetic subjects (n=233; 19F), median [interquartile range] age 50 [37-44] years, were analysed. MetS was construed in line with International Diabetes Federation (IDF) criteria and perceived stress with Cohen's 10-item Perceived Stress Scale. Plasma oxidative stress marker (free 8-iso-prostaglandin F_2α; 8-iso-PGF_2α), presence of coronary plaque, carotid artery intima-media thickness (cIMT), and physical activity level were also determined.

RESULTS

Obesity was established in 100 (42.92%), hypertension in 111 (47.64), whereas MetS was identified in 104 (44.63%) of the study subjects. A significant difference (p=0.003) in plasma 8-iso-PGF_2α level, depending on the MetS components status, was noted. The associations of perceived stress with plasma 8-iso-PGF_2α level and the select study variables were gender-specific. In multivariate analysis (adjusted for age and current smoking), positive associations of plasma 8-iso-PGF_2α levels with PSS score (B=0.108, 95% CI [0.008, 0.209], p=0.03) and systolic blood pressure (B=0.029, 95% CI [0.003, 0.057], p=0.02) in men only were established. Both the perceived stress (OR 1.101, 95% CI [1.001-1.202], p=0.03) and plasma 8-iso-PGF_2α levels (OR 1.223, 95% CI [1.046-1.432], p=0.01) impacted the prevalence of hypertension. Out of the MetS components, the effect of waist circumference (OR=1.138, 95% CI [1.064-1.218], p=0.0001) and glucose (B=2.696, 95% CI [1.081-6.725], p=0.03) were also encountered. No such associations were noted in women, though, neither in univariate nor in multivariate analyses. The prevalence of coronary plaque (0.001), obesity (p<0.001), hypertension (p<0.001) and median cIMT value (p=0.005), as well as leisure-time (p=0.04) and total walking physical activity (p=0.03), differed significantly between the subgroups stratified by MetS components status.

CONCLUSION

Both the perceived and oxidative stress were found instrumental in promoting hypertension in a cohort of police officers under study, whereas all study outcomes were conclusively gender-related.

Association between metabolic syndrome and work: an integrative review of the literature

The aim of this study was to highlight the association between occupational aspects and the occurrence of metabolic syndrome among various occupational groups. This is an integrative review of the literature that included articles indexed in the following databases: LILACS, SciELO, PubMed, and CINAHL. We evaluated 32 articles, most of which were published in Englishlanguage medical journals and with level 4 scientific evidence. The occupational aspects most commonly reported as associated with metabolic syndrome were occupation, work shift, and occupational stress. Our results indicated that occupational aspects could negatively interfere with workers' health; more robust longitudinal studies should contribute to further uncovering the reported associations.

Metabolic status is not associated with job stress in individuals with obesity: the ELSA-Brasil baseline

PURPOSE

Job stress has proven to be a relevant cause of stress for adults, but its effect on the development of metabolic alterations in individuals with obesity is still poorly explored. We aimed to investigate the association between job stress and metabolically unhealthy obesity (MUO) phenotype in participants with obesity at the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline assessment.

METHODS

This study analyzed data collected at the baseline examination between 2008 and 2010. A total of 2371 individuals with obesity were included. Two metabolic phenotypes were characterized based on the US National Health and Nutrition Examination Survey criteria. The job stress scale was based on the Brazilian version of the Swedish Demand-Control-Support Questionnaire. The association between job stress domains and MUO phenotype was assessed by binary logistic models.

RESULTS

In our sample, 1297 (54.7%) participants were women, mean age was 49.6 ± 7.1 years and 1696 (71.5%) had MUO. Low skill discretion was associated with MUO after adjustment for age, sex and race. However, in fully-adjusted models, the MUO phenotype was not associated with high job demand (odds ratio [OR] = 1.05; 95% confidence interval [95%CI] 0.82-1.35), low skill discretion (OR = 1.26; 95%CI 0.95-1.68), low decision authority (OR = 0.94; 95%CI 0.70-1.25) nor low social support (OR = 0.93; 95%CI 0.71-1.20).

CONCLUSION

We found a significant association between low skill discretion and an adverse metabolic profile in models adjusted for age, sex and race. No associations were significant between job stress domains and the metabolic profile of individuals with obesity in full models.

Prediction of metabolic syndrome based on sleep and work-related risk factors using an artificial neural network

BACKGROUND

Metabolic syndrome (MetS) is a major public health concern due to its high prevalence and association with heart disease and diabetes. Artificial neural networks (ANN) are emerging as a reliable means of modelling relationships towards understanding complex illness situations such as MetS. Using ANN, this research sought to clarify predictors of metabolic syndrome (MetS) in a working age population.

METHODS

Four hundred sixty-eight employees of an oil refinery in Iran consented to providing anthropometric and biochemical measurements, and survey data pertaining to lifestyle, work-related stressors and sleep variables. National Cholesterol Education Programme Adult Treatment Panel ІІI criteria was used for determining MetS status. The Management Standards Indicator Tool and STOP-BANG questionnaire were used to measure work-related stress and obstructive sleep apnoea respectively. With 17 input variables, multilayer perceptron was used to develop ANNs in 16 rounds of learning. ANNs were compared to logistic regression models using the mean squared error criterion for validation.

RESULTS

Sex, age, exercise habit, smoking, high risk of obstructive sleep apnoea, and work-related stressors, particularly Role, all significantly affected the odds of MetS, but shiftworking did not. Prediction accuracy for an ANN using two hidden layers and all available input variables was 89%, compared to 72% for the logistic regression model. Sensitivity was 82.5% for ANN compared to 67.5% for the logistic regression, while specificities were 92.2 and 74% respectively.

CONCLUSIONS

Our analyses indicate that ANN models which include psychosocial stressors and sleep variables as well as biomedical and clinical variables perform well in predicting MetS. The findings can be helpful in designing preventative strategies to reduce the cost of healthcare associated with MetS in the workplace.

Occupational Stress and Mental Health among Anesthetists during the COVID-19 Pandemic

Anesthetist-intensivists who treat patients with coronavirus disease 19 (COVID-19) are exposed to significant biological and psychosocial risks. Our study investigated the occupational and health conditions of anesthesiologists in a COVID-19 hub hospital in Latium, Italy. Ninety out of a total of 155 eligible workers (59%; male 48%) participated in the cross-sectional survey. Occupational stress was assessed with the Effort Reward Imbalance (ERI) questionnaire, organizational justice with the Colquitt Scale, insomnia with the Sleep Condition Indicator (SCI), and mental health with the Goldberg Anxiety and Depression Scale (GADS). A considerable percentage of workers (71.1%) reported high work-related stress, with an imbalance between high effort and low rewards. The level of perceived organizational justice was modest. Physical activity and meditation—the behaviors most commonly adopted to increase resilience—decreased. Workers also reported insomnia (36.7%), anxiety (27.8%), and depression (51.1%). The effort made for work was significantly correlated with the presence of depressive symptoms (r = 0.396). Anesthetists need to be in good health in order to ensure optimal care for COVID-19 patients. Their state of health can be improved by providing an increase in individual resources with interventions for better work organization.

Sleep Health Promotion in the Workplace

Poor sleep and sleepiness in the workplace are associated with accidents. A workplace sleep health promotion program was implemented in an Italian police unit. Of the 242 police officers in the unit, 218 (90%) agreed to take part in the program. A crossover trial was made in which the police officers were divided into two groups that performed sleep health promotion activities in the first and second year, respectively. The first group of officers showed significant sleep improvements at the end of the first year, while the second group had similar or worse parameters than at baseline. At follow-up, a significant improvement in the quantity and quality of sleep was reported in both groups. Sleep improvements at follow-up were associated with a marked reduction in the frequency of accidents at work and near-misses. Before the intervention, sleepiness was the best predictor of injuries (aOR 1.220; CI95% 1.044–1.426) and near-misses (aOR 1.382; CI95% 1.182–1.615). At follow-up, when sleep conditions had improved, insomnia symptoms were the most significant predictors of work accidents (aOR 13.358; CI95% 2.353–75.818). Sleep health promotion can be useful in police officers.

Differences in Body Composition across Police Occupations and Moderation Effects of Leisure Time Physical Activity

This study investigated differences in the body composition of police officers from different occupational groups and the moderation effects of leisure time physical activity (LTPA). A sample of 237 police officers (special anti-terrorist unit, gendarmerie, firefighters, and general duties) participated in the study. Body mass index (BMI), percent of body fat (%BF), percent of skeletal muscle mass (%SMM), and index of hypokinesia (IH) were assessed using a multichannel bioelectric impedance analyzer and officers reported the amount of LTPA using an international physical activity questionnaire. The sample was divided in three groups relative to LTPA, sedentary (0–149 min/week), moderately active (150–299 min/week), and very active (300+ min/week). Multiple analysis of variance (4 × 3) was used to analyze if occupational groups differed based solely on occupation, if officers from the same occupation differed in muscularity and fatness based on LTPA, and if any differences in body composition occurred between officers from different occupations with the same level of LTPA. Police officers from more physically demanding occupations demonstrated lower %BF and IH, while having higher %SMM. This was also observed among the officers of the same occupation who reported a higher LTPA, while officers who reported very high LTPA had similar body composition.

Utilization and Impact of Peer-Support Programs on Police Officers' Mental Health

Police officer suicide rates hit an all-time high in the province of Ontario, Canada, in 2018. Sadly, this statistic is somewhat unsurprising, as research has shown that police officers suffer from higher rates of mental health disorder diagnoses compared to the general public. One key reason for the elevated levels of suicide and other mental health issues among police officers is believed to stem from the stigma associated with seeking help. In an attempt to address these serious issues, Ontario’s police services have begun to create internal peer support programs as a way of supporting their members. The present research explores the experiences of police officers serving as peer-support team members, particularly with regards to the impacts of peer support. In addition, this research also examines the importance of discussing shared experiences regarding a lack of standardized procedures for the administration and implementation of peer support in relation to the Policy Feedback Theory. The Policy Feedback Theory (PFT) posits that, when a policy becomes established and resources are devoted to programs, it helps structure current activity. This study utilized a phenomenological, qualitative approach, with data collection consisting of face-to-face interviews with nine police officers serving on the York Regional Police’s peer-support team. The findings revealed that peer support is more than just a “conversation”; rather, it suggests to contribute to enhancing mental health literacy among police officers, and it significantly contributes to stigma reduction. The findings also revealed that internal policy demonstrated an organizational commitment to mental health and peer-support, and that a provincial standard is necessary to ensure best practices and risk management in the creation and maintenance of peer-support programs.

Stress-buffering effects of physical activity and cardiorespiratory fitness on metabolic syndrome: A prospective study in police officers

Metabolic syndrome (MetS) is a worldwide health concern related to cardiovascular disease. Stress at work increases the risk for MetS, whereas physical activity and cardiorespiratory fitness (CF) have been shown to be potential buffers against stress. The aim of this study was to test the stress-buffering effects of physical activity and CF on the relationship between work stress and MetS. In a prospective study, we followed 97 police officers (mean age = 39.7 years; mean body mass index = 25.74 kg/m²) over one year and assessed MetS, as defined by the National Cholesterol Education Program Adult Treatment Panel III. Stress at work was measured with the Job Content Questionnaire, as well as the Effort-Reward Imbalance Questionnaire. Physical activity was assessed objectively via 7-day accelerometry. CF was assessed with the Åstrand bicycle ergometer test. Hierarchical linear regression models were carried out to predict MetS at follow-up (mean overall MetS score = 1.22), after controlling for baseline levels and sociodemographic background (mean overall MetS score = 1.19). Higher CF levels were significantly associated with lower MetS risk at follow-up (β = -.38). By contrast, no main effects were found for physical activity and work stress. However, high effort and demand were significantly correlated with increased blood pressure (effort: r = .23 for systolic blood pressure; r = .21 for diastolic blood pressure) and waist circumference (effort: r = .26; demand: r = .23). Moreover, no significant interaction effects occurred between work stress and CF/physical activity. The results emphasize the importance of high levels of CF in the prevention of MetS in police officers. Accordingly, provision of regular training opportunities and repeated CF testing should be considered as a strategy in overall corporate health promotion.

Metabolic Syndrome Prevalence among Armed Forces Personnel (Military Personnel and Police Officers): A Systematic Review and Meta-Analysis

INTRODUCTION

Metabolic syndrome (MetS) is closely linked to type 2 diabetes and cardiovascular disease. Various studies have reported the prevalence of MetS in different armed forces personnel in different countries. However, performing a systematic review and meta-analysis on this subject seems necessary. The aim of this study was to estimate the pooled prevalence of MetS among armed forces personnel including members of the military and police forces.

MATERIALS AND METHODS

A systematic review was carried out on all associated papers published in PubMed, Scopus, Web of Science and Cochrane Library, encompassing the timeframe: November, 2018 to January 2000. The overall prevalence of MetS, and its prevalence based on different diagnostic criteria [National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III), American Heart Association (AHA) and International Diabetes Federation (IDF)] were pooled using a random-effects model.

RESULTS

Twenty five eligible studies were selected for the meta-analysis. Among all police officers contained in this study group, the overall prevalence of MetS was 26.2% (95% CI: 19.7-34%; Q = 229.45, p = 0.00). Among different military personnel contained in this study group, the overall estimation of MetS prevalence was 8.3% (95% CI: 6.3-11%; Q = 540.88, p = 0.00) the prevalence of MetS was 8.0% (95% CI: 5.7-11%; Q = 409.76, p = 0.00) according to the NCEP-ATP III criterion.

CONCLUSION

The findings from the present meta-analyses displayed a low prevalence of metabolic syndrome in armed forces in general. These findings will allow healthcare providers and policy-makers to find solutions in order to take action to reduce MetS risks on a wider scale, especially among police officers.

Hidden danger: A 22-years analysis of law enforcement deaths associated with duty-related illnesses (1997-2018)

Purpose –

Law enforcement is a dangerous profession not only due to assaults, accidents and homicides but also due to health risks. This study examined trends in the national frequency and rate of law enforcement jobrelated illness deaths in the United States over a 22-year period (1997-2018).

Design/methodology/approach –

Data were obtained from the National Law Enforcement Officers Memorial Fund (NLEOMF) on death frequencies related to health issues at work. Death rates were based on the total number of police officers in the United States [rate = (frequency/population at risk) × 100,000]. Trends were examined using standardized regression.

Findings –

A total of 646 deaths were attributed to job-related illness. There was a significant upward trend in overall job-related illness deaths (frequency analyses: β = 0.88, p < 0.0001; rate analyses: β = 0.82, p ≤ 0.0001) mainly driven by a significant increase in 911 cancer deaths (frequency analyses: β = 0.88, p < 0.0001; rate analyses: β = 0.88, p ≤ 0.0001). Nearly 82 percent of circulatory deaths were from a heart attack, with an average death age of 46.5 years.

Research limitations/implications –

Deaths were not included if they failed to meet medical requirements of the NLEOMF. The data are descriptive, do not estimate risk and should be interpreted cautiously.

Practical implications –

Police wellness programs may help to reduce the danger of deaths associated with job-related illness.

Originality/value –

This is among the first studies to examine frequency and rate of police health-related deaths due to job exposures.

Relations Between Frequency and Volume of Leisure-Time Physical Activity and Body Composition in Police Officers

Purpose: Leisure-time physical activity (LTPA) has always been very important for the maintenance and improvement of body composition. Thus, the aim of this study was to examine if the frequency and volume of LTPA (F-LTPA and V-LTPA) were related to indices of body composition in police officers. Method: A physical activity questionnaire was used to collect data from 346 male police officers regarding their F-LTPA and V-LTPA. They were divided into four groups relative to the frequency, and four groups relative to the volume of LTPA, labeled as inactive, seldom active, moderately active and very active for each LTPA indicator. Percent body fat (PBF), skeletal muscle mass (PSMM), skeletal muscle mass index (SMMI) and body fat mass index (BFMI) were assessed. Correlation analyses investigated associations and multivariate analysis of variance analysed the differences between body composition and LTPA, with significance set at p < .05. Results: The F-LTPA correlated (p < .001) to PBF (r = -0.306), BFMI (r = -0.289), PSMM (r = 0.309) and SMMI (r = -0.138, p = .010). The V-LTPA correlated (p < .001) to PBF (r = -0.370), BFMI (r = -0.348), PSMM (r = 0.311), and SMMI (r = -0.106, p = .049). The differences that occurred between more and less active police officers, whereby those who were very active had lower values of PBF and BFMI and higher values of PSMM and SMMI regardless of the frequency and volume of LTPA. PBF and PSMM were more affected by LTPA than SMMI and BFMI. Conclusions: F-LTPA and V-LTPA were considered important for police officers, whereby F-LTPA was related to muscle and V-LTPA to fat parameters of body composition.

Perceived stress and non-alcoholic fatty liver disease in apparently healthy men and women

Psychological stress may have adverse metabolic effects and induce unhealthy behaviors, but the role of stress in the development of non-alcoholic fatty liver disease (NAFLD) is largely unexplored. We investigated the association between perceived stress and the prevalence of NAFLD in a large sample of apparently healthy men and women. We performed a cross-sectional study of 171,321 adults who underwent health screening examination between 2011 and 2013 in one health screening center. Perceived stress was assessed using the short version of the Perceived Stress Inventory (PSI). NAFLD was assessed using ultrasonography in the absence of excessive alcohol use or any other identifiable cause of liver disease. The prevalence of NAFLD was 27.8%. In fully-adjusted multivariable models, the odds ratio (95% confidence intervals) for NAFLD comparing participants in the 5^th quintile of PSI score (≥23) with those in the lowest quintile (<12) was 1.17 (1.11, 1.22), with a moderately increased prevalence of NALFD across quintiles of PSI score. The positive association between PSI score and NAFLD was observed in all subgroups analyzed, although the association was stronger in men compared to women (p interaction <0.001), and in obese compared to non-obese (p interaction 0.005). In this large study of apparently healthy men and women, higher perceived stress was independently associated with an increased prevalence of NAFLD, supporting a possible relationship between perceived stress and NAFLD. Prospective study is needed to elucidate mediating mechanisms to warrant stress management to reduce NAFLD.

Dietary patterns in relation to major cardiovascular diseases risk factors

Purpose

The purpose of this study was to evaluate the association of empirically derived dietary patterns with hypertension and hyperlipidemia among a large sample of Iranian industrial employees.

Design/methodology/approach

This cross-sectional study was done under the framework of Epidemiological Survey of Chronic Diseases on Manufacturing Employees. Major dietary patterns were derived based on a validated short form of food frequency questionnaire (FFQ) using exploratory factor analysis. Self-administered validated questionnaires were used to collect data on socio-demographic and job-related variables of participants. Multivariable logistic regression was applied for association analyses.

Findings

Higher levels of Western dietary pattern increased significantly the risk of hypertension (odds ratio [OR] = 1.85, 95% CI [1.36-2.53], P trend <0.001) and hyperlipidemia (OR = 1.45, 95% CI [1.16-1.81], p = 0.001) even after controlling for confounding variables. The traditional dietary pattern was marginally associated with a significant increase in risk of hyperlipidemia ( = 1.14, 95% CI [0.92-1.41], p = 0.084) in the fully adjusted model. However, higher levels of healthy dietary pattern were significantly associated with a decreased risk of hyperlipidemia in the final model (OR 0.80, 95% CI [0.64-0.90], p = 0.025).

Originality/value

To the authors’ knowledge, an association analysis between dietary patterns and major cardiovascular disease risk in workforce population over the world is scarce and has not yet been conducted among Iranian industrial employees. This study’s findings are especially relevant for the industrial workforce population because they are at high risk of other job-related risks that increase the CVD risk.