Relationship between job stress and subjective oral health symptoms in male financial workers in Japan

Effect of Occupational Stress on Periodontitis According to the Salivary RANKL Level Among Iraqi Employees

Background

Findings show that periodontitis does not affect all populations; similarly, some individuals present risk conditions such as occupational stress, making them more susceptible to developing periodontitis through unhealthy habits like poor oral hygiene and immune suppression. Periodontitis triggers an inflammatory host immune response; "Receptor Activator Nuclear Factor KB ligand (RANKL)" is the primary regulator of osteoclast differentiation and activity. It was found that osteoclastic bone damage caused by periodontitis depends on the RANKL produced by osteoblastic and periodontal ligament cells.

Objective

This study aimed to assess the effect of occupational stress on employees with periodontitis using salivary RANKL marker.

Material and Methods

A case-control analysis was done at my clinic with 90 male employees aged 30-50. The participants completed self-administered questionnaires and had periodontal exams. Employee occupational stress was estimated using a life events scale questionnaire. Calibrated dentists performed the parameters used in the periodontal assessment after collecting whole unstimulated salivary samples from each employee to measure salivary RANKL using ELISA technique.

Results

The present finding revealed a statistically significant difference among groups in "probing pocket depth, plaque index, bleeding on probing, clinical attachment level, and salivary RANKL level". They were higher in the stressed employees' group, which is not statistically significant.

Conclusion

The findings of this investigation observed that occupational stress increased clinical periodontal parameters and salivary RANKL of periodontitis in employees.

Effects of social support on oral health behavior: Serial multiple-mediator model

OBJECTIVE

This study investigates the serial multiple mediation of job stress and perceived behavioral control (PBC) in the relationship between social support and oral health behavior (OHB).

MATERIALS AND METHODS

This cross-sectional study was conducted in Minhang District, Shanghai, China, between July and November 2021. 559 Employees from 10 community health centers were recruited. A five-part survey was used to collect data on demographic characteristics, social support, job stress, PBC and OHB. Descriptive statistics, independent-sample t-test, Pearson's correlation analysis, ordinary least-squares regression and the bootstrap method were used to analyze data.

RESULTS

Social support was found to impact OHB through three significant mediation pathways: the pathway through job stress (point estimate = 0.033; 95%BC CI [0.004, 0.089]), the pathway through PBC (point estimate = 0.283; 95%BC CI [0.174, 0.416]), and the serial multiple mediating pathway through first job stress and then PBC (point estimate = 0.006; 95%BC CI [0.001, 0.019]).

CONCLUSION

This study indicates that job stress and PBC play a serial multiple-mediator role in the relationship between social support and OHB. To ensure the effectiveness of social support intervention on OHB, workplace managers and employees should strengthen the motivators that could promote the reduction of job stress and the improvement of PBC.

Oral health outcomes and shift working among male workers: A cross-sectional survey

Working time outside routine daily working hours is known as shift working. Studies have shown adverse effects of shift working such as stress, obesity, and diabetes on the workers' health. The aim of the present study was to compare aspects of oral health in shift workers and non-shift workers of a cement factory in Shahroud, Iran. Study population comprised of 180 male workers of the factory in the year 2015. Convenience sampling was continued until recruiting 180 subjects of shift- and non-shift workers. Data collection included oral health questionnaire, health and safety executive (HSE) questionnaire, and clinical oral examination. The Chi-square test, Pearson correlation coefficient, and generalized Poisson model were employed for statistical evaluation. Mean age of the workers was 39.19 (±9.48); 53% had educational level of less than diploma. Their mean DMFT was 12.89 (±5.75) which correlated with number of years in shift work schedule (Pearson correlation coefficient: 0.41; p<0.001) but not correlated with job stress (Pearson correlation coefficient: -0.11; p = 0.12). Mean number of deep periodontal pockets among the workers was 5.03 (±1.84) that showed correlation with number of years in shift work schedule (Pearson correlation coefficient: 0.33; p<0.001) but no correlation with job stress (Pearson correlation coefficient: -0.03; p = 0.68). Adherence to various oral health behaviors was reported by less than half of the workers. Positive correlation of dental caries and periodontal diseases with shift working partly signals negative impact of working conditions on oral health among this group of workers which calls for modifications in their working environment to facilitate health practices.

Cross-sectional associations between effort-reward imbalance at work and oral diseases in Japan

Background

Psychological stress is a potential risk factor for oral diseases. However, evidence for the association between work stress and oral diseases is scarce. We aimed to examine the associations of work stress, according to the effort-reward imbalance model, with dental caries, periodontal status, and tooth loss.

Methods

This cross-sectional study included 184 regular employees at a medical university and 435 registrants of a web research company. Work stress was assessed using the effort-reward imbalance (ERI) ratio. Dental caries and tooth loss were assessed according to the number of decayed, filled, and missing teeth (DMFT) among the set of 28 teeth. Periodontal status was assessed using a self-administered questionnaire. For the DMFT, a linear regression model was used to estimate the unstandardised coefficients. A Poisson regression model was used to estimate the prevalence ratios (PRs) of poor periodontal status.

Results

Among medical university employees and employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was associated with -2.81 (95% CI [-4.70 to -0.92]; p-value = 0.004) and -0.84 (95% CI [-1.80 to 0.12]; p-value = 0.085) changes in the DMFT from adjusted linear regression models, respectively. In employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was also associated with 1.55 (95% CI [1.04-2.32]; p-value = 0.032) of the PR for poor periodontal status based on Poisson regression models.

Conclusion

ERI at work was associated with an increased risk of poor periodontal status.

Systematic Review of the Literature on Dental Caries and Periodontal Disease in Socio-Economically Disadvantaged Individuals

Dental caries and periodontal disease represent a health problem and a social cost for the entire population, and in particular for socio-economically disadvantaged individuals who are less resistant to disease. The aim of this review is to estimate the prevalence and severity of the two dental pathologies, caries and periodontal disease, in the different classes of socio-economically disadvantaged subjects and to understand which of them are most affected. A systematic search of the literature was performed in MEDLINE (via PubMed), EMBASE and Web of Science after establishing a suitable search strategy for each database, using keywords related to socio-economically vulnerable classes and health outcomes. Socio-economically disadvantaged individuals are more susceptible to tooth decay and periodontal disease (with relative tooth loss) than non-vulnerable people. Additionally, when multiple vulnerabilities are combined in the same subject, these oral diseases worsen. There is no type of vulnerability more affected by caries and periodontitis than others, since overall they all have severe disease indices. The data from this systematic literature review might be useful for health policy makers looking to allocate more resources and services to socially disadvantaged individuals, resulting in making them more resilient to oral disease due to their social marginalization.

Work stress and oral conditions: a systematic review of observational studies

OBJECTIVES

Although psychological stress is a risk factor for oral diseases, there seems to be no review on work stress. This study aimed to review the evidence on the association between work stress and oral conditions, including dental caries, periodontal status and tooth loss.

DESIGN

A systematic review of published observational studies.

DATA SOURCES

A systematic literature search was conducted in PubMed and Scopus databases on 12 August 2020.

STUDY SELECTION

Articles were screened based on the following inclusion criteria: published after 1966; in English only; epidemiological studies on humans (except case studies, reviews, letters, commentaries and editorials); and examined the association of work stress with dental caries, periodontal status and tooth loss.

DATA EXTRACTION

Data were extracted from eligible studies. A quality assessment was conducted using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

RESULTS

Of 402 articles identified, 11 met the inclusion criteria, and 1 study assessed the association of work stress with dental caries and periodontal status. Of 11 studies, 1 reported a non-significant association between work stress and dental caries; 8 of 9 studies reported a significant association between work stress and worse periodontal status; and 1 of 2 studies reported a significant association between work stress and tooth loss. Nine of 11 studies were cross-sectional, while the remaining 2 studies had unclear methodology. Only two studies were sufficiently adjusted for potential confounders. Eight studies assessed work stress but did not use the current major measures. Three studies were rated as fair, while eight studies had poor quality.

CONCLUSIONS

There is a lack of evidence on the association of work stress with dental caries and tooth loss. Eight studies suggested potential associations between periodontal status and work stress. Cohort studies using the major work stress measures and adjusting for the potential confounders are needed.

Home Visiting Nurses’ Job Stress and Error Incidents

The current study examined the relationship between home visiting nurses’ job stress and error incidents to provide a better understanding of risk management for home visiting nursing services. Home visiting nurses often perform patient care alone, under great mental and physical stress, increasing the risk of human error when executing tasks. A mail survey was distributed to 437 home visiting nurses working at agencies in 71 locations in Japan. The questionnaires were anonymously completed and included items on career history, experiences of job stress, and experiences of incidents. Answers were collected from 230 participants. After eliminating incomplete responses, 146 questionnaires were included in the analyses. Participants’ average age was 48.5 ± 9.3 years, and they had an average of 7.2 ± 5.6 years of experience in home visiting nursing services. In total, 21 (14.4%) were administrators, and 125 (85.6%) were staff nurses. Administrators experienced more no-harm incidents in which an error occurred but did not result in client injury than did staff nurses ( p < .05) and scored higher on three items of job stress (quantitative overload, fit to the job, and supervisor support) ( p < .05). Harmful incidents were positively associated with quantitative overload ( p < .05) and work environment ( p < .01). These results suggest that there is a limit to the extent to which an administrator can offer safe care. A less stressful working environment and active information exchange rooted in a culture of medical safety should reduce the number of incidents.

Influence of Occupational Stress and Coping Style on Periodontitis among Japanese Workers: A Cross-Sectional Study

The aim of this cross-sectional study was to evaluate the association between the influence of occupational stress and coping style on periodontitis among Japanese workers. The study sample included 738 workers (age range: 19-65 years) at a manufacturing company in Kagawa Prefecture, Japan. To analyze occupational stress and coping style, all participants answered a self-report questionnaire composed of items on their work environment and oral health behavior. Oral examinations were performed by calibrated dentists. Among all workers, 492 (66.7%) workers were diagnosed with periodontitis, and 50 (6.8%) were diagnosed with a high stress-low coping condition. Significant differences (p < 0.05) were observed between the periodontitis and non-periodontitis groups in terms of age, gender, body mass index, smoking status, daily alcohol drinking, monthly overtime work, worker type, and stress-coping style. Logistic regression analysis showed that a high stress-low coping condition was associated with an increased risk of periodontitis (odds ratio: 2.79, 95% confidence interval: 1.05-7.43, p = 0.039). These findings suggest that a high stress-low coping condition is associated with periodontitis among the 19-65 years of age group of Japanese workers.

[Factors Associated with Stress Check Attendance: Possible Effect of Timing of Annual Health Examination]

OBJECTIVES

The stress check program has been part of annual employees' health screening since 2015. Employees are recommended, but not obliged, to undergo the stress check offered. This study was designed to examine the factors associated with stress check attendance.

METHODS

A total of 31,156 Japanese employees who underwent an annual health examination and a stress check service at an Occupational Health Service Center in 2016 participated in this study. Data from the annual health examination and stress check service included stress check attendance, date of attendance (if implemented), gender, age, workplace industry, number of employees at the workplace, and tobacco and alcohol consumption. Data were analyzed using multiple logistic regression.

RESULTS

The mean rate of stress check attendance was 90.8%. A higher rate of stress check attendance was associated with a lower duration from the annual health examination, age ≥30 years, construction and transport industry, and 50-999 employees at the workplace. A lower rate of stress check attendance was associated with medical and welfare industry and ≥1,000 employees at the workplace.

CONCLUSIONS

These findings provide insights into developing strategies for improving the rate of stress check attendance. In particular, stress check attendance may improve if the stress check service and annual health examination are conducted simultaneously.