title: Work stress, caregiving, and allostatic load: prospective results from the Whitehall II cohort study.
abstract: OBJECTIVE
  Studies investigating health effects of work and family stress usually consider these factors in isolation. The present study investigated prospective interactive effects of job strain and informal caregiving on allostatic load (AL), a multisystem indicator of physiological dysregulation.
  
  
  METHODS
  Participants were 7007 British civil servants from the Whitehall II cohort study. Phase 3 (1991-1994) served as the baseline, and Phases 5 (1997-1999) and 7 (2002-2004) served as follow-ups. Job strain (high job demands combined with low control) and caregiving (providing care to aged or disabled relatives) were assessed at baseline. AL index (possible range, 0-9) was assessed at baseline and both follow-ups based on nine cardiovascular, metabolic, and immune biomarkers. Linear mixed-effect models were used to examine the association of job strain and caregiving with AL.
  
  
  RESULTS
  High caregiving burden (above the sample median weekly hours of providing care) predicted higher AL levels, with the effect strongest in those also reporting job strain (b = 0.36, 95% confidence interval = 0.01-0.71); however, the interaction between job strain and caregiving was not significant (p = .56). Regardless of job strain, participants with low caregiving burden (below sample median) had lower subsequent AL levels than did non-caregivers (b = -0.22, 95% confidence interval = -0.06--0.37).
  
  
  CONCLUSIONS
  The study provides some evidence for adverse effects of stress at work combined with family demands on physiological functioning. However, providing care to others may also have health protective effects if it does not involve excessive time commitment.
authors.affiliation: From the Department of Public Health (Dich, Lange, Rod), University of Copenhagen, Copenhagen, Denmark; and Department of Epidemiology and Public Health (Head), University College London, London, England, UK.
authors.forename: Nadya
authors.initials: N
authors.lastname: Dich
authors.forename: Theis
authors.initials: T
authors.lastname: Lange
authors.forename: Jenny
authors.initials: J
authors.lastname: Head
authors.forename: Naja Hulvej
authors.initials: NH
authors.lastname: Rod
mesh_terms: D000328:Adult; D052636:Allostasis / Q000502:physiology*; D017028:Caregivers / Q000523:psychology; D004651:Employment / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000503:physiopathology*; D006113:United Kingdom