title: A streamlined approach for assessing the Allostatic Load Index in industrial employees.
abstract: Work stress is common and can lead to various bodily dysfunctions. The Allostatic Load Index (ALI) is a tool to measure the wear and tear of the body caused by chronic stress. This cross-sectional study aimed to explore the association of work-related stress and ALI in German industrial employees. A short form ALI should be developed for practical use of company physicians. In this exploration of an industrial cohort (n = 3797; 79.3% male), work stress was measured by the effort-reward imbalance (ERI) questionnaire in 2009-2011. ALI was calculated using 15 variables including anthropometric data, heart rate variability, as well as blood and urine samples based on predefined subclinical cut-off values. Differences in ALI related to low (≤1) and high (>1) ERI categories were tested. Logistic regression models estimated odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the association between ALI and work stress controlling for multiple confounders. Employees exposed to high work stress showed higher ALI scores (p < 0.001) compared to those with low stress levels. In multivariable models, ALI was associated with work stress (OR 1.19 [95% CI: 1.00, 1.42]; p < 0.05) following adjustment for a range of potential confounders. By reducing ALI parameters to five variables this association increased modestly and remained statistically significant (OR 1.27 [95% CI: 1.05, 1.54]; p < 0.05). The results indicate that work stress is associated with ALI in German industrial employees. A short form index seems to be a promising approach for occupational health practitioners. The results should be validated in further longitudinal explorations defining a standard set of variables including gender-related thresholds.
authors.affiliation: a Medical Faculty Mannheim, Mannheim Institute of Public Health, Social and Preventive Medicine, Heidelberg University , Mannheim , Germany and.|b Occupational Health Department , Allianz SE , Munich , Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Mauss
authors.affiliation: a Medical Faculty Mannheim, Mannheim Institute of Public Health, Social and Preventive Medicine, Heidelberg University , Mannheim , Germany and.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Jarczok
authors.affiliation: a Medical Faculty Mannheim, Mannheim Institute of Public Health, Social and Preventive Medicine, Heidelberg University , Mannheim , Germany and.
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Fischer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000401:Aircraft; D000419:Albuminuria; D052636:Allostasis; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D004738:Engineering; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006339:Heart Rate; D006801:Humans; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D066192:Manufacturing Industry; D008875:Middle Aged; D016272:Occupational Health; D016017:Odds Ratio; D012201:Reward; D013315:Stress, Psychological / Q000378:metabolism / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference; D049629:Waist-Hip Ratio; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D002097:C-Reactive Protein; D002784:Cholesterol; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003404:Creatinine; D006442:Glycated Hemoglobin; D014280:Triglycerides; C517652:hemoglobin A1c protein, human
keywords: Allostatic load; corporate health management; effort–reward imbalance; employees; heart rate variability; psychosocial load; work stress