Chronic work stress and exhaustion is associated with higher allostastic load in female school teachers

Abstract

Epidemiological studies have shown that chronic work stress or unfavourable psychosocial work conditions are prospectively associated with different adverse health outcomes. The aim of the present cross-sectional study was to investigate the relationship between work-related chronic stress as well as exhaustion and a cumulative measure of physiological wear-and-tear called allostastic load (AL). AL could be a possible biological pathway for how chronic work stress and exhaustion lead to health impairments in the long run. As the teaching profession has been proposed to be a potentially high stressful occupation, chronic work stress (effort-reward-imbalance) and exhaustion were assessed in 104 female school teachers. AL was first analyzed according to McEwen's classical model comprised of ten parameters including cortisol, epinephrine and norepinephrine, dehydroepiandrosterone-sulphate (DHEA-S), waist/hip-ratio (WHR), glycosylated haemoglobin (HbA1c), high-density lipoprotein (HDL), total cholesterol/HDL-ratio, and systolic and diastolic blood pressure. Additionally it was extended to include tumor-necrosis-factor-alpha (TNF-alpha), C-reactive protein (CRP), fibrinogen, D-dimer, percent-body-fat, triglycerides, and glucose levels. A substantial proportion of our sample was highly exhausted whereas relatively few teachers showed high effort-reward-imbalance. AL scores were significantly higher in women high on effort-reward-imbalance or suffering from exhaustion. Although all teachers had been in a good health status, chronic work stress as well as exhaustion appears to be associated with changes in a multi-system summary indicator of physiological risk.

Effort-reward imbalance at work and cardiovascular diseases

“…Finally, a summary index of stress-related biological markers of 'allostatic load' has been proposed by McEwen [31], indicating increased susceptibility to cardiovascular risk and disease. In a study on female teachers it was demonstrated that the group scoring high on ERI measures exhibited a significantly higher mean score than the less stressed group [39]. Taken together, naturalistic and experimental studies supplement epidemiological evidence by demonstrating psychobiological processes that possibly mediate the observed associations of psychosocial adversity at work with cardiovascular disease.…”

Health status of long-term sick leave and working female teachers in Germany: A cross-sectional study

“…The teaching profession has been labeled as highly stressful [30,31] and such exposure may elevate the risk for mental and physical health problems [32,33]. Moreover relationships between mental and physical health components have already been investigated and demonstrated on several occasions [34].…”

Adverse effects of psychosocial work factors on blood pressure: systematic review of studies on demand–control–support and effort–reward imbalance models

“…The current review does not provide meta-analytical estimates since the available data did not meet the criteria for homogeneity in methods used to assess job strain and ERI, confounders, outcome measures, and biases potentially affecting internal validity. Our review however provides an in-depth analysis of several potential explanations for data inconsistencies (ie, gender, study design, types of BP measures, instruments for measuring psychosocial factors, categorization of exposure to psychosocial fac- (149,185,190) 0 / 0 0/0 1 (191) / 1 (191) 1 / 4 BP level 1 (189) / 2 (183,189) 0 / 0 0/0 1 (191) / 1 (191) 2 / 3 Men Hypertension 4 (184)(185)(186)190) / 4 (184)(185)(186)190) 0 / 0 0/0 0 / 1 (191) 4 / 5 BP level 0 / 0 1 (188) / 1 (188) 0/0 0 / 1 (191) 1 / 2 tors, control for potentially confounding factors, and participation rate). Such analysis allowed the identification of "optimal" methods to consistently observe the deleterious effect of psychosocial work factors on BP, namely the use of a prospective design and ambulatory BP measures.…”