Stress and Subclinical Cardio-Metabolic Disease in Police: A Longitudinal Study

警察工作的某些特征，如轮班工作，长时间工作，高要求和创伤性暴露，与心理压力水平增加有关，在某些情况下，与不良心血管结果有关。在一段时间内进行的观察性研究可以提供更有说服力的证据，证明这些工作场所压力源会导致不良的生理和心理健康结果。因此，该项目的总目标是对大约475名警察进行纵向后续评估，他们的基线数据和规程基础设施已经建立。该研究将通过检查压力的生理和心理措施，并评估这些措施与亚临床标志物或心血管和代谢疾病的早期迹象在基于人群的设计的潜在关联，评估警察工作场所的压力。疾病标志物包括血压;血脂、葡萄糖和胰岛素的实验室测量;评估自主神经系统功能的心率变异性;测量颈动脉壁厚度（动脉粥样硬化）和肱动脉反应性（内皮或血管功能）的超声成像研究;以及体脂、瘦组织成分和骨密度的双能X射线吸收测定（DXA）测量。还需要检查的是已知对健康有害的心理社会因素，如感知到的压力、抑郁和敌意，以及已知具有保护作用的因素（例如，社会支持和社会支持）。关于压力对健康的影响的研究结果可以转化为更好的预防措施。从这项研究中获得的复杂的前瞻性数据的分析可能有助于更好地了解如何暴露于压力源随着时间的推移可能会导致心血管和代谢异常的早期指标。根据美国国家职业安全与健康研究所的数据，将自己的工作描述为压力非常或非常大的工人比例可能高达40%（压力...在工作中; NIOSH出版号99- 101）。鉴于压力在工作场所可能相对普遍，预防可能与压力有关的不良健康后果可使很大一部分工作人口受益。 公共卫生相关性：警察工作中固有的压力源和相关的生活方式因素与不良的心血管和代谢健康结果有关。然而，到目前为止，大多数研究都是横断面设计，主要集中在明显的临床结局上。因此，该项目的总体目标是纵向研究职业压力源对警官心血管和代谢疾病早期症状的影响，以进一步了解这一主题并加强该领域的预防工作。

DESCRIPTION (provided by applicant): Certain characteristics of police work such as shift work, long work hours, high demands, and traumatic exposures have been associated with increased levels of psychological stress and in some cases with adverse cardiovascular outcomes. An observational study conducted over a period of time can provide more convincing evidence that these workplace stressors lead to development of adverse physiological and psychological health outcomes. Thus, the general objective of this project is to conduct a longitudinal follow-up assessment of approximately 475 police officers for whom baseline data and a protocol infrastructure have already been established. The study will assess police workplace stress by examining physiological and psychological measures of stress and evaluating potential associations of these measures with subclinical markers or early signs of cardiovascular and metabolic disease in a population-based design. Markers of disease include blood pressure; laboratory measurement of lipids, glucose, and insulin; heart rate variability to assess autonomic nervous system function; ultrasound imaging studies to measure carotid artery wall thickness (atherosclerosis) and brachial artery reactivity (endothelial or vascular function); and dual-energy x-ray absorptiometric (DXA) measurement of body fat, lean tissue composition, and bone density. Also to be examined are psychosocial factors known to be detrimental to health such as perceived stress, depression, and hostility, and factors known to be protective (e.g., resiliency and social support). The research findings on the health consequences of stress can be translated into improved prevention practices. Analysis of the complex prospective data acquired from this research may contribute to a better understanding of how exposure to stressors over time may lead to early indicators of cardiovascular and metabolic abnormalities. According to the National Institute for Occupational Safety and Health, the percentage of workers who describe their job as very or extremely stressful can be as high as 40 percent (Stress...At Work; NIOSH Publication No. 99- 101). Given this likelihood that stress is relatively common in the workplace, prevention of adverse health consequences that may be associated with stress could benefit a large proportion of the working population. PUBLIC HEALTH RELEVANCE: Stressors inherent in police work and related lifestyle factors have been associated with adverse cardiovascular and metabolic health outcomes. However, the majority of studies has thus far been cross sectional in design, and has focused mostly on apparent clinical outcomes. Thus, the overall goal of this project is to longitudinally examine the impact of occupational stressors on early signs of cardiovascular and metabolic disease in police officers in order to further knowledge on this topic and enhance prevention efforts in the field.