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

描述(由申请人提供)：警察工作的某些特点，如轮班工作、长时间工作、高要求和创伤暴露，与心理压力水平增加有关，在某些情况下还会导致不利的心血管后果。一项在一段时间内进行的观察性研究可以提供更令人信服的证据，证明这些工作场所的压力源会导致不利的生理和心理健康结果。因此，该项目的总体目标是对已建立基线数据和礼宾基础设施的大约475名警官进行纵向后续评估。这项研究将通过检查压力的生理和心理指标，并在基于人群的设计中评估这些指标与亚临床标志或心血管和代谢性疾病的早期迹象的潜在关联，来评估警察工作场所的压力。疾病的标志物包括血压；实验室测量血脂、血糖和胰岛素；心率变异性以评估自主神经系统功能；超声成像研究以测量颈动脉壁厚度(动脉粥样硬化)和臂动脉反应性(内皮或血管功能)；以及双能X射线吸收法(DXA)测量体脂、瘦组织成分和骨密度。还将检查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，以及已知具有保护性的因素(例如，复原力和社会支持)。关于压力对健康影响的研究结果可以转化为改进的预防做法。对从这项研究获得的复杂的前瞻性数据的分析可能有助于更好地理解随着时间的推移暴露于应激源如何可能导致心血管和代谢异常的早期指标。根据国家职业安全与健康研究所的数据，认为自己的工作压力很大或非常大的员工比例高达40%(工作压力……；NIOSH出版物第99-101号)。鉴于压力在工作场所相对常见的可能性，预防可能与压力有关的不利健康后果可能使大部分工作人口受益。

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.