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、高要求和创伤性暴露，与心理压力水平的增加有关，在某些情况下还与心血管疾病的不良后果有关。在一段时间内进行的一项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利的生理和心理健康结果的发展。因此，该项目的总目标是对大约475名警官进行纵向后续评估，他们的基线数据和议定书基础设施已经建立。该研究将在基于人群的设计中，通过检查压力的生理和心理测量，并评估这些测量与亚临床标志物或心血管和代谢疾病早期症状的潜在关联，来评估警察的工作压力。疾病的标志包括血压；血脂、葡萄糖和胰岛素的实验室测量；心率变异性评估自主神经系统功能；超声成像研究测量颈动脉壁厚度（动脉粥样硬化）和肱动脉反应性（内皮或血管功能）；以及双能x线吸收仪（DXA）测量体脂肪、瘦组织组成和骨密度。还需要检查已知对健康有害的社会心理因素，如感受到的压力、抑郁和敌意，以及已知具有保护作用的因素（如复原力和社会支持）。关于压力对健康的影响的研究结果可以转化为改进的预防措施。分析从这项研究中获得的复杂的前瞻性数据可能有助于更好地理解长期暴露于压力源如何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非常或极其有压力的工人的比例可能高达40%。在市场中运作;NIOSH出版物编号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。

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.