Hair cortisol in relation to job stress and depressive symptoms.

BACKGROUND: Measurement of hair cortisol concentration (HCC) may be used as a biomarker for chronic stress. However, the association between stress and HCC has rarely been investigated in a working population. AIMS: To explore associations between (i) HCC and various stress measures and (ii) HCC and symptoms of depression in Belgian workers. METHODS: Hair samples were collected from workers in two production companies and cortisol content was determined by liquid chromatography tandem mass spectrometry. Participants completed a questionnaire including socio-demographics, health behaviours and standardized measures for assessing stress. RESULTS: After excluding those workers suffering from a psychiatric or neuroendocrine disease and those treated with glucocorticoids, there were a total of 102 workers with both questionnaire, cortisol results and anthropometric measures. Median HCC was 5.73 pg/mg hair (interquartile range = 4.52-9.06). No significant associations were found between cortisol and the standardized measures related to several work psychosocial risk factors. A significantly lower mean HCC was found in shift workers compared with dayworkers, adjusted for age. Additionally, a significant higher mean HCC was found in workers with symptoms of depression compared with those without symptoms of depression, after adjustment for age. CONCLUSIONS: HCC showed a limited applicability as a biomarker for job stress in this sample, although the results suggest this method may be a suitable marker for detecting early symptoms of depression. Further research is needed to investigate the applicability of HCC in the working environment and within job stress research.

Nursing staff and their team: Impact on intention to leave.

AIM: The aim was to examine the relationship between the quality of team-member exchange experienced by nursing staff and their intention to leave. Job satisfaction and affective organizational commitment are considered as mediators. BACKGROUND: While the shortage of nurses is a management and policy priority, few studies have studied the relationships between nursing staff and their team, key organizational attitudes, and intentions to leave the organization. METHOD: A questionnaire was administered to 217 registered nurses and nurse assistants in Belgium. Data were collected in 2012. To analyse the data, descriptive statistics, correlation, regression and path analyses were conducted. FINDINGS: Team-member exchange has a positive impact on nursing staff satisfaction and affective commitment. Job satisfaction and affective organizational commitment fully mediated the impact of team-member exchange on nursing staff's intention to leave. CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY: This study illustrates the potential benefits of the positive influence of team-member exchange on key organizational attitudes of nursing staff, and the negative influence on intention to leave through affective commitment and job satisfaction.

Mechanisms of stress, energy homeostasis and insulin resistance in European adolescents--the HELENA study.

BACKGROUND AND AIMS: Stress is hypothesized to facilitate the development of obesity, whose the foundations are already set during childhood and adolescence. We investigated the relationship between the stress-system, selected mechanisms of energy homeostasis and insulin resistance (IR) in a sample of European adolescents. METHODS AND RESULTS: Within HELENA-CSS, 723 adolescents (12.5-17.5 years) from 10 European cities provided all the necessary data for this study. Fasting blood samples were collected for cortisol, leptin, insulin and glucose analysis. HOMA-IR was calculated from insulin and glucose concentrations. Adolescents' body fat (BF) %, age and duration of exclusive breastfeeding were assessed. For boys and girls separately, the relationship of cortisol with leptin, insulin, glucose and HOMA-IR was examined by computing Pearson correlation coefficients and Hierarchical Linear Models (HLMs), with 'city' as cluster unit, adjusting for age, BF% and duration of exclusive breastfeeding. In boys, Pearson correlation coefficients illustrated positive correlations of cortisol with insulin (r = 0.144; p = 0.013), glucose (r = 0.315; p < 0.001) and HOMA-IR (r = 0.180; p = 0.002), whilst in girls, this positive relationship was observed for leptin (r = 0.147; p = 0.002), insulin (r = 0.095; p = 0.050) and HOMA-IR (r = 0.099; p = 0.041), but not for glucose (r = 0.054; p = 0.265). Observed associations were independent of adolescents' age, BF% and duration of exclusive breastfeeding after computing HLMs. CONCLUSION: This study suggests that the stress-system is positively related to mechanisms of energy homeostasis and IR in European adolescents, and reveals a potential small gender difference in this relationship. The hypothesis that stress might facilitate the development of obesity during adolescence is supported.

Social motives for drinking in students should not be neglected in efforts to decrease problematic drinking.

High heavy drinking prevalence persists in students. Recently, drinking motivation received a lot of attention as an important determinant. Enhancement and coping motives are mostly positively related and conformity motives are mostly negatively related with heavy drinking. Relations are less clear for social motives. This study aimed at gaining more insight in the role of drinking motives in heavy drinking students. Overall, 15 897 Belgian university and college students (mean age: 20.7, SD = 2.6) anonymously participated in an online survey. Logistic regressions tested relationships between motives and problematic drinking (>weekly drinking, ≥monthly binge drinking and being at risk for problematic drinking by the Alcohol Use Disorders Identification Test [AUDIT]). Social motives had the highest prevalence, followed by enhancement, coping and conformity motives. Men engaged more in problematic drinking and reported more motives, except for coping. Enhancement, coping and social-motivated students have higher chances for problematic drinking, while the opposite is true for conformity-motivated students. Although this study found a similar ranking of motives as in other studies, a relationship between problematic drinking and all motives, including social motives, was revealed. This might indicate the different functions of social motives in heavy drinking in different cultures/sub-populations and countries. This finding is relevant for the development of interventions.

Job strain in relation to body mass index: pooled analysis of 160 000 adults from 13 cohort studies.

BACKGROUND: Evidence of an association between job strain and obesity is inconsistent, mostly limited to small-scale studies, and does not distinguish between categories of underweight or obesity subclasses. OBJECTIVES: To examine the association between job strain and body mass index (BMI) in a large adult population. METHODS: We performed a pooled cross-sectional analysis based on individual-level data from 13 European studies resulting in a total of 161 746 participants (49% men, mean age, 43.7 years). Longitudinal analysis with a median follow-up of 4 years was possible for four cohort studies (n = 42 222). RESULTS: A total of 86 429 participants were of normal weight (BMI 18.5-24.9 kg m(-2) ), 2149 were underweight (BMI < 18.5 kg m(-2) ), 56 572 overweight (BMI 25.0-29.9 kg m(-2) ) and 13 523 class I (BMI 30-34.9 kg m(-2) ) and 3073 classes II/III (BMI ≥ 35 kg m(-2) ) obese. In addition, 27 010 (17%) participants reported job strain. In cross-sectional analyses, we found increased odds of job strain amongst underweight [odds ratio 1.12, 95% confidence interval (CI) 1.00-1.25], obese class I (odds ratio 1.07, 95% CI 1.02-1.12) and obese classes II/III participants (odds ratio 1.14, 95% CI 1.01-1.28) as compared with participants of normal weight. In longitudinal analysis, both weight gain and weight loss were related to the onset of job strain during follow-up. CONCLUSIONS: In an analysis of European data, we found both weight gain and weight loss to be associated with the onset of job strain, consistent with a 'U'-shaped cross-sectional association between job strain and BMI. These associations were relatively modest; therefore, it is unlikely that intervention to reduce job strain would be effective in combating obesity at a population level.

Individual and contextual influences of workplace social capital on cardiovascular health.

Social capital is commonly defined as features of social relationships, such as levels of interpersonal trust and norms of reciprocity and mutual aid, that facilitate collective action for mutual benefit. An extended research tradition exists around the contextual effects of social capital at the level of geographical areas such as neighborhoods, but more recently workplace social capital has received growing attention in literature. An overview of the different theoretical approaches and empirical findings of the concept of workplace social capital will be presented. Studies have shown associations between workplace social capital and indicators of mental and physical health, but very few research has focused on the relation with cardiovascular disease. An integrated theoretical model of reciprocity as key aspect of social capital was developed that distinguishes both emotional and instrumental dimensions of reciprocity among coworkers and supervisors at the individual and workplace level. This model has been empirically tested using data from the BELSTRESS study including more than 24.000 middle-aged men and women at work in 32 different workplaces. Data were collected through self-administered questionnaires and bio-clinical examinations. Results will be presented on the impact of workplace social capital on behavioral and clinical cardiovascular risk factors.

Effect of a tailored behavior change program on a composite lifestyle change score: a randomized controlled trial.

To evaluate the effect of a tailored behavior change program on a composite lifestyle change score. A randomized controlled trial conducted in Belgium in 2007-08 with 314 participants allocated to a control and an intervention condition. The intervention was a tailored behavior change program (web-based and individual coaching). The dose of the coaching was chosen by the participants and registered. Outcome measures were weight, saturated fat intake, fruit and vegetable intake, physical activity, smoking status and a composite lifestyle change score. Mann-Whitney U-tests, Kruskal-Wallis tests, t-tests and one-way analyses of variance were used to compare the study conditions and three intervention dose groups (no/low, medium and high intervention dose). There were no significant differences between the study conditions or between the intervention dose groups for the individual lifestyle factors. The composite lifestyle change score was significantly higher in the high intervention dose group compared with the no/low intervention dose group (P = 0.009). The composite lifestyle change score was positively related to the intervention dose, while the individual lifestyle factors were not. Behavior change programs that target multiple lifestyle factors could be evaluated by using a composite lifestyle change score taking into account the intervention dose.

Behavioural and psychosocial correlates of nondipping blood pressure pattern among middle-aged men and women at work.

The underlying pathogenetic mechanisms of nondipping blood pressure (BP) pattern are not completely understood. Especially the role of psychosocial correlates remains unclear. The aim was to assess the association between nondipping BP pattern, behavioural and psychosocial factors in a sample of working men and women. The study sample included 167 working men and women aged 40-64 years from the BELSTRESS cohort. Socio-demographic, behavioural and psychosocial factors were assessed by self-administered questionnaires. Participants were medically examined and underwent an ambulatory BP monitoring during 24 h. Nondipping was defined when the average nocturnal decline in BP was <10%. The prevalence of nondipping for both systolic and diastolic BP was 7.8%. Nondipping was not significantly related to smoking, alcohol consumption and leisure time physical activity. A crude significant association was observed between nondipping and sleep problems. After adjusting for gender, education and body mass index, the risk for nondipping was associated with job strain, living alone, being unsatisfied about the contact with one's children, depressive symptoms and vital exhaustion. Nondipping BP pattern was consistently related to psychosocial factors in this study: positive associations were observed with measures of job strain, poor private life support (living alone and being unsatisfied about the contact with one's children) and mental health problems (depressive symptoms and vital exhaustion).

Rotating shift work and the metabolic syndrome: a prospective study.

BACKGROUND: Several studies have documented on the elevated cardiovascular risk among shift workers. In order to further explore this relation, we aimed at assessing the association between rotating shift work and the incidence of the metabolic syndrome (MetS). METHODS: In this population-based prospective study, 1529 employees from several large Belgian companies were followed for a median observation period of 6.6 years with respect to the onset of the MetS and its separate components. RESULTS: At baseline, 309 men (20.2%) were rotating shift workers. The MetS incidence rate in these shift workers (60.6 per 1000 person-years) was increased in comparison with day workers (37.2 per 1000 person-years) with an odds ratio (95% CI) of 1.77 (1.34-2.32). Multivariate adjustment for potential lifestyle and work-related confounders did only marginally affect the strength of the association. The risk for the development of MetS gradually increased independently with accumulated years of shift work. Rotating shift work not only had an impact on MetS as a cluster of conditions but on each of its individual components as well. CONCLUSIONS: Hence, prospective evidence was found that rotating shift work increases the risk for developing the MetS over a period of 6 years.

Perceived job stress and incidence of coronary events: 3-year follow-up of the Belgian Job Stress Project cohort.

Psychosocial characteristics have been linked to coronary heart disease. In the Belgian Job Stress Project (1994-1999), the authors examined the independent role of perceived job stress on the short-term incidence of clinical manifest coronary events in a large occupational cohort. A total of 14,337 middle-aged men completed the Job Content Questionnaire to determine the dimensions of the extended job strain model, job demands, decision latitude, and social support. Jobs were categorized into high strain, low strain, active jobs, and passive jobs. During the 3-year follow-up, 87 coronary events were registered. At baseline, 17% of workers experienced high strain. Job demands and decision latitude were not significantly related to the development of coronary heart disease after adjustment for covariates. The 38% risk excess among subjects classified in the high-strain category did not reach statistical significance. However, coronary heart disease incidence was substantially associated with the social support scale independently of other risk factors, with an adjusted hazard ratio of 2.4 (95% confidence interval: 1.4, 4.0) between extreme tertiles. No convincing evidence for an association of job demands, decision latitude, or job strain with the short-term incidence of coronary heart disease was found. However, our study underscores the importance of a supportive social work environment in the prevention of coronary heart disease.