Concept: Stress, Cytokines and Heart Disease in Police

Details

• Personal Author:
  Ekkekakis P ; Franke WD ; Kohut ML ; Miller DB ; Russell DW
• Description:
  Law enforcement officers have higher all-cause morbidity and mortality than the general population. Cardiovascular disease (CVD) accounts for a significant portion of this excess illness, with published prevalences as high as 1.7 times that of the general population. There are over 17,000 criminal justice agencies in the United States that employ over 800,000 sworn officers. Therefore, identifying job-related sources of cardiovascular disease is a crucial step towards reducing this excess prevalence. Since the prevalence of traditional CVD risk factors among law enforcement officers is similar to the general population, other mechanisms must be involved in this excessive morbidity. Cardiovascular disease is now recognized as an inflammatory disease and inflammatory mediators are an important part of this process. Stress can markedly alter the production of several pro- and anti-atherogenic inflammatory mediators. Therefore, this research project tested the hypotheses that 1) compared to the general population, law enforcement officers have higher levels of pro-atherogenic inflammatory mediators and lower levels of anti-atherogenic inflammatory mediators and 2) job-related stress is associated with these differences. To test these hypotheses, inflammatory mediators (IL-1B, IL-6, TNF-a, C-reactive protein, fibrinogen, IL-4, IL-10), global stress, job-related stress (job strain, vital exhaustion, effort-reward imbalance) and social support were compared among 444 sworn law enforcement officers of the Iowa Department of Public Safety and 166 demographically similar non-officers. Neither global CVD risk, expressed as the Framingham Risk Score, nor the number of metabolic syndrome risk factors differed between these two groups. IL-4 did not differ significantly between the two groups while four of the remaining six mediators were higher in the officers (range = 1.8 - 5.2 fold higher). The other two were 25-33% lower. Global stress was higher in the control participants than the officers as was job strain and vital exhaustion. Effort-reward imbalance was higher in the officers, primarily due to relatively greater extrinsic effort. In both groups, social support was equally high. However, none of these stress measures explained more than 4% of the variability in any of the inflammatory mediators. The key findings of this research project are 1) law enforcement officers may be at an increased risk for CVD due to a relatively pro-inflammatory vascular milieu but 2) this increased risk does not appear to be associated with either job-related stress or traditional CVD risk factors. The mechanisms underlying this pro-inflammatory profile remain uncertain, although candidates are shiftwork and poor sleep quality. Both are common to law enforcement and limited evidence suggests that both are associated with inflammation. The utility of these results to the workplace is primarily recognizing that members of the law enforcement profession may have an increased risk for CVD that would not be detected with a typical medical examination. Most physicians routinely screen for traditional CVD risk factors, such as hypertension, hyperlipidemia and tobacco use. However, the risk factor of increased inflammatory mediators is novel, nontraditional, and not routinely assessed in most physicians' offices. Thus, CVD risk may be underestimated in law enforcement officers. [Description provided by NIOSH]
• Subjects:
  Cardiovascular Diseases Cardiovascular System Law Enforcement Morbidity Mortality Occupational Health Risk Assessment Risk Factors Safety Shift Work Schedule Sleep Sleep Initiation And Maintenance Disorders Stress, Psychological

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• Keywords:
  Cardiovascular Disease Cytokines Job Stress Law Enforcement Law Enforcement Workers Morbidity Rates Mortality Rates Police Officers Risk Factors Shift Work Sleep Deprivation

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• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  Iowa ; OSHA Region 7
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-15
• NIOSHTIC Number:
  nn:20058920
• NTIS Accession Number:
  PB2022-100296
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R21-OH-008270, 2011 Mar; :1-15
• Contact Point Address:
  Warren D. Franke, Ph.D., 247 Forker Building, Ames, IA 50011
• Email:
  wfranke@iastate.edu
• Federal Fiscal Year:
  2011
• Performing Organization:
  Iowa State University
• Peer Reviewed:
  False
• Start Date:
  20060901
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20090831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:b4ce660c9fa31401c337f5c8c2bea15b72bffd484f5c4d4b8e16a29a446dcdad7a85b3d07e4724777ea88b901bf2aff406d235f7c0526adbfde961a94b3e1db7
• Download URL:
  https://stacks.cdc.gov/view/cdc/218959/cdc_218959_DS1.pdf
• File Type:
  [PDF - 245.90 KB ]