Stress and Subclinical Cardio-Metabolic Disease in Police: A 12-Year Longitudinal Study

Details

• Personal Author:
  Vena JE ; Vila BJ ; Violanti JM ; Wactawski-Wende J
• Description:
  Certain characteristics of police work such as shift work, long work hours, high job demands, and traumatic exposures have been associated with increased levels of psychological stress and with adverse cardiovascular outcomes. This study provided a unique opportunity to longitudinally study police stress, work exposures and cardiovascular disease. There were four areas of investigation where we observed significant changes over the time period (1) lifestyle; (2) work related and psychological conditions; (3) cardiovascular measures including metabolic syndrome components, and (4) balances in stress hormones such as cortisol. Examples of physiological measures included blood pressure; autonomic nervous functioning, height, weight, Body Mass Index (BMI), percent body fat, abdominal obesity, waist circumference and bone density. The study assessed carotid artery thickness (plaque buildup) and artery expansion health with ultrasound. Small vessels in the eye were examined for damage as an indicator of future cardiovascular health. Hormones known to be biological markers of stress (e.g. cortisol) were measured using saliva samples. Psychological measures included posttraumatic stress disorder (PTSD), depression, anxiety, suicide ideation, and others. Measures considered protective against stress were resiliency, and social support. Information on sleep quantity and quality were obtained from worn devices (actigraph watches) which provided continuous recording of movement data without the need for technical assistance or overnight stays in the laboratory. Overall the longitudinal measure of police work stressors increased significantly over the study period. Stress and biological stress influences may affect pathological physiological outcomes such as cardiovascular disease. Other noticeable changes were a significant drop in physical activity, increased BMI, reduced artery flexibility, and increased carotid artery thickness over time. A significant increase in the metabolic syndrome (components which increase the risk for heart disease) was found over the study period. A dysregulation the stress hormone cortisol was noted and associated with poorer artery health. There was a significant increase in work hours and second jobs associated with poorer sleep among officers. PTSD remained relatively high over the study time period. Both PTSD and depression may promote poor health through a complex interaction between biological and psychological mechanisms. At the same time, psychological factors considered protective (resiliency) decreased. These factors taken together were considered as contributing to a potential increased risk for subclinical cardiovascular disease and mental health problems. The results of this study added to the understanding of how police exposure to work and life stressors over time were associated with early indicators of cardiovascular and metabolic abnormalities in police officers. The study emphasizes the need for increased police training in stress reduction and wellness. The establishment of wellness programs in police work may help to reach the goal of holistic well-being in this stressful occupation. In the long run, this will help to keep officers healthy and better serve the public. [Description provided by NIOSH]
• Subjects:
  Cardiovascular Diseases Cardiovascular System Energy Metabolism Law Enforcement Mental Health Nervous System Occupational Health Safety Shift Work Schedule Sleep Stress, Psychological Stress Disorders, Post-Traumatic

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• Keywords:
  BMI Body Mass Index Cardiovascular Disease Job Stress Law Enforcement Workers Mental Health Metabolic Effects Police Officers Post-traumatic Stress Disorder PTSD Shift Work Traumatic Incident Stress

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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:
  New York ; OSHA Region 10 ; OSHA Region 2 ; OSHA Region 4 ; South Carolina ; Washington
• 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:
  1-55
• NIOSHTIC Number:
  nn:20064586
• NTIS Accession Number:
  PB2022-100414
• 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, R01-OH-010807, 2020 Oct; :1-55
• Contact Point Address:
  John M. Violanti, PhD, Epidemiological and Environmental Health, School of Public Health & Health Professions, 270 Farber hall, University at Buffalo, State University of New York, Buffalo, NY 14214
• Email:
  violanti@buffalo.edu
• Federal Fiscal Year:
  2021
• NORA Priority Area:
  Public Safety
• Performing Organization:
  State University of New York at Buffalo
• Peer Reviewed:
  False
• Start Date:
  20150901
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20190831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:daf8c76d3afefe7ff1d02852ca38667d36e55099eedd4409d8b6c450335409491c89a4a4a71bab70c880451130db0e6de185e1cecd37b04b8e77bbbf1e45fe97
• Download URL:
  https://stacks.cdc.gov/view/cdc/219102/cdc_219102_DS1.pdf
• File Type:
  [PDF - 511.21 KB ]