17 Data of occupational-medical check-up examinations challenging the concept of allostatic load

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IntroductionThe Allostatic Load Index (ALI) [McEwen 1993, 2001] assesses the physiological adaption to chronic stress by cumulative changes in the circulation, respiration, inflammation, metabolic and anthropometric system. The ALI thus can function as a risk marker for secondary prevention in occupational medicine. The aim of this study was to create an ALI by using routine data from an executive check-up program of an international company and to examine the relationship between ALI and work-related surrogate health parameters.MethodsDatasets from 307 examinations of 151 executives (19♀, 132♂) were available. Each participant attended at least one check-up examination between 2003 and 2015. The mean of age was 43.6 (SD ±6.6, 31–64 y). We developed four different ALI. Thyreotropin was used as a proxy variable for a primary mediator [MacLean, 1994]. For each ALI the association to the Work Ability Index (WAI) and the category of sick leave days (SLD) was examined by using generalised linear mixed models. Zero inflation was considered for SLD. All analyses were conducted with R 3.3.3 or SPSS 23.ResultsALI 1 showed a significant negative association with the WAI (B=−0.680, SE=0.266, p=0.049). The results for ALI 2 had a similar trend (B=−0.355, SE=0.201, p=0.081). The higher the ALI the lower the workability was rated. After adjustment for zero inflation ALI 3 and 4 showed a positive association with SLD, that is, there is a significant difference between the category of no SLD and any SLD.ConclusionThis study led to first hints that biomarkers form a secondary prevention program are useful to calculate a meaningful ALI. This ALI could be used as a marker in workplace health promotion. Further studies with a longitudinal approach and a broader range of occupations are recommended.

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