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NIOSH Programs > Work Organization and Stress-Related Disorders > NIOSH Funded Research Grants
Work Organization and Stress-Related DisordersActivities: NIOSH Funded Research GrantsNIOSH sponsors research and training through its extramural programs, which complement the Institute's intramural programs. More information is available from the NIOSH Office of Extramural Programs. Practical Circadian Interventions for Night Shift WorkMillions of U.S. workers have to work night shifts, resulting in serious consequences such as sleep deprivation, fatigue, reduced alertness, impaired performance, gastrointestinal disorders, and reduced job and public safety. These problems occur because the circadian clocks of the workers do not usually phase shift (reset) to adjust to night work and day sleep schedules. Thus, there is a misalignment between the physiological circadian rhythms and the work and sleep schedule. Night workers are forced to work and sleep when their bodies are not prepared for either. We have shown, in simulated night shift studies, that appropriately timed bright light during the night shift combined with specific dark periods for daytime sleep can produce complete re-alignment of circadian rhythms with the night work, day sleep schedule. However, with complete adjustment night workers would not be adapted to the night time sleep schedule that they subsequently follow on their days off. This will limit the practical application of these types of schedules. We plan to test a schedule for permanent night work that would produce sufficient re-alignment both during night shifts and during days off. Subjects will "work" in the lab and sleep at home. Treatment groups will be exposed to bright intermittent light during the night shifts and will adhere to prescribed dark/sleep episodes (for daytime sleep after night work and sleep on days off). This treatment should phase delay the circadian clock (set it later) to a compromise position, in between complete adaptation to night work and complete adaptation to days off. Control groups will remain in ordinary room light during the night shifts and will be free to sleep whenever they choose while off work. A series of experiments are proposed in which circadian phase will be assessed on different days of the schedule by measuring the circadian rhythm of melatonin. We will determine whether the compromise phase position can be achieved and maintained in the treatment groups despite alternations between series of night shifts and days off. We will determine whether more subjects in the treatment groups than in the control groups obtain a favorable compromise phase position. We will determine whether the treatment groups perform better and feel more alert on the night shift than the control groups, and whether they obtain more sleep. This work will have important implications for the health, safety, and well being of the night shift worker.
Evaluation of Workplace Violence Prevention InterventionWorkplace violence is pervasive in the social service and health care setting. Washington State workers' compensation assault injury data for 1995-2000 ranks Social Services as the highest risk major industry (142.0 per 10,000 workers) followed by Health Services (74.6 per 10,000 workers). Within Social Services, Residential Care ranked second among specific industries with a rate of 301 per 10,000 workers. To address these data, we will conduct a comprehensive assessment of risk factors for violence and occurrences of violence in a sample of social service workplaces. Upon completion of the initial risk assessment we will develop and implement a comprehensive violence prevention program in these workplaces. The program will be developed in concert with federal OSHA Guidelines for violence prevention. Management Commitment and Employee Involvement are inherent in the design of the proposed study and include the formation and work of joint labor-management advisory groups. A Worksite Analysis will include focus groups, a pre-intervention survey, and walk-through evaluations. Hazard Prevention and Control will be accomplished by implementing recommendations from the walkthrough survey and focus groups. The advisory groups in consultation with project staff will review and make recommendations for necessary changes to policies and procedures. Training and Education will take place in year three of the study. Formative evaluation of the project will be ongoing. The impact of the intervention on staff assault experience will be evaluated one year following implementation of the program. The specific aims of the proposed five-year project are as follows. 1) Describe environmental, organizational, and behavior/interpersonal risk factors for workplace violence present in the social service workplace. 2) Assess the assault experience of staff in these workplaces. 3) Examine the relationship between organizational factors and staff assaults in this sample of workplaces. 4) Design and implement a violence prevention intervention within these workplaces. 5) Conduct a process and outcome evaluation of the intervention in sample workplaces one year following program implementation.
Origins and Health Impact of Relational Conflict at WorkThis project will examine the effects of interpersonal relationships in the workplace on anger and physical health. The specific aims of this project are to (1) identify the structural sources and extent of interpersonal conflict in the workplace, (2) specify the origins of conflict in relation to social statuses, occupational status, and job conditions, (3) document the consequences of conflict for emotions and health, and (4) determine the mediating and moderating functions of the sense of mastery and supportive bonds in the workplace.
Effects of Light at Night on Circadian System in NursesEnvironmental lighting powerfully influences the circadian system in humans. Particularly, light exposure that occurs at night may have an adverse effect on cancer risk through suppression of melatonin, a hormone that is intimately linked with the circadian system and which may have cancer protective effects. In observational studies, night work has consistently been associated with an increase in breast and colorectal cancer risk, potentially mediated through the melatonin pathway. In 2003, the Institute of Cancer Research for the Health and Safety Executive (HSE) classified the overall evidence for an association between shift work and risk of breast cancer appreciable. Up to 17 percent of all full-time wage and salary workers work alternative shifts in the U.S. Among those, shifts that include night work are most prevalent and account for 6.4 percent of all full-time wage and salary workers. Although much work has been done to measure the effects of light on melatonin, light measurements, particularly in the short wavelength portion of the visible spectrum, which only recently was found to have the largest impact on circadian functions in humans, were not able to capture the precise effects of light on melatonin, to date. Thus, this proposal will evaluate light exposure in rotating shift workers based on the recent information on the specific wavelengths that affect melatonin levels in humans, and will relate those measures to the response of their circadian system, as measured by melatonin levels in urine. Specifically, we will measure light exposure by applying a new device, a circadian light meter that captures the short wavelength portion of visible light, which has been described to most strongly suppress melatonin levels and phase shift the circadian pace maker as part of the light's influence on non-image forming function in humans. Urine collections will be conducted during three of the overall 7 days of study period. The study involves approximately 180 women, all participants of the ongoing Nurses Health Study II. By selecting a sample of women stratified on their shift schedules we will be able to evaluate differential effects of light exposure in subgroups of night workers. Because the proposed study takes advantage of previously collected detailed demographic and medical information in a large prospective study of nurses, the NHS II cohort, the proposed study is both a particularly relevant contribution to current literature and also very cost-effective.
Stress, Cytokines and Heart Disease in PoliceLaw enforcement officers have a higher prevalence of cardiovascular disease (CVD) than the general population which cannot be explained by an excess of conventional risk factors. CVD is an inflammatory disease and several aspects of the law enforcement profession, e.g. job-related stress, can affect inflammatory mediators. The objective of this proposal is to test the hypothesis that officers have a higher risk of cardiovascular disease due to alterations in pro- and anti-atherogenic inflammatory mediators which are associated with job-related stress. This hypothesis will be tested by pursuing two specific aims: 1) Quantify the levels of pro- and anti-atherogenic cytokines and other inflammatory mediators in law enforcement officers and 2) Determine the forms of job-related stress most associated with changes in these inflammatory mediators. Under the first aim, levels of pro-atherogenic C-reactive protein* fibrinogen, TNF- a, IL-1P, IL-6, and IL-18 and anti-atherogenic IL-4 and IL-10 will be compared in law enforcement officers to an otherwise similar general population cohort. Under the second aim the association between these inflammatory mediators, a general measure of perceived stress, the job-related stress measures of vital exhaustion, job strain and effort-reward imbalance, and the stress biomarker of salivary cortisol will be determined. The rationale for the proposed research is that, once the pathogenesis of the increased prevalence of cardiovascular disease in this profession is understood, specific interventions can be designed to combat the identified risk factor(s). The proposed work is innovative because we have conceptually linked inflammatory mediators associated with cardiovascular disease and work-related factors that can affect these mediators to a demonstrated increased prevalence of cardiovascular disease in law enforcement officers. The proposed work is significant because it is expected to increase our understanding of the mechanisms underlying the pathogenesis of cardiovascular disease in this high stress occupation.
JUSTA: Justice and Health for Poultry WorkersThe overall goal of this project is to address the health disparities faced by immigrant Latino poultry workers in rural, western North Carolina (NC), through a partnership (JUSTA-Justice and Health for Poultry Workers) of community advocates, environmental health sciences, and health care providers. Workers in the poultry industry in the U.S. experience a disproportionate share of occupation-attributed musculoskeletal, skin and respiratory disorders. Recent trends in this industry have concentrated the injuries in a worker population that is poor, minority, and comprised predominantly of immigrants. These workers are purposively recruited into jobs rejected by the local population, and lack the means to protect themselves from hazards. The exposures of workers also affect their families. To bring about greater social and environmental justice for these workers, the proposed work will have two loci: helping individual workers and their families to be more resilient to stressors, strengthening community-based organizations so that they can move toward social and regulatory change and justice. Community advocates, health care providers and environmental health researchers will work together in this project to address five Specific Aims: 1) to encourage social action by Latino community-based advocacy groups in western NC to effect policies that reduce the burden of occupational and environmental health disparities due to employment in the poultry industry; 2) to construct the foundation on which to base educational materials and communication strategies designed to prevent or reduce exposure to physical and social occupational stressors and their effects among Latino poultry worker families; 3) to develop culturally and linguistically appropriate educational materials and implement programs that will promote ways to prevent or reduce exposure to physical and social occupational stressors and their effects among Latino poultry worker families; 4) to develop educational materials and implement programs that will better prepare health care providers to recognize and treat with cultural competence illnesses related to poultry production and processing among immigrant families, and counsel families on ways to prevent or reduce exposure; and 5) to evaluate the process and outcomes of community participation in this project so that it can be used by other community-based organizations to engage community residents in efforts to reduce environmental and occupational risks in their own communities.
Impact of Work Organization on Women’s Postpartum HealthThe specific aims of this project are to model (1) the relationship between the organization of work (job stress, work schedule, job flexibility) and women's post-partum health trajectories, (2) the role of perceived work-family conflict as a mediator of the relationship between the organization of work and women's post-partum health at specific points in time, and (3) the relationship between total workload (hours of paid employment, hours of family labor, number of children, household structure) and women's post-partum health at specific points in time.
Sleep Disorders Management, Health and Safety in PoliceSleep Disorders may cause the deaths of up to 20,000 people each year in the United States, and lead to loss of health, poor quality of life, and decreased job productivity. Because of their career-long exposure to long work hours and frequent overnight shift duty, police officers are at extremely high risk of suffering sleep disorders, including obstructive sleep apnea, insomnia, and shift work sleep disorder. Our research group has conducted numerous studies of sleep deprivation and interventions to reduce the adverse effects of sleep deprivation on safety, health, and performance of personnel in numerous occupational groups: police, physicians in training (residents), astronauts, air force pilots, nuclear power plant workers, truckers, and industrial workers. We have a successful track record of disseminating research results to inform local and national policy changes. We propose to conduct a randomized, prospective study of the effect of a novel Sleep Disorders Detection and Treatment Program - Operation Healthy Sleep. Because of the high prevalence of sleep disorders among police, and the profound effect of sleep disorders on performance, safety, and job experience, we hypothesize that implementation of Operation Healthy Sleep will: 1. improve the mean nightly sleep and alertness of police officers; 2. improve police officer safety, as determined by: a. decreased rates of motor vehicle crashes; b. decreased on-the-job injuries; 3. improve police officer productivity, as determined by: a. increased arrest and conviction rates; b. decreased response time and completion time (clear time) for calls on duty; c. decreased rates of civilian complaints and inappropriate use of force; 4. improve officers' and families' job satisfaction and ability to cope with shift work. By establishing a comprehensive sleep disorders detection and treatment program and rigorously testing its effects across a range of health, safety, and work outcomes, we hope to develop a model program that can be broadly replicated to improve the safety, health, and performance of police officers, as well as other shift workers, across the country.
Longitudinal Measurement of Work Stressors in PregnancyThe specific aim of this project is to obtain preliminary data assessing two models of occupational stress during pregnancy, in particular measuring repeatedly and longitudinally across the course of pregnancy to evaluate the possibility that these may change across pregnancy. This proposal aims also to evaluate the use of the effort-reward imbalance (ERI) model, which has not been tested in pregnant workers or used in studies of pregnancy outcomes.
Safety of Nighttime Construction ActivitiesNight construction has increased dramatically over the last few years, especially in highway construction. However, it poses unique risks for construction since night-time illumination has not been effectively deployed resulting in decreased visibility for workers and motorists. Also more motorists are likely to be fatigued or driving under the influence of drugs and alcohol, increasing their propensity to accidents. According to national statistics, about 60% of all work zone fatalities occur at night. Our long-term goal is to evaluate safety issues in nighttime construction as a necessary prerequisite to the development of strategies to improve safety, quality and productivity of nighttime construction operations on highways and in other sectors of construction. This 5-year research study will comprise of 3 major components: (1) Exploratory component-Years 1 and 2; (2) Intervention/prevention component-Years 3 and 4 and (3) Translation component-Year 5. The specific aims of the study are four-fold: 1. Review current production and safety practices contractors during nighttime construction and maintenance in order to examine issues related to safety, efficiency and quality construction during nighttime operations (Year 1). 2. Collect and analyze lighting and construction production and safety data from construction sites where nighttime operations have been prevalent (Year 1 and 2). 3. Develop models for improved lighting and other strategies on such sites, and explore opportunities for implementing them on ongoing and future construction projects and run pilot studies testing the models for validating possible relationships between improving such strategies and construction safety (Years 3 and 4). 4. Translating results from the research environment into the construction industry, based on the outcomes of the models developed and pilot studies (Year 5). Our partners in this research project include the Indiana Department of Transportation, Walsh Construction and Rieth Riley Construction-heavily involved in night-time construction on highways, and F.A. Wilhelm Construction-involved in nighttime operations on commercial, institutional and industrial projects.
Development of a Behavioral Measure of Supervisor SupportThe specific aim of this project is to examine behaviors that supervisors need to exhibit in order to lead to worker perceptions of managerial supportiveness for work and family. The project is also the first to explicitly link work-family demand conflicts to both worker safety and the mental and physical health of workers and their families.
Center for the Promotion of Health in the New England WorkplaceThe Center for the Promotion of Health in the New England Workplace (CPH-NEW) is a cooperative initiative by investigators from two major public universities in the New England area, the University of Massachusetts Lowell (UML) and the University of Connecticut (UC), along with the private sector (St. Paul Travelers Insurance Company. Genesis HealthCare Corporation. Liberty Mutual Research Institute for Safety), labor (Massachusetts Nurses Association and the Connecticut Council for Occupational Safety and Health), and state government (Massachusetts and Connecticut Departments of Public Health). The key academic departments are Work Environment at UML and Occupational and Environmental Medicine, Occupational Health Psychology, and Health Promotion at UC. Strengths of CPH-NEW lie in extensive group experience in occupational health and safety (OHS), psychology, and health promotion and education (HPE); technical expertise in survey research and biostatistics; and educational and outreach infrastructure. Cross disciplinary collaboration will rest on both project- and methodology-oriented teams as well as on the investigators strongly established relationships. "Exploratory,-Efficacy, and Effectiveness" research project #1, "Promoting Physical and Mental Health of Caregivers Through Trans-disciplinary Intervention" will be conducted within Genesis HealthCare Corporation, a major East Coast provider of nursing home and assisted living care. A no-lift program in 217 facilities will be paired with two types of health promotion programs to compare worker health outcomes in sites with: 1) workplace intervention only; 2) both workplace intervention and HPE; and 3) workplace intervention plus a participatory health promotion program. Research Project #2, entitled "Health Improvement through Training and Employee Control (HITEC)," involves comparison of traditional HPE/workplace intervention with an experimental program featuring employee control. All sites will be St. Paul Travelers insured, paired on the basis of intervention type. The Education, Translation, Communication and Dissemination" project builds on Heart and Stroke Partnership plans developed by the MA and CT Departments of Health. The Center will develop curriculum and offer training sessions primarily on the relationship between work-related stress and the development of heart disease and stroke. CPE-NEW will greatly advance public health by integrating two core public health areas (OHS and HPE), thus linking primary prevention to the workplace, and the workplace to primary prevention.
Healthier Workforce Center for ExcellenceThe Healthier Workforce Center for Excellence (HWCE) will be designed to improve our understanding of effective, integrated employee health programs and to translate this evidence base into practice for the benefit of employed populations. While the value of creating integrated health protection and health promotion programs has been described, there are many uncertainties related to practical implementation of such programs. It is not clear, for instance, how integration should best be achieved with regards to the following variables: private vs. public sector; type of work setting (e.g., manufacturing vs. high-tech); number and variety of job types in the particular workforce; effectiveness, availability, and utilization of existing health protection and health promotion resources; and the relative impact of company-, group-, and individual-level interventions. The HWCE will explore the effects of different integrated health protection/health promotion programs tailored to meet the needs of three different work environments: a health insurance company, a manufacturing firm, and a public university workforce that is decentralized, with widely varying job types. The Center's goals are: (1) To examine the relationships among predictors for absenteeism, work-related injury, workers' compensation claims, healthcare expenditures, and overall health. ( 2) To implement, evaluate, and compare three integrated health protection/health promotion models for the private and public sectors: (a) a policy approach to achieving integrated employee health; (b) an intervention based around an integrated worker safety/health promotion committee and (c) an intervention using a health counselor to integrate the delivery of health protection and health promotion services in a public sector setting; and (3) To establish a learning network of interactive partnerships with employers, employee groups including unions, and health care organizations. The policy-focused project will be evaluated with time series and cost effectiveness analyses. The worker safety/health promotion committee project will employ a quasiexperimental design with a delayed intervention component. The health counselor project will be a randomized controlled trial. And the learning network/education and translation project will be examined primarily using formative and process evaluation measures. The Center's research will improve public health by helping to develop workplaces that address employee health in a more effective, integrated fashion. The Center will also develop a learning network with employers, worker groups, universities, and others so that research findings can rapidly be put into practice in many settings throughout the U.S.
Evaluation of Organizational Justice Intervention to Alleviate TYPE III ViolenceModel workplace policies directed at preventing Type HI workplace violence (coworker violence) are widely available, yet their impact on workplace and worker health has never been rigorously evaluated. This application describes an organizational level intervention focused on organization justice because there is a growing awareness of the importance of organizational climate in contributing to Type III violence. Workplaces with good organizational justice environments foster a healthy work climate that is less permissive towards Type III workplace violence. To date, organizational justice research has been largely correlational, with no intervention studies to show that changing this important aspect of the work setting can reduce coworker violence. Research which includes process and outcome measures are critically needed to assess the impact of prevention efforts on victims, employers and workplaces. An interdisciplinary team of seasoned intervention researchers and state government partners who have conducted workplace violence intervention research for the past seven years will carry out the proposed work. The proposed research will be conducted in two phases. Phase one will include a screening survey of a large cross-section of state government workers and managers (N= 18,000) to assess the prevalence of Type HI workplace violence in their workplaces and associated climate for organizational justice. These screening data will then be used to rank workplaces by risk of Type III violence. Six agencies at high risk of Type HI violence will be randomly assigned to either the intervention or control condition. Researchers and agency partners will then develop, implement and rigorously evaluate the impact of a violence prevention intervention on Type III workplace violence, and organizational justice climate. The following specific aims address both phases of the proposed work: 1) To assess past six month prevalence of Type IE workplace, associated circumstances and employer response to violence using a screening cross-sectional survey. 2) To describe organizational justice climate for Type III workplace violence prior to intervention in six NY state agencies. 3) To develop and implement a workplace violence prevention policy and associated activities in three NY state agencies with a high prevalence of Type IH workplace violence based on screening. 4) To evaluate the impact of a workplace violence prevention program on organizational justice climate and the incidences and prevalence of Type III workplace violence by comparing intervention and control agencies. |
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NIOSH Program Portfolio:Work Organization and Stress-Related Disorders |
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