Work-related psychosocial stress and allostatic load within firefighters

Abstract

The aim of this study was to investigate the nature and type of psychosocial stress experienced by firefighters through investigating the cumulative effects of work-related factors on their health by reviewing current literature. In addition, the study investigated a range of physiological markers of chronic stress experience (i.e., an allostatic load index), and determined relationships between allostatic load and work-related stressors amongst 6 firefighters. Results from the systematic review showed the significant role psychosocial stressors played on the health outcomes of the studied firefighters. Psychosocial factors (including social support, job demand/pressure, lack of reward, organizational system, occupational climate/environment, self-esteem, rank of work, shift work, shift work and self esteem) showed various associations with unfavourable health outcomes in firefighters. The pilot study revealed high perceived stress levels among the sample population. Significant associations were observed between hair cortisol level (stress response) and perceived stress reported by the firefighters. Systolic blood pressure and HbA1c levels also showed a positive correlation with perceived stress. The study population reported significant concern on the following psychosocial factors: organizational structure, clear leadership and expectations, involvement and influence, and workload management. The allostatic load index (ALI) in our study population was relatively high when compared with other population groups. Certain biomarkers of the ALI surpassed their accepted cut-off levels (systolic blood pressure, BMI and hair cortisol levels). Despite high perceived stress levels and corresponding ALI, we were unable to find a significant association between ALI and workplace stressors in our study population. Future research should include a longitudinal study with an effective sample size using multi-systemic variables (ALI) to investigate biologic wear and tear associated with firefighting.