Association between occupational stress, work shift and health outcomes in hospital workers of the Recôncavo of Bahia, Brazil: the impact of COVID-19 pandemic

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Abstract

The aim of this study was to ascertain the level of occupational stress before and during the COVID-19 pandemic, how it changed and its association with health outcomes of hospital workers in the Recôncavo of Bahia, Brazil. A longitudinal study was conducted with 218 hospital workers over 18 years old. A semi-structured questionnaire was used for collecting sociodemographic, occupational, lifestyle, anthropometric and health data. The main exposures were occupational stress, assessed through Job Content Questionnaire and classified according to the Demand-Control Model and reported shift work. Health outcomes considered were nutritional status assessed by BMI, waist circumference and body fat percentage, health self-perception and cardiovascular risk factors. We used McNemar χ ² or Wilcoxon tests to compare the levels of exposure and outcome variables before and during the pandemic, and OR to evaluate associations between changes in occupational stress and shift work with health outcomes. During the pandemic, participants reported increased occupational stress and shift work and lower self-perceived health and had higher BMI and cardiovascular risk factors, compared with before the pandemic. No association was observed between change in occupational stress and health outcomes. However, increased amount of shift work was related to increased BMI in the overall sample (OR 3·79, 95 % CI (1·40, 10·30)) and in health workers (OR 11·56; 95 % CI (2·57, 52·00)). These findings support calls to strengthen labour policies to ensure adequate working conditions for hospital workers in context of the COVID-19 pandemic.

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Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.

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