We are writing to request funding from the California Wellness Foundation for an innovative health promotion project that aims at improving the mental and cardiovascular health of working people in Southern California through assessment of workplace stressors and evaluation of cardiovascular risks. The proposed program will be carried out by an interdisciplinary research team from the UC Irvine Center for Occupational and Environmental Health.
The Center for Occupational and Environmental Health (COEH), based in the College of Medicine at UC Irvine, has been supported by State funds since it was established in 1979. The COEH is a multi-discipline center with principal programs in environmental epidemiology, occupational medicine, and toxicology. The Center has a long-standing reputation for excellence in providing a broad range of occupational and environmental health research, training, clinical services, and consultations for individuals, communities, businesses, and government agencies. The COEH Medical Clinic is a point of referral for clinical evaluation related to occupational and environmental exposure in the Southern California Region.
The proposed health promotion project is a part of a larger program, the STEP (surveillance, treatment, and early prevention) program being developed at the COEH. The STEP program aims to provide comprehensive services for improving mental and cardiovascular health of working people through surveillance, evaluation, and treatment of workplace psychosocial and physical health outcomes. Data from the surveillance system will be used to develop primary and secondary prevention programs at the workplace, with referrals for evaluation and treatment of those individuals with early manifestations of cardiovascular risks.
The program will be built on existing research conducted by the COEH interdisciplinary team. Two key team members are Peter L. Schnall MD, MPH and Dean Baker MD, MPH. Dr. Schnall is an Associate Clinical Professor of Medicine of the COEH, and Director of the Center for Social Epidemiology. As a pioneer expert in the area of social epidemiology and cardiovascular disease he has published extensively in fields of psychosocial stress, hypertension, and public health. He has led a major NIH-funded research and training program on the relationship between job strain and ambulatory blood pressure which has contributed to the establishment of job strain as a risk factor for CVD cardiovascular diseases. Dr. Schnall will be the Principal Investigator. Dr. Baker is a Professor of Medicine, Director of the COEH, and Chief of the Occupational and Environmental Medicine Division, Department of Medicine, UC Irvine. As a leading expert in environmental Epidemiology research with a focus on community-based clinical studies, work related stress, and public health research.; he has more than twenty years of research experience in environmental epidemiological studies with workplaces, communities, and school systems. Dr. Baker will be a Co-Investigator.
This innovative health project is based on a considerable body of scientific evidence that the biological mechanisms by which psycho-social factors such as work stress are perceived and processed by the central nervous system can lead to deleterious cardiovascular changes. This proposed project integrates biomedical, psychosocial, and epidemiological perspectives and takes advantage of newly developed biomedical techniques. This project defines "workplace stressors" as objective work place conditions that cause feelings of stress and "stress" as a subjective metal and physical state that results from exposure to stressors. The specific aims of this proposed program are: a) to assess the prevalence of job stressors and cardiovascular risk factors (i.e., high blood pressure, smoking, bmi, total cholesterol level, alcohol, etc.); b) to explore relationships among job stressors, psychological outcomes, and hypertension; c) to provide initial evaluations of individual workers with early manifestations of cardiovascular disease and d) to identify specific workplace stressors amenable to intervention or /amelioration.
The project will utilize survey methods and interviews as well as innovative biomedical techniques to assess workplace stressors and cardiovascular risks. The COEH research team will also use focus group methods to address concerns of workers regarding work-related stress and health problems, with a participatory and empowerment perspective. Multiple self-administered questionnaires will be used to assess work-related psychosocial stressors and other non-work stressors. Cardiovascular risks will be assessed through recently available devices based on newly developed biomedical technologies. Ambulatory blood pressure and heart rates will be assessed with an automated wrist monitor once every 30 minutes throughout a typical work day and the cholesterol level will be assessed through a device that processes finger stick blood tests. All data collection including questionnaires, blood pressure, and cholesterol assessment will be done at the worksite.
The proposed project will target a diverse workforce of different occupations from the education and manufacturing sectors of our economy in Southern California. We have obtained support to work with teachers and staff in Orange County as well as with UAW-Chrysler warehouse workers in Southern Los Angeles. We will recruit at least one or two additional workforces as part of this project for a total of 1,500 working men and women. This study project will also provide a careful assessment of psychosocial workplace stressors, and cardiovascular risks for each participant. For those participants with early manifestations of cardiovascular disease, the program will provide referrals for further medical evaluation and treatment. Information obtained through this project could be used to develop intervention programs to reduce job stress and improve wellness of workers at different worksites. We strongly believe that the findings of this project have great potential for improving the psychosocial wellness and cardiovascular health of working men and women in Southern California.
Peter L. Schnall MD, MPH
Dean Baker MD, MPH.