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The relation between psychosocial working conditions and work-related musculoskeletal complaints
Published in Richard Graveling, Ergonomics and Musculoskeletal Disorders (MSDs) in the Workplace, 2018
Leif W. Rydstedt, J. Paul Weston
Homeostasis, a term originally coined by Cannon (1932), is the body’s ability to maintain its many physiological variables in an optimal balanced state. A stressor is anything that disturbs this balanced state, and the stress response is the body’s attempt to restore homeostasis. Allostasis (McEwen, 1998) is a more recent expansion of the definition of homeostasis. This takes into account the variation of bodily physiological set points under stress and the brain’s reaction to stress through body’s wide changes, including anticipatory behavioural change. It has been described as ‘constancy through change’ (McEwen, 1998). As opposed to physical stressors, psychosocial stressors associated with modern work have been shown to activate this system. Evidence for this can be drawn from changes in blood and salivary levels of catecholamines in relation to common work-related psychosocial issues (Lundberg, 2002). In relation to the type of acute physical threats associated with the possible dangers in a natural environment, the acute physiological stress response has proven adaptive for humans as well as for animals (Lundberg, 2005). However, if these responses become too frequent or are inadequately turned off, this will finally result in allostatic load reactivity, which can be seen as a strong precursor of various types of ill health (McEwen, 1998).
Therapeutic Use of Stress to Provoke Recovery
Published in William J. Rea, Kalpana D. Patel, Reversibility of Chronic Disease and Hypersensitivity, Volume 4, 2017
In order to maintain, for as long as possible, the system's ability to cope with stress (through defense and adaptation), thereby forestalling the system's transitioning into the stage of late chronic disease, it is therefore critically important that therapeutic interventions target the system's allostatic load and adaptation reserves. In an ongoing manner, treatments must hone in on correcting for both the system's toxicities (by lightening the total body load, thereby easing its allostatic load) and the system's deficiencies (by replenishing the total body reserves, thereby reinforcing its adaptation reserves).
Work Capacity, Stress, Fatigue, and Recovery
Published in R. S. Bridger, Introduction to Human Factors and Ergonomics, 2017
The allostatic load is the result of repeated exposure to high demands over long periods of time resulting in long-term health problems such as heart disease and reduced immunity to disease. Risk factors include multiple exposure to novel stressors or to stressors that are beyond the ability to cope.
Stressors, allostatic load, and health outcomes among women hotel housekeepers: A pilot study
Published in Journal of Occupational and Environmental Hygiene, 2019
Marie-Anne S. Rosemberg, Yang Li, Daniel S. McConnell, Marjorie C. McCullagh, Julia S. Seng
The allostatic load index (ALI) consisted of nine biomarkers: SBP, DBP, HR, WHR, BMI, HDL, HbA1c, CRP, and cortisol. Medication use was adjusted for in the preliminary analysis. Participants taking medications for hypertension at the time of assessment had 10 mmHg and 5 mmHg added to their respective SBP and DBP. Medication was adjusted. We dichotomized each biomarker into high- and low-risk two ways. To construct an ALI based on clinical risk parameters established for adult women (ALI-Clinical), we used clinical risk cut-points and summed the number of high-risk biomarkers for each person. The common method of summing the number of high-risk quartiles for each person (ALI-Quartile) was used.(30) Both ALI-Clinical and ALI-Quartile scores range from 0–9.
The impaired healing hypothesis: a mechanism by which psychosocial stress and personal characteristics increase MSD risk?
Published in Ergonomics, 2022
Another theory that has been increasingly used to understand how psychological stressors lead to pathophysiological responses in workers is Allostatic Load (i.e. the cost of maintaining Allostasis), proposed by McEwen in 1998 (McEwan 1998). Allostasis (literally “maintaining stability, or homeostasis, through change”) refers the process of adaptation of an organism to acute stress across all biological systems, as a means to restore homeostasis after a challenge (McEwen 2000). Biological systems promote and coordinate adaptation using systemic mediators (cortisol, sympathetic and parasympathetic mediators, pro- and anti-inflammatory cytokines, metabolic mediators, and hormones), via a non-linear network in which each mediator regulates other mediators, often in a reciprocal fashion, with the brain typically coordinating these efforts (Karatsoreos and McEwen 2011; Sterling 2012). While adaptive acutely, chronic overactivity of a system, such as, cardiovascular, metabolic, immune, hypothalamus-pituitary-adrenal (HPA) axis, sympathetic-adrenal-medullary (SAM) system, and cognitive centres of the brain, in response to chronic or severe stressors (McEwen 1998; Karatsoreos and McEwen 2011) can induce a domino effect on the interconnected systems, leading one or more to overcompensate or become dysregulated, and can lead to the eventual disruption of a system, leaving the organism open to stress-related diseases (McEwen and Gianaros 2011; Juster, McEwen, and Lupien 2010). For example, pro-inflammatory cytokines released from injured cells or macrophages can enter the blood stream and become systemic. This can stimulate production of corticosteroids by the brain that then, in turn, reduce inflammatory cytokine production, as seen in Figure 1. Sympathetic and parasympathetic nervous systems (fight or flight systems) exert differential effects on pro-inflammatory cytokines, with the former stimulating production and the latter inhibiting them. When these responses are unbalanced, appropriate inflammatory responses may be inhibited, or vice versa. Allostatic Load is the accumulated burden (“wear and tear”) on the brain and other systems from trying to re-establish allostasis after exposure to repeated or chronic stressors (McEwen 1998; McEwen 2000), while Allostatic Overload occurs when the demands of the stressor exceed the body’s ability to repeatedly adapt, leading to disordered and diseased endpoints (Juster, McEwen, and Lupien 2010). In the current context, an allostatic overload due to psychological stress may result in a diminished healing capacity, which when paired with the physical process of tissue damage (fatigue failure) may result in increased MSD risk. The following sections will examine the effects of psychological stress and certain personal characteristics on healing kinetics and how these factors might influence the development of MSDs.