Association Between Occupational Stress, Work Shift and Health Outcomes in Hospital Workers of the Recôncavo of Bahia, Brazil: The Impact of Covid-19 Pandemic.

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 Body Mass Index (BMI), Waist Circumference (WC), and Body Fat Percentage (BF%); health self-perception; and cardiovascular risk factors. We used McNemar chi-squared or Wilcoxon tests to compare levels of exposure and outcome variables before and during the pandemic, and odds ratios to evaluate associations between changes in occupational stress and shiftwork with health outcomes. During the pandemic, participants reported increased occupational stress and shift work, 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, CI95% 1.40-10.30), and in health workers (OR 11.56; CI95% 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.