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Job Stress and Health: What the Research Tells Us

Updated: Mar 25, 2022

Stress in the workplace is inevitable so workers have to learn to cope with it one way or another. But how is coping really possible when stress (the problem) is an ambiguous term usually defined by a person’s perception of it? Without appropriate coping tools, people turn to #alcohol and drugs believing they can solve the problems but instead this only adds to their stress!

Thankfully, I can now report about an accepted method to define (quantify stress using physiological variables) and subsequently increase the specificity of interventions and objectively measure outcomes on stress levels. Heart rate variability (HRV) is a valid and reliable measurement of stress and HRV biofeedback an effective intervention.

In a recent report on military special operators, researchers found that acute stress can cause cognitive impairments and cognitive inflexibility. The report suggested that all military personnel should be involved in stress exposure training with the goal of becoming more stress-tolerant.

The report also emphasized the importance of physiological control and recommended better methods to determine those that are stress hardy and resilient and whether resiliency can be improved by training.


Cardiovascular Disease

Many studies suggest that psychologically demanding jobs that allow employees little control over the work process increase the risk of #cardiovascular disease.

Musculoskeletal Disorders

On the basis of research by NIOSH and many other organizations, it is widely believed that job stress increases the risk for the development of back and upper extremity #musculoskeletal disorders.

Psychological Disorders

Several studies suggest that differences in rates of mental #HealthProblems (such as depression and burnout) for various occupations are due partly to differences in job stress levels. (#Economic and #lifestyle differences between occupations may also contribute to some of these problems.)

Workplace Injury

Although more study is needed, there is a growing concern that stressful working conditions interfere with safe work practices and set the stage for injuries at work.

Suicide, Cancer, Ulcers, and Impaired #Immune Function

Some studies suggest a relationship between stressful working conditions and these health problems. However, more research is needed before firm conclusions can be drawn.

Stress, Health, and Productivity

Studies show that stressful working conditions are actually associated with increased absenteeism, tardiness, and intentions by workers to quit their jobs all of which have a negative effect on the bottom line.

Stress Prevention and Job Performance

St. Paul Fire and Marine Insurance Company conducted several studies on the effects of stress prevention programs in hospital settings. Program activities included

  1. employee and management education on job stress,

  2. changes in hospital policies and procedures to reduce organizational sources of stress, and

  3. establishment of employee assistance programs.

In one study, the frequency of medication errors declined by 50 percent after prevention activities were implemented in a 700-bed hospital. In a second study, there was a 70 percent reduction in malpractice claims in 22 hospitals that implemented stress #prevention activities. In contrast, there was no reduction in claims in a matched group of 22 hospitals that did not implement stress prevention activities.

According to data from the Bureau of Labor Statistics,

workers who must take time off work because of stress, #anxiety, or a related disorder will be off the job for about 20 days.

The inverted-U hypothesis is considered the most plausible explanation for the stress and performance relationship. The inverted-U hypothesis is founded upon the classic work of Yerkes and Dodson whose law states that for every behavior there is an optimal level of arousal. This optimal level of arousal typically is of moderate-intensity in order to produce maximum performance. Simply stated, the relationship between performance and arousal is quadratic as opposed to linear and takes the form of an inverted-U.

Yerkes, R. M., & Dodson, J. D. The relation of strength of stimulus to rapidity of habit formation. Journal of Comparative Neurology and Psychology, 1908.18, 459–82.

The key to minimizing the untoward effects of #stress, therefore, is to find and apply the optimal effort to tasks without sacrificing personal health. Fortunately, scientists have now developed methods to quantify stress using AI algorithms and sensor technology. Once a baseline is established guidance can be given on how to build resiliency in the ANS. These results are then compared to this baseline. One valid and reliable method is the quantification of stress using heart rate variability (HRV) analytics.


Mobile Stress Assessment and Biofeedback Training

Heart Rate Variability is recognized as a primary method of a non-invasive quantitative assessment of the function of the cardiovascular system (CVS), ANS, and other #physiological mechanisms responsible for the regulation of an #organism. Methods of HRV analysis were introduced over 50 years ago and developed as a diagnostic and intervention method in space medicine.

Variability in heartbeat intervals is used as a real-time measure of the CVS and ANS functioning.

In a recent systematic review of HRV and occupational stress research scientists concluded that “occupational stress is associated with lowered HRV, specifically with reduced #parasympathetic activation. Thus, analysis of HRV can be used as an informative marker for physiological impacts of workplace stressors.”

“BODY HEALTH ANALYZER” is a Mobile HRV Monitoring and #Biofeedback Delivery System that includes a Medical-grade Bluetooth pulse oximeter (SpO2) finger clip—Health assessment and biofeedback software for Windows 10—Optional Medical-grade Bluetooth blood pressure monitor—Optional Windows 10 tablet with 10” touchscreen, a detachable keyboard and case, and preinstalled BHA software.

Body Health Analyzer is a new high-quality instrument designed for professionals and home users to assess, track, and manage health with ease.

Body Health Analyzer is based on years of science behind #HeartRate Variability combined with a new artificial intelligence capability to evaluate health state, chronic disease progression, manage stress, and much more.

Using medical-grade sensors allows the Body Health Analyzer to read health-related metrics with high accuracy in a simple non-obtrusive way.

Body Health Analyzer Health Reports Include Measures of:

  1. STRESS INDEX—provides an estimation of stress levels.

  2. AUTONOMIC BALANCE—provides an estimation of functional balance between the sympathetic and parasympathetic branches of the autonomic nervous system.

  3. RESTING HEART RATE—an average heart rate reading taken at rest.

  4. HRV INDEX—provides an estimation of the overall activity of the autonomic #NervousSystem.

  5. VAGAL INDEX—provides an estimation of the tone of the Vagus nerve which predominantly represents the function of the parasympathetic nervous system.

  6. ADAPTATION EFFORT—provides an estimation of the intensity of activity of bodily functions adapting to adverse changes inside and outside of the body to maintain its homeostasis.

  7. ADAPTATION RESERVE—provides an estimation of the number of the body’s resources available in the body’s efforts to restore its homeostasis.

  8. HEALTH STAGE INDEX—provides an estimation of the process of disease development passing several stages from the normal condition to an evident pathology.

  9. SpO2—indicates how well your body is supplied with #oxygen. Perceived emotional and physical problems are assessed using.

Patient Health Questionnaire (PHQ) that measures depression, anxiety, somatic complaints, and the Perceived Stress Scale (PSS). HRV results are correlated with PHQ, PSS, and other physical and emotional data providing a comprehensive psychophysiology profile.

Biofeedback training for stress management involves syncing respiration with heart rate and producing a condition referred to as respiratory sinus arrhythmia (RSA), known to facilitate a decrease in stress while strengthening the peripheral nervous system.

To accomplish RSA a person follows a breath-pacer set at a prescribed pace which changes their HRV. Subsequently, the PNS will improve and symptoms decrease. Positive changes in increasing percentages are rewarded. The process continues until the person can achieve a high level and maintain it for increasing amounts of time. A training report is recorded and trended.

Individuals and designated team leaders can use a system like this to monitor their stress over time and outcomes of training. Workers may use it at home as often as they want and share their measurements with the team leader.

The collection of HRV assessment and #training data will have an immediate and long-term impact on the corporation and the employee. The employee will acquire a convenient HRV measurement system that can be used to assess and monitor their stress levels. Moreover, the user can employ effective biofeedback techniques to prevent or ameliorate the negative effects of stress.

Finally, by studying HRV changes and correlating them with various activities corporations can gain insight into the factors that positively and negatively affecting performance. Predictive analytics derived from this data will have an immediate and long-term impact on employee health as well as the selection and retention of employees.

The collection of HRV assessment and training data will have an immediate and long-term impact on the corporation and the employee. The employee will acquire a convenient HRV measurement system that can be used to assess and monitor their stress levels. Moreover, the user can employ effective biofeedback techniques to prevent or ameliorate the negative effects of stress.



Dr. Russoniello has more than thirty years of experience as a therapist/counselor educator and researcher. He is currently Professor and Director of East Carolina University’s Center for Applied Psychophysiology and its Wounded Warrior training program. Dr. Russoniello has been the principal investigator on several Department of Defense grants developing physiological measuring and biofeedback products for improving Wounded Warrior and Warfighter functioning. His work for DoD included the development of a mobile telehealth system based on heart rate variability analysis and intervention and a game based neurocognitive assessment. The development of these products resulted in seven invention disclosures. Dr. Russoniello is a licensed professional counselor and senior fellow in both biofeedback and neurofeedback. He is a past-president of the Association for Applied Psychophysiology and the American Therapeutic Recreation Association. Dr. Russoniello’s research has been published in a broad spectrum of professional journals including, Behavioral Medicine, Military Behavioral Health, Military Psychology, Journal of Applied Psychophysiology and Biofeedback, Cyberpsychology, Behavior, and Social Networking, and Games for Health. His work has been featured in ArsTechnica, CNN, BBC, New York Times, Washington Post, Web MD, Wired Magazine, and in a TED talk. In 2015 Dr. Russoniello received the Governor James E. Holshauser Award for Public Service, the University of North Carolina’s highest public service award.

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