Examining Work Stress and Air Pollutants Exposure of Home Healthcare Workers

Abstract

Occupational exposures in on-campus healthcare settings have increasingly been investigated, while the sector of home healthcare typically receives less focus. This study explored work stress exposure and air pollution’s effects on home healthcare workers through the collection of multiple salivary cortisol samples per day, the completion of stress diaries, and the use of low-cost personal air monitors. This study was designed to identify the physiological responses to various types of stress, as well as the impact of air pollution on the home healthcare workforce. Due to the sample size and duration, the data showed that neither the stress levels recorded in the diaries (p = 0.754), nor the air pollution data (with only VOC and PM1 having Pearson correlation coefficients of >0.25), exhibited a significant association with the cortisol levels. The air sensor data were inconsistent with previously published indoor air pollutant literature. Forty percent of events reported by participants were identified as high stressor (level 6–10) events. One participant in this study accounted for 18% of these high-stress events. The most common emotional responses to these stressor events included feelings of frustration, irritation, anger, and fury, which together comprised 22.4% of the reactions. Future work should include studies with a larger sample size, a more robust air quality monitor, and a longer study duration to improve the power to detect potential associations. Although previous studies have indicated that home healthcare workers experience workplace stress and exposure to multiple air pollutants, this study did not detect a consistent relationship between these exposures and the physiological stress response.