Stressors, allostatic load, and health outcomes among women hotel housekeepers: A pilot study

Biometrics for Industry 4.0: a survey of recent applications

The Fourth Industrial Revolution, also known as Industry 4.0, represents the rise of digital industrial technology that is propagating at an exponential rate compared to the previous three revolutions. Interoperability is a basis of production, where there is a continuous exchange of information between machines and production units that act autonomously and intelligently. Workers play a central role in making autonomous decisions and using advanced technological tools. It may involve using measures that distinguish individuals, and their behaviours and reactions. Increasing the level of security, allowing only authorized personnel access to designated areas, and promoting worker welfare can have a positive impact on the entire assembly line. Thus, capturing biometric information, with or without individuals' knowledge, could allow identity verification and monitoring of of their emotional and cognitive states during the daily actions of work life. From the study of the literature, we outline three macro categories in which the principles of Industry 4.0 are merged and the functionalities of biometric systems are exploited: security, health monitoring, and quality work life analysis. In this review, we present an overview of all biometric features used in the context of Industry 4.0 with a focus on their advantages, limitations, and practical use. Attention is also paid to future research directions for which new answers are being explored.

Work Challenges and Health of Immigrant Hotel Housekeepers: Part 2

Background:

Hotel housekeepers’ major responsibility is to perform cleaning tasks. In the course of performing their duties, hotel housekeepers are disproportionately exposed to multiple workplace hazards (i.e., physical, chemical, biological, and psychosocial hazards) that put them at risk of adverse health consequences. This study aims to discover the occupational and health challenges encountered by immigrant hotel housekeepers in Orlando, Florida, and help hotel management to develop strategies to improve their occupational health.

Methods:

This study adopted an interviewer-administered survey method for data collection. Data were collected from members of the United Here Union, Local 7373 in Orlando, Florida. Trained Spanish–English bilingual associates of the Union administered the surveys through interviews with participants. Descriptive statistics and stepwise multiple regression were employed to analyze data ( n = 140) using SPSS 22.

Findings:

This study shows that Florida hotel housekeepers participating in this study worked under great time pressures, endured excessive workloads, did not have enough time to rest and recover, and often skipped or shortened lunch breaks. Participants believed that their employers valued work productivity more than their safety and health. More than half of the respondents experienced racial discrimination at their workplaces.

Conclusion/Application to Practice:

The article brings an important contribution to the awareness of housekeepers’ feelings toward their work and the need for effective safety and health policies and programs.

Allostatic Load Measurement: A Systematic Review of Reviews, Database Inventory, and Considerations for Neighborhood Research

BACKGROUND

Neighborhoods are critical to understanding how environments influence health outcomes. Prolonged environmental stressors, such as a lack of green spaces and neighborhood socioeconomic disadvantage, have been associated with higher allostatic load levels. Since allostatic load levels experienced earlier in life have stronger associations with mortality risk, neighborhoods may be uniquely suited to monitor and mitigate the impacts of environmental stressors. Researchers often study allostatic load in neighborhoods by utilizing administrative boundaries within publicly accessible databases as proxies for neighborhoods.

METHODS

This systematic review of reviews aims to identify commonly used biomarkers in the measurement of allostatic load, compare measurement approaches, inventory databases to study allostatic load, and spotlight considerations referenced in the literature where allostatic load is studied in neighborhoods. The review was conducted using the search term "allostatic load" in the MEDLINE, CINAHL, and PsychINFO databases. The search results were filtered to include reviews.

RESULTS

The search returned 499 articles after deduplication. Overall, 18 synthesis reviews met the inclusion criteria and were retained for extraction. The synthesis reviews analyzed represented 238 studies published from 1995 to 2020. The original ten biomarkers were most often used to measure allostatic load. More recently, body mass index and C-reactive protein have additionally been frequently used to measure allostatic load burden.

CONCLUSIONS

The scientific contributions of this study are that we have identified a clear gap in geographic considerations when studying allostatic load. The implication of this study is that we have highlighted geographic concepts when conducting neighborhood-level research using administrative databases as a neighborhood proxy and outlined emerging future trends that can enable future study of allostatic load in the neighborhood context.

Association of indoor noise level with depression in hotel workers: A multicenter study from 111 China's cities

Several studies have elucidated the link between outdoor noise and depression, but the relationship between indoor noise levels and depression symptoms in residential and public places remains unclear. This study was a multicenter observational study with a cross-sectional design. In 2019, a total of 10 545 indoor noise levels on-site and 26 018 health data from practitioners were collected from 2402 hotels in 111 cities. Indoor daily noise data levels were detected, and PHQ-9 questionnaires were used to collect health data. Logistic analysis was used to determine the association between depression score and noise level, negative binomial regression was used to determine potential risks. The geometric mean indoor noise level was 38.9 dB (A), with approximately 40.9% of hotels exceeding the 45 dB value (A). Approximately 19.1% of hotel workers exhibited mild and above depressive symptoms. In addition to functional zoning, geographic location, central air conditioner, decoration status, and other factors had an impact on noise levels (p < 0.05). Results of logistic and negative binomial regression showed the following: (1) there was significantly positive association between indoor noise and high depression scores above 2 (OR = 1.007, 95% CI: 1.002, 1.012) and (2) some sub-groups were more susceptible to this effect, especially for the younger female workers working in the first-tier cities, having higher education level, lower level of income, smoking, and longer working hours. This study confirms an early potential effect of indoor noise on depression. It is recommended to implement evidence-based measures to control noise sources in hotels.

Investigating Employment Quality for Population Health and Health Equity: A Perspective of Power

Employment quality (EQ) has gained increasing attention as a determinant of health, but the debate among occupational health researchers over the measurement of EQ poses a challenge to advancing the literature. This is especially problematic when the concept is used across social, cultural, and national borders, as EQ is shaped by power dynamics within sociopolitical and economic contexts that are specific to each society. Investigating EQ in context could help develop a clearer understanding as to why EQ is configured in certain ways, how best EQ could be measured, how EQ impacts health, and ultimately how EQ could be improved. In this paper, we propose that attention to social context-and in particular power-may help advance the research on EQ and health. We present an allegory, or a visual description, that articulates the power balance in the employer-worker relation as well as in the sociopolitical context in which the employer-worker relation takes place. We end by proposing specific approaches for occupational health researchers to incorporate a perspective of power in EQ research that may clarify the concept and measurement of EQ. A clearer recognition of EQ as a product of power in social context aligns with the research approach of addressing work as a social structural determinant of health.

The Quality of Life and the Bio-Molecular Profile in Working Environment: A Systematic Review

Working life is characterised by various requirements and degrees of control in meeting these demands. The imbalance of these elements with workers’ resources can result in work-related stress involving the repeated activation of stress response systems. Modifications in the bio-molecular profile may represent a biological signature of individuals’ life experiences and provide evidence on pathways through which such stressors can result in health outcomes. The aim of our systematic review is to characterize the quality of life (QOL) and the bio-molecular profile in the working population, to highlight if the alteration observed might be related to the working conditions. The article query was performed on PubMed, Embase, and Cochrane CENTRAL and results have been presented according to three molecular pathways involved in the stress response: oxidative stress, inflammation, and neuroendocrine activation. The epidemiological sample has been sub-grouped into “clinical” and “non-clinical” populations according to the presence of a diagnosis of psychological disorders. Besides some critical issues, the review highlights the importance of developing a valid array of biological indicators, measurable in non-invasive matrices, sensitive to both derangements from physiological conditions and stress reduction, useful for identifying those groups at higher risk of health outcomes and, eventually, promoting workers’ wellbeing.

Examining allostatic load, neighborhood socioeconomic status, symptom burden and mortality in multiple myeloma patients

The objective of this study is to examine the association between neighborhood socioeconomic status (nSES) and baseline allostatic load (AL) and clinical trial endpoints in patients enrolled in the E1A11 therapeutic trial in multiple myeloma (MM). Study endpoints were symptom burden (pain, fatigue, and bother) at baseline and 5.5 months, non-completion of induction therapy, overall survival (OS) and progression-free survival (PFS). Multivariable logistic and Cox regression examined associations between nSES, AL and patient outcomes. A 1-unit increase in baseline AL was associated with greater odds of high fatigue at baseline (adjusted OR [95% CI] = 1.21 [1.08–1.36]) and a worse OS (adjusted hazard ratio, [95% CI] = 1.21 [1.06–1.37]). High nSES was associated with worse baseline bother (middle OR = 4.22 [1.11–16.09] and high 4.49 [1.16–17.43]) compared to low nSES. There was no association between AL or nSES and symptom burden at 5.5 months, non-completion of induction therapy or PFS. Additionally, there was no association between nSES and OS. AL may have utility as a predictive marker for OS among patients with MM and may allow individualization of treatment. Future studies should standardize and validate AL patients with MM.

Chronic Pain and Work Conditions of Hotel Housekeepers: A Descriptive Study

Objectives: To estimate the prevalence of musculoskeletal pain of hotel housekeepers (HHs) and to describe the work conditions and perception of health in this occupational group in the Balearic Islands, Spain. Methods: Cross-sectional descriptive study with HHs of the Balearic Islands, performed in primary care. Random sample of HHs who worked during the 2018 season. We collected information on sociodemographic variables, job characteristics, workload, pain, perceived health, and physical activity. After participants signed the informed consent form, we conducted a face-to-face interview in the primary care centre and accessed the participants’ electronic health records. Results: 1043 HHs aged 43.3 ± 10 years and with 10.7 ± 9.1 years worked as HHs were included. 51% (95% CI: 48–54%) reported chronic pain, mainly in the lower back 28.7% (95% CI: 25.9–31.5%), hands/wrists 23.7% (95% CI: 21.1–26.4%), neck 21.6% (95% CI: 19.1–24.3%), shoulders 19.9% (95% CI: 17.4–22.4%), and back 17.8% (95% CI: 15.4–20.2%). Pain was associated with older age, more years worked, more beds made/day and difficulty in pushing the housekeeping cart. More than half HHs reported that they did not incorporate occupational risk prevention measures (ORPMs) into their routine; 17.3% (95% CI: 15.1–19.7%) HHs considered their health as poor or very poor. Perception of health was worse in HHs with chronic pain. Conclusions: A high percentage of HHs of the Balearic Islands reported chronic pain, a low compliance with ORPMs and compared to women of the same sociodemographic profile they perceive a worse health status.

Differences in cardiovascular risk levels between cleaning staff and hotel housekeepers

Background and objective

Cardiovascular diseases are the leading cause of morbidity and mortality worldwide, with a greater incidence in the most disadvantaged social classes. In this study, we aimed to evaluate the level of cardiovascular risk in cleaning workers.

Methods

This was a descriptive, cross‐sectional study in 46.632 cleaning workers (40.169 women and 6.463 men). Thirty‐one different scales related to cardiovascular risk were studied (14 assessing overweight and obesity, 5 determining the risk of nonalcoholic fatty liver disease, 5 scales of cardiovascular risk, 4 atherogenic indices, and 3 scales of metabolic syndrome, among others). The results obtained were divided between personnel who perform their cleaning tasks in the hotel and catering industry and those in other sectors.

Results

The prevalence of obesity and arterial hypertension in cleaning workers was over 20% in both sexes. A similar amount was observed in moderate or high values on the REGICOR (Registre GIroní del COR) scale. More than 15% presented metabolic syndrome according to the NCEP ATPIII (National Cholesterol Education Program‐Adult Treatment Program III) criteria, while over 10% of women and 20% of men had a high risk of nonalcoholic fatty liver disease assessed with the fatty liver index.

Conclusion

Cardiovascular risk is higher, in both sexes, in the group of cleaning workers who work in companies other than hotels.

The Importance of Biobehavioral Research to Examine the Physiological Effects of Racial and Ethnic Discrimination in the Latinx Population

A growing body of research is documenting how racial and ethnic populations embody social inequalities throughout the life course. Some scholars recommend the integration of biospecimens representing the hypothalamic-pituitary-adrenal axis, neurological and endocrinological processes, and inflammation to capture the embodiment of inequality. However, in comparison to other racial and ethnic groups, there has been little research examining how Hispanic/Latinx persons embody racial and ethnic discrimination, much less resulting from institutional and structural racism. We provide a rationale for expanding biobehavioral research examining the physiological consequences of racism among Latinx persons. We identify gaps and make recommendations for a future research agenda in which biobehavioral research can expand knowledge about chronic disease inequities among Latinx populations and inform behavioral and institutional interventions. We end by cautioning readers to approach the recommendations in this article as a call to expand the embodiment of racism research to include the diverse Latinx population as the United States addresses racial inequity.

Immigration-related stressors and health outcomes among low-wage immigrant hotel workers: A pilot study

BACKGROUND

Immigrants comprise over 40% of the low-wage workforce. They are more likely to be employed in service industries, paid less, and experience more illness and injuries than their native counterparts.

DESIGN/OBJECTIVE

The aim of this cross-sectional pilot study was to explore the relationship between immigrant workers' stressors and health.

SAMPLE

Twenty-five female Mexican immigrant hotel workers.

MEASUREMENTS

Surveys and blood samples were analyzed and compared to national data. Descriptive statistics and linear regression were used for analysis.

RESULTS

Longer length of stay, older age at migration, and higher Demands of Immigration (DI) were significantly associated with more chronic conditions. Higher DI were significantly associated with more depressive symptoms. This is comparable to national data (n = 468) which shows a significant relationship between length of stay, Allostatic Load (AL), and chronic conditions (β = 0.14, p = .043; β = 0.13, p = .025).

CONCLUSIONS

Immigrant-specific factors affect individuals' health. More studies are needed to further explore the relationship between DI and health among foreign-born workers.

Allostatic Load and Its Impact on Health: A Systematic Review

INTRODUCTION

Allostatic load refers to the cumulative burden of chronic stress and life events. It involves the interaction of different physiological systems at varying degrees of activity. When environmental challenges exceed the individual ability to cope, then allostatic overload ensues. Allostatic load is identified by the use of biomarkers and clinical criteria.

OBJECTIVE

To summarize the current knowledge on allostatic load and overload and its clinical implications based on a systematic review of the literature.

METHODS

PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to December 2019. A manual search of the literature was also performed, and reference lists of the retrieved articles were examined.We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical adult populations.

RESULTS

A total of 267 original investigations were included. They encompassed general population studies, as well as clinical studies on consequences of allostatic load/overload on both physical and mental health across a variety of settings.

CONCLUSIONS

The findings indicate that allostatic load and overload are associated with poorer health outcomes. Assessment of allostatic load provides support to the understanding of psychosocial determinants of health and lifestyle medicine. An integrated approach that includes both biological markers and clinimetric criteria is recommended.

The impact of discrimination on allostatic load in adults: An integrative review of literature

OBJECTIVE

The objective of the paper is to critically review the current state of the literature on the association between discrimination and allostatic load (AL) in adults and determine whether this association differs by sociodemographic characteristics.

METHODS

An extensive literature search was conducted in PubMed, CINAHL, PsycINFO, and Embase to identify studies that investigated the association between discrimination and AL. The search was limited to the English language, articles that were peer-reviewed and articles that were published within the last 10 years.

RESULTS

A total of 11 studies met the eligibility criteria for this review, 8 of which were cross-sectional and 3 of which were longitudinal. There was heterogeneity in the type of discrimination measured, the composition of AL summary score, and the analytic approach utilized to examine the relationship of interest. Nine studies found a significant, positive association between discrimination and AL. The types of discrimination found to be positively associated with AL included lifetime discrimination, childhood racial discrimination, everyday discrimination, and everyday weight discrimination. One study found that this association differed by educational attainment.

CONCLUSION

There is evidence that discrimination is associated with AL. Longitudinal studies with diverse samples are needed to further explore this association and how it differs based on sociodemographic characteristics.

Associations between Indoor Environmental Quality and Infectious Diseases Knowledge, Beliefs and Practices of Hotel Workers in Wuhan, China

Knowledge, beliefs, and practices regarding infectious diseases are key elements that ensure practitioners' health and safety. It is important to carry out such a survey in hotels. This study aims to determine the levels of knowledge, beliefs, and practices regarding infectious diseases among practitioners and their associations with the environmental quality of hotels in Wuhan, China. We surveyed infectious disease knowledge, beliefs, and practices of practitioners in 18 hotels and detected these hotels' environment, including physical factors of temperature, humidity, noise, and the indoor air quality of benzene, toluene, xylene, formaldehyde, CO, CO₂, the total count of fungi, aerobic plate count, PM₁₀, and PM_2.5. 128 practitioners were included, and 28.9% were male. The questionnaire included knowledge, beliefs, and practices regarding infectious diseases. Our study found moderate levels of knowledge and beliefs, and good health practices. People's beliefs toward COVID-19 were correlated significantly with their knowledge (p < 0.05). Beliefs and health practices were correlated significantly with environmental quality (p < 0.05). However, the environmental quality was correlated negatively with the classification of hotels. Conclusively, despite the good health practices of practitioners, the knowledge and beliefs toward infectious diseases need to strengthen. Hotels should emphasize health education in practitioners and the improvement of environmental hygiene. Integrating all three components into a comprehensive environmental promotion program is warranted.

Occupational exposure and health risks of volatile organic compounds of hotel housekeepers: Field measurements of exposure and health risks

Hotel housekeepers represent a large, low-income, predominantly minority, and high-risk workforce. Little is known about their exposure to chemicals, including volatile organic compounds (VOCs). This study evaluates VOC exposures of housekeepers, sources and factors affecting VOC levels, and provides preliminary estimates of VOC-related health risks. We utilized indoor and personal sampling at two hotels, assessed ventilation, and characterized the VOC composition of cleaning agents. Personal sampling of hotel staff showed a total target VOC concentration of 57 ± 36 µg/m3 (mean ± SD), about twice that of indoor samples. VOCs of greatest health significance included chloroform and formaldehyde. Several workers had exposure to alkanes that could cause non-cancer effects. VOC levels were negatively correlated with estimated air change rates. The composition and concentrations of the tested products and air samples helped identify possible emission sources, which included building sources (for formaldehyde), disinfection by-products in the laundry room, and cleaning products. VOC levels and the derived health risks in this study were at the lower range found in the US buildings. The excess lifetime cancer risk (average of 4.1 × 10-5 ) still indicates a need to lower exposure by reducing or removing toxic constituents, especially formaldehyde, or by increasing ventilation rates.

Perceived Factors of Stress and Its Outcomes among Hotel Housekeepers in the Balearic Islands: A Qualitative Approach from a Gender Perspective

Tourism is the main economic sector in the Balearic Islands (Spain) and hotel housekeepers (HHs) are a large occupational group, in which stress is becoming a major issue. This study aims at exploring in-depth factors perceived as stressors by HHs and key-informants, and their effects on work-life balance (WLB). A qualitative design with phenomenological approach was used, conducting six focus groups with 34 HHs and 10 individual interviews with key-informants. Results were analyzed adopting the job demands-resources model and a gender perspective. High demands, e.g., work overload, time pressure, physical burden…, lack of enough resources and little control, derived from role conflict, unexpected events…, were the most important factors explaining HHs' stress. Additionally, this imbalance was perceived as leading to health problems, mainly musculoskeletal disorders. Working schedule was mentioned as a facilitator to WLB, whereas an imbalance between job demands and resources led to work-home conflict, preventing them from enjoying leisure time. Multiple roles at work and at home increased their stress. HHs experienced their job as invisible and unrecognised. Regarding practical implications, our recommendations for hotel organization include reducing workload and increasing resources, which would improve the job demands-resource balance, diminish negative mental and physical outcomes and improve WLB.

Interventions to promote hotel workers' health: A scoping review

BACKGROUND

The hospitality industry employs millions of workers and is a key contributor to the US economy. Despite being essential drivers in the industry's success, hotel workers, particularly hotel housekeepers, are exposed to occupational hazards and experience disproportionate rates of injuries and chronic health conditions. Thus there is a significant need for health promotion efforts directed toward these workers. However, little is known about existing interventions targeting their health.

METHODS

We conducted a scoping review to identify and appraise workplace health promotion interventions targeting hotel employees. We performed a scoping review following the framework outlined by Arksey and O'Malley (2005). Our literature search process was recorded using the preferred reporting items for systematic reviews and meta-analyses. Basic study information was compiled into a matrix table. Study quality was assessed using the template for intervention description and replication.

RESULTS

Eight unique interventions were identified, occurring at over 30 hotels with participants ranging between 16 and 1207 employees. Though many of the reported health outcomes were not statistically significant, studies reported results with clinical implications, including decreased numbers of injury claims, reduced anxiety, improvements in cardiovascular disease risk indicators, such as body mass index, and increased knowledge among participants.

CONCLUSIONS

This is the first review to interrogate the literature on existing workplace interventions targeting the health of hotel workers. While some studies found significant improvements in health outcomes, few conducted rigorous program evaluation. The results highlight the need for more and effective interventions targeting these at-risk workers.

Allostatic load and women's brain health: A systematic review

Allostatic load represents the 'wear and tear' of chronic stress on the brain and body that may differ between men and women. A small but growing number of studies are assessing allostatic load in relation to mental health. The objective of this systematic review was to (1) assess sex differences in allostatic load and (2) identify allostatic load associations that are specific to women. We systematically searched for allostatic load studies that included psychosocial causes and/or psychiatric consequences. Our search focused on allostatic load studies that disaggregated by sex and that include women. Sixty-two studies were included in this systematic review. First, men appear to have higher allostatic load than women. Second, women show gender-specific variation for numerous factors such as age, race/ethnicity, adversities, social support, and health behaviors that influence associations between allostatic load and mental health. Recommendations are made to guide researchers advance sex and gender approaches.