Measuring allostatic load in the workforce: a systematic review

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  • MAUSS Daniel
    Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Germany Occupational Health Services, Allianz Germany, Germany
  • LI Jian
    Institute of Occupational and Social Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Germany
  • SCHMIDT Burkhard
    Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Germany
  • ANGERER Peter
    Institute of Occupational and Social Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Germany
  • JARCZOK Marc N.
    Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Germany

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The Allostatic Load Index (ALI) has been used to establish associations between stress and health-related outcomes. This review summarizes the measurement and methodological challenges of allostatic load in occupational settings. Databases of Medline, PubPsych, and Cochrane were searched to systematically explore studies measuring ALI in working adults following the PRISMA statement. Study characteristics, biomarkers and methods were tabulated. Methodological quality was evaluated using a standardized checklist. Sixteen articles (2003–2013) met the inclusion criteria, with a total of 39 (range 6–17) different variables used to calculate ALI. Substantial heterogeneity was observed in the number and type of biomarkers used, the analytic techniques applied and study quality. Particularly, primary mediators were not regularly included in ALI calculation. Consensus on methods to measure ALI in working populations is limited. Research should include longitudinal studies using multi-systemic variables to measure employees at risk for biological wear and tear.

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