{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T11:39:45Z","timestamp":1776166785642,"version":"3.50.1"},"reference-count":25,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This comparative cross-sectional study simultaneously investigated the dual health burden of body mass index (BMI) and common mental disorders (CMDs) driven by occupational stressors in two stepwise regression models. By classifying stress exposure into three clinically relevant tiers (low, moderate, and severe) in two distinctive populations\u2014a hospital and a manufacturing company\u2014we used the validated SDS-30 and SRQ-20 instruments. The robust multiple regression models uncovered a highly nuanced landscape of employee well-being that highlights the context-dependent nature of psychosocial hazards. The most compelling findings emerged from the interaction analyses, which demonstrated that the physical and mental consequences of severe stress do not impact the workforce uniformly. Regarding mental health, severe occupational stress proved to be a potent catalyst for CMD symptoms, but this psychological toll was significantly magnified within the hospital sector relative to the manufacturing environment. An opposite, yet equally context-dependent, pattern emerged regarding physical health. In the main-effects-adjusted model, the severity of occupational stressors did not demonstrate a statistically significant linear association with an overall increase in BMI. However, the interaction model revealed a hidden vulnerability: employees in operational field roles who report severe stress are highly susceptible to severe BMI increases compared with admin personnel. While administrative staff may face sedentary risks, field workers under severe stress likely endure higher physiological allostatic load, erratic shift patterns that disrupt circadian metabolic rhythms, and potentially poorer dietary coping mechanisms during active labor. This combination of physical exhaustion and severe psychological tension severely disrupts metabolic homeostasis, forcing the redistribution of adipose tissue and driving the observed BMI spike.<\/jats:p>","DOI":"10.3390\/ijerph23040495","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T10:29:08Z","timestamp":1776162548000},"page":"495","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Occupational Stressors and Dual Health Burden: Associations Between Body Mass Index and Common Mental Disorders Among Hospital and Manufacturing Employees in Indonesia"],"prefix":"10.3390","volume":"23","author":[{"family":"Herqutanto","sequence":"first","affiliation":[{"name":"Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta Pusat 10310, Indonesia"},{"name":"Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON), Pusat Kajian Gizi Regional (PKGR) Universitas Indonesia, Jakarta Timur 13120, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3100-3269","authenticated-orcid":false,"given":"Muchtaruddin","family":"Mansyur","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta Pusat 10310, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annisa","family":"Maulidina","sequence":"additional","affiliation":[{"name":"Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON), Pusat Kajian Gizi Regional (PKGR) Universitas Indonesia, Jakarta Timur 13120, Indonesia"},{"name":"Mailman School of Public Health, Columbia University, New York City, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Abror Rizani","family":"Fahmi","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta Pusat 10310, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"ref_1","first-page":"121","article-title":"Exploring the Multifaceted Nature of Occupational Stress Among Nurses: A Systematic Review","volume":"19","author":"Sundram","year":"2024","journal-title":"Kesmas Natl. Public Health J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1007\/s40200-021-00748-9","article-title":"The Association between Job Stress and Metabolic Syndrome among Medical University Staff","volume":"20","author":"Eftekhari","year":"2021","journal-title":"J. Diabetes Metab. Disord."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"238","DOI":"10.5114\/hpr.2022.116812","article-title":"Development and Validation of a Stress Response Measure: The Daily Stress Response Scale (DSRS)","volume":"10","author":"Debowska","year":"2022","journal-title":"Health Psychol. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1111\/obr.12725","article-title":"Work-Related Psychosocial Factors and Metabolic Syndrome Onset among Workers: A Systematic Review and Meta-Analysis","volume":"19","author":"Watanabe","year":"2018","journal-title":"Obes. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1007\/s11547-013-0329-0","article-title":"Work Stress and Metabolic Syndrome in Radiologists: First Evidence","volume":"119","author":"Magnavita","year":"2014","journal-title":"Radiol. Medica"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Zhang, M., Liu, B., Ke, W., Cai, Y., Zhang, L., Huang, W., Yan, X., and Chen, H. (2024). Correlation Analysis between Occupational Stress and Metabolic Syndrome in Workers of a Petrochemical Enterprise: Based on Two Assessment Models of Occupational Stress. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-18305-3"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Alhajaji, R., Alfahmi, M.Z., Alshaikhi, S.A., Fairaq, A.M., Fudlaldeen Jan, S., Aljuaid, S., AlFaifi, M., Alaboud, M.S., Khojah, I.M., and Alkofide, H. (2025). The Influence of Workplace Stressors on the Risk of Cardiovascular Diseases among Healthcare Providers: A Systematic Review. Front. Psychiatry, 16.","DOI":"10.3389\/fpsyt.2025.1461698"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Chen, W.-L., Wang, C.-C., Chiang, S.-T., Wang, Y.-C., Sun, Y.-S., Wu, W.-T., and Liou, S.-H. (2018). The Impact of Occupational Psychological Hazards and Metabolic Syndrome on the 8-Year Risk of Cardiovascular Diseases\u2014A Longitudinal Study. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0202977"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"De Lira, C.R.N., Akutsu, R.D.C., Coelho, L.G., Da Silva, K.B.B., Pitangueira, J.C.D., Zandonadi, R.P., and Costa, P.R.D.F. (2023). Influence of Occupational Stress on the Body Mass Index of Hospital Workers: A Systematic Review. Nutrients, 15.","DOI":"10.3390\/nu15183944"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"445","DOI":"10.2147\/DMSO.S68283","article-title":"Effect of BMI on Cardiovascular and Metabolic Syndrome Risk Factors in an Appalachian Pediatric Population","volume":"7","author":"Conway","year":"2014","journal-title":"DMSO"},{"key":"ref_11","first-page":"709","article-title":"Psychosocial Occupational Exposures and Mental Illness\u2014a Systematic Review with Meta-Analyses","volume":"119","author":"Seidler","year":"2022","journal-title":"Dtsch. \u00c4rzteblatt Int."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.physbeh.2011.03.002","article-title":"Opposing Effects of Chronic Stress and Weight Restriction on Cardiovascular, Neuroendocrine and Metabolic Function","volume":"104","author":"Flak","year":"2011","journal-title":"Physiol. Behav."},{"key":"ref_13","first-page":"459","article-title":"The Relation of Strength of Stimulus to Rapidity of Habit-Formation","volume":"18","author":"Yerkes","year":"1908","journal-title":"J. Comp. Neurol."},{"key":"ref_14","unstructured":"Fitzsimons, S. (2025). Is It Burnout or Rustout?, The British Psychological Society."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1146\/annurev.clinpsy.1.102803.144141","article-title":"Stress and Health: Psychological, Behavioral, and Biological Determinants","volume":"1","author":"Schneiderman","year":"2005","journal-title":"Annu. Rev. Clin. Psychol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.2105\/AJPH.2019.305278","article-title":"Shift Work and Poor Mental Health: A Meta-Analysis of Longitudinal Studies","volume":"109","author":"Torquati","year":"2019","journal-title":"Am. J. Public Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"26","DOI":"10.35457\/jares.v6i2.1640","article-title":"Relationship between Job Stress and Employee Performance in Manufacturing Industry in Indonesia","volume":"6","author":"Sari","year":"2021","journal-title":"JARES"},{"key":"ref_18","unstructured":"Kementerian Ketenagakerjaan Republik Indonesia (2026, April 04). Peraturan Menteri Tenaga Kerja dan Transmigrasi Nomor PER.02\/MEN\/1980 Tentang Pemeriksaan Kesehatan Tenaga Kerja Dalam Penyelenggaraan Keselamatan Kerja, Available online: https:\/\/temank3.kemnaker.go.id\/page\/perundangan_detail\/60\/e5877dd2eb4ed8b16d77e6d13951d760#:~:text=Peraturan%20Menteri%20Tenaga%20Kerja%20dan%20Transmigrasi%20(Permenakertrans),ditetapkan%20dan%20diundangkan%20pada%209%20Juni%201980."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e04575","DOI":"10.24857\/rgsa.v18n4-018","article-title":"Work Stress in Health Professionals: A Systematic Review","volume":"18","author":"Diaz","year":"2024","journal-title":"RGSA"},{"key":"ref_20","first-page":"1919","article-title":"Comparative Study of Stressors in the Manufacturing and Service Sector: A Literature Review","volume":"21","author":"Rao","year":"2024","journal-title":"Migr. Lett."},{"key":"ref_21","first-page":"2670","article-title":"Occupational Stress Among Building Construction Workers","volume":"14","author":"Devi","year":"2022","journal-title":"Int. J. Early Child. Spec. Educ."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s40557-016-0090-7","article-title":"Erratum to: The Relationship between Quality of Sleep and Night Shift Rotation Interval","volume":"28","author":"Kim","year":"2016","journal-title":"Ann. Occup. Environ. Med."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Awada, M., Becerik Gerber, B., Lucas, G.M., and Roll, S.C. (2024). Stress Appraisal in the Workplace and Its Associations with Productivity and Mood: Insights from a Multimodal Machine Learning Analysis. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0296468"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"52","DOI":"10.7454\/jki.v25i1.1210","article-title":"Voices of Indonesian Manufacturing Workers in Rotating Shift Systems","volume":"25","author":"Permatasari","year":"2022","journal-title":"J. Keperawatan Indones."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Kreemers, L.M., Van Hooft, E.A.J., Van Vianen, A.E.M., and Sisouw De Zilwa, S.C.M. (2020). Testing a Self-Compassion Intervention Among Job Seekers: Self-Compassion Beneficially Impacts Affect Through Reduced Self-Criticism. Front. Psychol., 11.","DOI":"10.3389\/fpsyg.2020.01371"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/4\/495\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T10:33:08Z","timestamp":1776162788000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/4\/495"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,14]]},"references-count":25,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["ijerph23040495"],"URL":"https:\/\/doi.org\/10.3390\/ijerph23040495","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,14]]}}}