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Landsbergis, Paul
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Biography
MA, Psychology, New York University; EdD, Labor Studies, Rutgers University; MPH, PhD, Epidemiology, Columbia University
Institutional profile
Dr. Landsbergis is an Associate Professor in the Department of Environmental and Occupational Health Sciences. He holds a PhD in Epidemiology from Columbia University and an EdD in Labor Studies from Rutgers University. He has extensive experience conducting research, teaching and public education on socioeconomic position, work organization, lean production, work stress, the changing nature of work, hypertension, cardiovascular disease, psychological disorders and musculoskeletal disorders, and on interventions to reduce job stress and improve worker health. He has led international study groups in conducting research and publishing on these topics. He also has expertise in the measurement of blood pressure while employees are working as a biological marker of job stress. 'While working" blood pressure measurements help to identify individuals with “masked hypertension” (who are at high risk for cardiovascular disease), a potentially large group of individuals with normal clinic blood pressure but elevated blood pressure while at work. Sources of stress at work are risk factors for masked hypertension. His related research and teaching interests include occupational health psychology, occupational health and safety, occupational epidemiology, ergonomics, social epidemiology and reducing health disparities. He is Deputy Editor of the American Journal of Industrial Medicine.
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Publication Open Access Clinical experience and results of a Sentinel Health Investigation related to indoor fungal exposure.(Environmental Health Perspectives, 1999-06) Johanning, E; Landsbergis, P; Gareis, M; Yang, C S; Olmsted, EThis is a review of exposure conditions, clinical presentation, and morbidity of children and adults with indoor fungal exposure such as toxic Stachybotrys chartarum. Indoor exposure was characterized using different methods including microscopic, culture, cytotoxicity screening tests, and chemical analyses. Clinical case histories and physical and laboratory findings are presented of children (age < 18 years, n = 22; mean age 9 years; 60% females) and adults (age >18 years, n = 125; mean age 39 years, 67% females) who consulted an environmental health specialty clinic. In the pediatric patients' exposure history, widespread fungal contamination of water-damaged building materials with known toxic or allergic fungi was identified. Primarily disorders of the respiratory system, skin, mucous membranes, and central nervous system were reported. Some enumeration and functional laboratory abnormalities, mainly of the lymphatic blood cells, were observed, although no statistically significant differences were found. IgE or IgG fungi-specific antibodies, used as exposure markers, were positive in less than 25% of all tested cases. In an evaluation of a symptomatic girl 11 years of age (sentinel case investigation) living in an apartment with verified toxigenic fungi (i.e., S. chartarum), several health indicators showed improvement after exposure cessation.Publication Open Access Predicting new major depression symptoms from long working hours, psychosocial safety climate and work engagement: a population-based cohort study(BMJ, 2021-06-23) Zadow, Amy Jane; Dollard, Maureen F; Dormann, Christian; Landsbergis, PaulObjectives: This study sought to assess the association between long working hours, psychosocial safety climate (PSC), work engagement (WE) and new major depression symptoms emerging over the next 12 months. PSC is the work climate supporting workplace psychological health. Setting: Australian prospective cohort population data from the states of New South Wales, Western Australia and South Australia. Participants: At Time 1, there were 3921 respondents in the sample. Self-employed, casual temporary, unclassified, those with working hours <35 (37% of 2850) and participants with major depression symptoms at Time 1 (6.7% of 1782) were removed. The final sample was a population-based cohort of 1084 full-time Australian employees. Primary and secondary outcome measures: The planned and measured outcomes were new cases of major depression symptoms. Results: Long working hours were not significantly related to new cases of major depression symptoms; however, when mild cases were removed, the 41-48 and ≥55 long working hour categories were positively related to major depression symptoms. Low PSC was associated with a threefold increase in risk for new major depression symptoms. PSC was not related to long working hours, and long working hours did not mediate the relationship between PSC and new cases of major depression symptoms. The inverse relationship between PSC and major depression symptoms was stronger for males than females. Additional analyses identified that WE was positively related to long working hours. Long working hours (41-48 and ≥55 hours) mediated a positive relationship between WE and major depression symptoms when mild cases of major depression were removed. Conclusion: The results suggest that low workplace PSC and potentially long working hours (41-48; ≥55 hours/week) increase the risk of new major depression symptoms. Furthermore, high WE may increase long working hours and subsequent major depression symptomsPublication Open Access Associations of work hours with carotid intima–media thickness and ankle–brachial index: the Multi-Ethnic Study of Atherosclerosis (MESA)(BMJ, 2012-07-05) Charles, Luenda E; Fekedulegn, Desta; Burchfiel, Cecil M; Fujishiro, Kaori; Landsbergis, Paul; Diez Roux, Ana V; MacDonald, Leslie; Foy, Capri G; Andrew, Michael E; Stukovsky, Karen H; Baron, SherryObjectives: Long working hours may be associated with cardiovascular disease (CVD). The objective was to investigate cross-sectional associations of work hours with carotid intima-media thickness (CIMT) and ankle-brachial index (ABI). Methods: Participants were 1694 women and 1868 men from the Multi-Ethnic Study of Atherosclerosis. CIMT and ABI were measured using standard protocols. Information on work hours was obtained from questionnaires. Mean values of CIMT and ABI were examined across five categories of hours worked per week (≤20, 21-39, 40, 41-50 and >50) using analysis of variance/analysis of covariance. p Values for trend were obtained from linear regression models. Results: Mean age of participants was 56.9±8.4 years; 52.4% were men. Distinct patterns of association between work hours and the subclinical CVD biomarkers were found for women and men, although this heterogeneity by gender was not statistically significant. Among women only, work hours were positively associated with common (but not internal) CIMT (p=0.073) after full risk factor adjustment. Compared with women working 40 h, those working >50 h were more likely to have an ABI <1 (vs 1-1.4) (OR=1.85, 95% CI 1.01 to 3.38). In men, work hours and ABI were inversely associated (p=0.046). There was some evidence that the association between work hours and ABI was modified by occupational category (interaction p=0.061). Among persons classified as management/professionals, longer work hours was associated with lower ABI (p=0.015). No significant associations were observed among other occupational groups. Conclusions: Working longer hours may be associated with subclinical CVD. These associations should be investigated using longitudinal studies.Publication Open Access Associations of occupation, job control and job demands with intima-media thickness: The Multi-Ethnic Study of Atherosclerosis (MESA)(BMJ, 2010-10-08) Fujishiro, Kaori; Diez Roux, Ana V; Landsbergis, Paul; Baron, Sherry; Barr, R Graham; Kaufman, Joel D; Polak, Joseph F; Stukovsky, Karen HinckleyObjectives: Occupation has been linked to cardiovascular disease (CVD) incidence and mortality, but few studies have investigated occupation in relation to early atherosclerotic disease. This study examined associations between various occupational characteristics and carotid artery intima-media thickness (IMT) in a multi-ethnic sample. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) recruited 6814 adults aged 45-84 years and free of clinical CVD (response rate 60%, 51% female). Questionnaire data were used to determine occupational group (managerial/professional, sales/office, service, blue-collar), psychosocial job characteristics (ie, job demands, job control) and other sociodemographic information. Results: Common carotid artery (CCA)-IMT was greater for blue-collar jobs than for management/professional jobs (mean difference = 0.012 mm, p = 0.049) after adjustment for age, sex, race, place of birth (US or foreign born) and CVD risk factors. Compared to management/professional jobs, internal carotid artery (ICA)-IMT was greater for sales/office, service and blue-collar jobs (mean difference = 0.071 mm, p < 0.001; 0.057 mm, p = 0.009; and 0.110 mm, p < 0.001, respectively) after adjustment for age, sex, race and place of birth. The difference between blue-collar jobs and management/professional jobs remained significant after additional adjustment for CVD risk factors, income and education (mean difference = 0.048 mm, p = 0.045). Higher levels of control at work were associated with thinner CCA-IMT (mean difference = -0.009 mm, p = 0.016, adjusted for age, sex, race and place of birth) but not with ICA-IMT. Job demands had no significant association with IMT. Conclusions: Blue-collar jobs and low levels of job control were associated with the development of subclinical atherosclerosis.Publication Open Access Job strain and coronary heart disease(Elsevier BV, 2013-02) Landsbergis, Paul; Schnall, PeterPublication Open Access Explaining racial/ethnic differences in all-cause mortality in the Multi-Ethnic Study of Atherosclerosis (MESA): Substantive complexity and hazardous working conditions as mediating factors(Elsevier BV, 2017-12) Fujishiro, Kaori; Hajat, Anjum; Landsbergis, Paul A.; Meyer, John D.; Schreiner, Pamela J.; Kaufman, Joel D.Research on racial/ethnic health disparities and socioeconomic position has not fully considered occupation. However, because occupations are racially patterned, certain occupational characteristics may explain racial/ethnic difference in health. This study examines the role of occupational characteristics in racial/ethnic disparities in all-cause mortality. Data are from a U.S. community-based cohort study (n=6342, median follow-up: 12.2 years), in which 893 deaths (14.1%) occurred. We estimated mortality hazard ratios (HRs) for African Americans, Hispanics, and Chinese Americans compared with whites. We also estimated the proportion of the HR mediated by each of two occupational characteristics, substantive complexity of work (e.g., problem solving, inductive/deductive reasoning on the job) and hazardous conditions (e.g., noise, extreme temperature, chemicals), derived from the Occupational Information Network database (O*NET). Analyses were adjusted for age, sex, nativity, working status at baseline, and study sites. African Americans had a higher rate of all-cause death (HR 1.41; 95% confidence interval [CI]: 1.19-1.66) than whites. Chinese-American ethnicity was protective (HR 0.59, CI: 0.40-0.85); Hispanic ethnicity was not significantly different from whites (HR 0.88; CI: 0.67-1.17). Substantive complexity of work mediated 30% of the higher rate of death for African Americans compared with whites. For other groups, mediation was not significant. Hazardous conditions did not significantly mediate mortality in any racial/ethnic group. Lower levels of substantive complexity of work mediate a substantial part of the health disadvantage in African Americans. This job characteristic may be an important factor in explaining racial health disparities.Publication Open Access Lower socioeconomic status among men in relation to the association between job strain and blood pressure(Scandinavian Journal of Work, Environment and Health, 2003-06) Landsbergis, Paul A; Schnall, Peter L; Pickering, Thomas G; Warren, Katherine; Schwartz, Joseph EObjectives: This study attempted to determine whether the association between job strain (high job demands plus low job control) and blood pressure among men varies by socioeconomic status. Methods: The cross-sectional associations between job strain and ambulatory blood pressure, by level of education, occupational status, and income, and the interaction between job strain and these measures of socioeconomic status were assessed by multiple linear regression, adjusted for age, race or ethnicity, body mass index, alcohol use, smoking, standing position, and worksite for 283 men, aged 30-60 years, from eight worksites in New York City. Results: A substantial association between job strain and work ambulatory blood pressure was found among men with lower socioeconomic status, ranging from 2.7-11.8 mm Hg systolic to 1.9-6.1 mm Hg diastolic blood pressure, depending upon the measure of socioeconomic status examined. However, in the groups with high socioeconomic status, the association between job strain and ambulatory blood pressure at work was much smaller, the range in blood pressure being 0-5.3 (systolic) and 0.2-2.1 (diastolic) mm Hg. Two of the 10 tests of the interaction between job strain and socioeconomic status had a P-value of <0.05. Conclusions: These data provide evidence that the relationship between job strain and blood pressure is greater among men with lower socioeconomic status. PubMed DisclaimerPublication Open Access Relation between job strain, alcohol, and ambulatory blood pressure.(Ovid Technologies (Wolters Kluwer Health), 1992-05) Schnall, P L; Schwartz, J E; Landsbergis, P A; Warren, K; Pickering, T G"Job strain" (defined as high psychological demands and low decision latitude on the job) has been previously reported to be associated with increased risk of hypertension and increased left ventricular mass index (LVMI) in a case-control study of healthy employed men, aged 30-60 years, without evidence of coronary heart disease. We hypothesized that job strain would be associated with increased ambulatory blood pressure (AmBP). A total of 264 men at eight work sites wore an AmBP monitor for 24 hours on a working day. In an analysis of covariance model, job strain was associated with an increase in systolic AmBP of 6.8 mm Hg (p = 0.002) and diastolic AmBP of 2.8 mm Hg at work (p = 0.03) after adjusting for age, race, body mass index, Type A behavior, alcohol behavior, smoking, work site, 24-hour urine sodium, education, and physical demand level of the job. Alcohol use also had a significant effect on AmBP. However, among subjects not in high-strain jobs, alcohol had no apparent effect on AmBP at work. Instead, alcohol use and job strain interacted such that workers in high-strain jobs who drank regularly had significantly higher systolic AmBP at work (p = 0.007). Among the other risk factors, only age, body mass index, and smoking had significant effects on AmBP. Job strain also had significant effects on AmBP at home and during sleep as well as on LVMI.Publication Open Access Mental health outcomes among urban public transport workers: A systematic literature review(Elsevier BV, 2024-05) Cendales, Boris E.; Gómez-Ortiz, Viviola; Useche, Sergio A.; Cedillo, Leonor; Stephenson, Daryl W.H.; Landsbergis, PaulBackground Although abundant evidence suggests that Urban Public Transport (UPT) workers are at high risk of poor mental health, there is no consensus on the exposures that explain these outcomes, nor on the effectiveness of mental health interventions in this occupational group. Objective This study aims to systematically review the literature on the mental health of UPT workers to assess the effects of occupational exposures and interventions. Method A systematic review was conducted following the PRISMA guidelines. The literature search was performed from 1990 to December 2021 in three databases (PubMed, Scopus, and the Web of Science). The included observational, experimental, intervention and qualitative studies were critically appraised and assessed for risk of bias. A narrative evidence synthesis was conducted by mental health outcomes, occupational exposures, and intervention categories. Results The database search yielded 1383 records. A total of 83 studies (49 cross-sectional, 8 longitudinal, 8 experiments, 7 interventions, and 11 qualitative) met the inclusion criteria. Bus drivers were the most studied population, followed by metro and train drivers. The included studies covered eleven mental health outcomes: sleep problems, fatigue and recovery needs, alcohol and substance use, PTSD, panic disorders, depression, anxiety, psychopathology symptoms, psychosomatic symptoms, and psychological stress. Work organization-related stressors (work content, workload and pace, working hours, participation and control, career development, status and salary, role in the organization, and interpersonal relationships) and occupational safety risks are the main predictors of negative mental health outcomes. Most intervention studies focus on the management of PTSD symptoms of UPT workers exposed to safety hazards. Conclusion The results of this review contribute to the consensus on the antecedents of negative mental health outcomes among UPT workers, as well as to the identification of intervention targets and promising research lines for the development of this study field.Publication Open Access Expanding the Conceptualization of Support in Low-Wage Carework: The Case of Home Care Aides and Client Death(MDPI AG, 2021-12-30) Tsui, Emma K.; LaMonica, Marita; Hyder, Maryam; Landsbergis, Paul; Zelnick, Jennifer; Baron, SherryHome care aides are a rapidly growing, non-standard workforce who face numerous health risks and stressors on the job. While research shows that aides receive limited support from their agency employers, few studies have explored the wider range of support that aides use when navigating work stress and considered the implications of these arrangements. To investigate this question, we conducted 47 in-depth interviews with 29 home care aides in New York City, focused specifically on aides' use of support after client death. Theories of work stress, the social ecological framework, and feminist theories of care informed our research. Our analysis demonstrates aides' extensive reliance on personal sources of support and explores the challenges this can create in their lives and work, and, potentially, for their communities. We also document aides' efforts to cultivate support stemming from their home-based work environments. Home care aides' work stress thus emerges as both an occupational health and a community health issue. While employers should carry responsibility for preventing and mitigating work stress, moving toward health equity for marginalized careworkers requires investing in policy-level and community-level supports to bolster employer efforts, particularly as the home care industry becomes increasingly fragmented and non-standard.