All ETDs from UAB

Advisory Committee Chair

Claudiu T Lungu

Advisory Committee Members

Peter Chen

Karen Heaton

Dale Dickinson

Tran Huynh

Ilias Kavouras

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Public Health


Job stress often causes work-related physical injuries and chronic exposure to such environment may lead to poor health outcomes. Job stress in recent years has grown significantly within the workforce due to performance pressure, long work hours and poor pay structures. Nurses work in the forefront to save patients’ lives. High job demand in this noble profession often leads to progressive decline in physical and mental health. There are existing reports that nurses in the United States (US) suffer from “burnout” syndrome which may also negatively affect patient care. There are very few studies that measured work-related stress in nurses and disease risk. Oxidative stress is an imbalance between the generation of reactive oxygen species (ROS) during cellular metabolism (free radicals) and antioxidant defenses in living organisms. Oxidative stress is associated with many debilitating diseases including iv cardiovascular diseases and cancer. Several studies have previously reported that psychological stress induces rapid generation of ROS. This cross-sectional study aimed to investigate if significant relationship existed between Job stress indicators (JSI) and oxidative damage (OD) biomarkers among nurses. Emergency department nurses were recruited from University of Alabama at Birmingham Hospital for this proposed study following IRB approval. Job stress was evaluated in participants from survey questionnaires using the Effort Reward Imbalance model. OD biomarkers (hydrogen peroxide, 8- hydroxyl- 2’-deoxyguanosine, malondialdehyde and 8-Isoprostane) were measured from spot urine specimen. Urinary metabolic profile was also obtained by Nuclear Magnetic Resonance spectroscopy. The study is novel in determining job-related pathological changes with health consequences occurring in emergency department nurses.

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