Stress and depression have reached epidemic levels worldwide and have become critical global health problem concerns. There are strong evidence linking occupational activity and occupational stress to adverse health consequences. These include work absence, hypertension, cardiovascular disorders, and substance use (1–3). Occupational stress is also a major cause of mental disease, injury, and high staff turnover (4–6). Occupational stress is defined by the National Institute for Occupational Safety and Health as the stress that occurs when job demands are inconsistent with an employee's ability, employer expectations, and emotional responses (7). Globally, about three million employees have complained about occupational stress problems, and the prevalence of occupational stress varied from 30 to 52.5% (8, 9). Occupations with commonly high occupational stress risks, such as doctors and nurses, have widely reported occupational stress prevalence and risk factors (10–12). Other industries with a large number of employees (such as manufacturing or transportation enterprises) may be under-reporting the issue at high risk of occupational stress.

Employees in the manufacturing and transportation industries are distinguished from other professionals, such as doctors and nurses. Most employees are less educated, have low annual family incomes, and are at a higher risk of work stress and mental health problems, particularly those working in cities. While most studies have focused on occupational stress concerns for doctors, nurses, teachers, and other groups (12, 13), few studies have reported the prevalence of occupational stress in larger samples or compared workers in different kinds of enterprises. Evidence from epidemiological studies suggests that salary, educational status, and job role likely contribute to the development of occupational stress. Several theses on work have shown companies that use an autonomous model with a payment–reward imbalance (14), suggesting that employees in industry enterprises are a vulnerable population for occupational stress. Workers with a lower education exhibited more depressive symptoms during the coronavirus disease (COVID-19) pandemic in Istanbul and the Philippines (12, 13). Workers with lower wages have higher job insecurity or temporariness, which is significantly positively associated with higher job stress (15). Workers in these enterprises are primarily engaged in repetitive, monotonous work, which increases their risk of occupational stress. However, the prevalence of occupational stress among workers in industrial enterprises is unclear, although risk factors for occupational stress are undoubtedly present. Hence, we hypothesized that workers in these enterprises would be at a high risk of occupational stress. This study aimed to determine the prevalence of occupational stress, and compare it between different industries.

The present study conducted an extensive cross-sectional survey of 13,867 industrial workers in Beijing, China, from 2021 to 2022. We used the self-administered New Brief Job Stress Questionnaire (BJSQ) to evaluate occupational stress status. The prevalence of occupational stress and its risk factors were analyzed. This study provides evidence for a better understanding of occupational stress in industrial enterprises.

In this study, we found that the prevalence of high occupational stress was 8.9% among workers in industrial enterprises; 3.3% in the EHGWPS enterprises; 10.3% in manufacturing enterprises; and 5.8% in transportation enterprises. Furthermore, the study also provided evidence that factors such as sex, education status, job experience, and industry category were associated with high occupational stress status.

In modern society, high occupational stress contributes to a series of mental and physical illnesses. It causes psychological issues, cardiovascular disease, and musculoskeletal disorders (18), costing healthcare systems approximately 300–400 million dollars per year (19). At the same time, high occupational stress is a major factor negatively affecting employees' performance, attitudes, and behaviors (20, 21). Therefore, identifying the prevalence and related factors of high occupational stress among industry workers is important to safeguard the workforce. This study supports public health efforts to provide greater protection for workers in industrial enterprises.

Current literature on occupational stress among industrial enterprise workers has not been widely reported. The available studies have primarily been conducted on occupational stress among manufacturing service and petroleum enterprises, which indicated that the prevalence of occupational stress varied from 15.8 to 72.2% among workers (22–25). The prevalence of occupational stress among electronic manufacturing service companies was reported to be 19.5 and 15.8%, according to the high strain and effort-reward imbalance models, respectively (25). Several studies have reported that occupational stress is common among nurses and doctors, two professions that are often the focus of occupational stress research. The prevalence of occupational stress among hospital staff was 45.0% (95% CI 24.3–67.5%) during the COVID-19 epidemic, according to a review article (26). Occupational stress prevalence was 41.2% in a cohort of Australian nurses (27). In this study, we found that the prevalence of high occupational stress was 8.9% among workers in 19 enterprises, lower than in most reports. Most studies use easier criteria for determining occupational stress, while our study only reported high occupational stress; the criteria for occupational stress were more stringent, which may explain the lower prevalence. Workers in industrial enterprises are likely to face fewer challenges than hospital employees. Their work generally has fixed and clear goals, with established methods and routines. In addition, the data of this study were from the Healthy Enterprises Construction Activities; the overall health promotion measures of these enterprises were better than those of standard enterprises.

The BJSQ scores and prevalence of occupational stress in the manufacturing industry were higher than both those of the EHGWPS and transportation industries. However, they were lower than doctors and nurses, which may be due to differences in workplace and job content. This demonstrates the necessity of identifying the specific prevalence of occupational stress in different occupations (10, 11, 13). The manufacturing industry is a typical labor-intensive industry, with many assembly line operations and repetitive mechanical labor. The working process is tedious and monotonous. Therefore, workers are vulnerable to high occupational stressors. A study has indicated that occupational stress caused by assembly line work is likely associated with changes in immune function; salivary sIgA and lysozyme are potential biomarkers (28).

To determine the factors affecting BJSQ scores among workers, we performed a multivariate analysis. The results showed that sex, age, educational status, and job experience were likely influencing factors of the four occupational stress sub-dimensions. Wang et al. reported that the prevalence of occupational stress in male electronic manufacturing service workers (19.4%) was higher than that in female workers (12.6%) (25). This may be due to the male tendency to undertake more work in industrial enterprises (29). Older adult workers with longer job experience had higher job stressors than younger workers, while the social support scores of older workers were higher than those of younger workers. Hsu HC also reported that old age was related to more work stressors, but typical psychological health (30). Workers with higher education had lower job stressors and higher social support and a lower prevalence of occupational stress. This was consistent with the studies by Assari et al. (31) and Kakemam et al. (32). Because education level is related to salary, job position/grade, and human stress-adjusting ability factors (33–35), the actual relationship between education level and occupational stress may be complex. Furthermore, the outbreak of COVID-19 has increased the frequency and duration of mask use. This can affect the humidification process of inhaled air, potentially leading to an inflammatory response of the upper respiratory tract, and increasing the risk of occupational stress (36).

To our knowledge, this is the first study to report the prevalence of occupational stress among the manufacturing, transportation, and EHGWPS industries to determine the prevalence and explore the occupational stress factors in large samples in China. The current findings suggest that the prevalence of occupational stress in these populations was low. Demographic factors, including sex, age, educational status, and job experience, were also associated with high occupational stress. In particular, workers in manufacturing enterprises were more vulnerable to occupational stress than those in other enterprises. Such workers are particularly susceptible to occupational stress, and additional prevention and health promotion efforts are needed to reduce occupational stressors (37).

This study had some limitations. Our sample of EHGWPS and transportation enterprises was low, which affects the comparability across industries. Because this was a cross-sectional study, causal inferences could be made. Further research should be conducted to determine predictors of occupational stress among industrial workers. Furthermore, a detailed assessment of related risk factors (e.g., long working hours, position, and salary) was not performed, which made it impossible to evaluate the associations between occupational stress and these factors. A more comprehensive assessment of the demographic and work-related factors should be considered in further studies. Third, despite the study's large sample size, the workers were all from a single province in China. This likely affected the extrapolation of the conclusion.

The prevalence of occupational stress is not high in the EHGWPS, manufacturing, and transportation industry workers in Beijing, China, but is still worthy of attention. Workers in manufacturing enterprises with a lower education status, who were male, and who had more job experience were more vulnerable to occupational stress. Further research is needed to help improve the wellbeing of these workers and minimize poor mental health in the manufacturing and transportation industries.

The original contributions presented in the study are included in the article/Supplementary material, further inquiries can be directed to the corresponding author/s.

The studies involving human participants were reviewed and approved by the Medical Ethics Committee of the Beijing Institute of Occupational Disease Prevention and Treatment. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.

Conceptualization, study design, and original draft preparation: TY and XD. Data collection, data analysis, and interpretation: TY, FJ, MB, HW, XC, TL, TX, and JW. Review and editing: BL, DN, JL, and XD. All authors have read and agreed to the published version of the manuscript.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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