Repeated exposure to acute occupational stressors and violence poses significant mental and physical risks to workers. However, current methods for assessing the impact of these stressors, such as subjective self-reports and single-modal wearable technologies, do not capture continuous physiological and psychological responses to workplace stressors. To address this issue, we developed a multi-modal wearable armband that can non-invasively monitor physiological signals without interfering with work requirements. The armband can continuously record electrocardiogram, photoplethysmography, activity levels, and pulse transit time (PTT) - a biomarker of cuffless blood pressure. We conducted a study with sixteen nurses working 12-hour shifts at Intensive Care Unit, where they reported incidents of violence while wearing the armband for seven consecutive days. We analyzed the ratio of low- and high-frequency components of inter-beat-intervals of heart beats (LF/HF ratio) and PTT for one hour before and after the incidents to capture physiological responses and recovery patterns. Our results showed that the LF/HF ratio increased after the incident occurrence and reached baseline within 30 minutes, while the PTT decreased and persisted for more than an hour. This finding suggests that PTT can be a reliable biomarker for stress recovery. Continuous PTT measurement can be used to optimize individual and team performances based on recovery patterns in demanding work environments. In summary, our study highlights the importance of continuous physiological monitoring in assessing the impact of workplace stressors and provides a new method for measuring stress recovery using PTT.
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