European Journal of Cardiovascular Medicine

Occupational health is central to global NCD control as sedentary jobs continue to rise. Professionals in banking and financial services face compounded risk due to long sitting hours, poor ergonomics, psychosocial stress, and dietary transitions [1–3].

Gupta et al. reported over 60% of Indian IT and bank professionals were overweight or hypertensive due to inactivity and erratic diet [1]. Tiwari et al. confirmed screen exposure and poor sleep are predictors of metabolic stress in Indian financial workers [2].

In Bangladesh, high perceived stress, inactivity, and obesity were prevalent among private-sector workers [3], while in Nepal, long sitting hours strongly predicted BMI and hypertension [4].

Globally, sedentary behavior is now considered an independent risk factor for all-cause mortality, especially in LMICs [5].

However, few studies contextualize these findings in politically unstable zones like Kashmir, where chronic environmental stress may amplify workplace hazards. Bank employees in Kashmir thus represent a critical and under-studied occupational group.

This study aims to explore the prevalence and associations of occupational and lifestyle risk factors among Kashmiri bank employees, offering evidence for policy and public health reform..

Study Design and Setting: A cross-sectional analytical study was conducted from June to November 2023 among employees working in public and private sector banks across urban and semi-urban areas of Kashmir.

Sample Size and Sampling Technique: A sample size of 360 was initially calculated based on 50% expected prevalence of lifestyle risk factors, 5% margin of error, 95% confidence level, and 10% non-response rate. However, 450 participants were ultimately recruited. Stratified random sampling was used: banks were stratified into public and private sectors, then branches were randomly selected. Within selected branches, employees were chosen via simple random sampling.

Inclusion and Exclusion Criteria: Inclusion: Full-time bank employees aged 25–60 years with ≥1 year of job tenure. Exclusion: Individuals with diagnosed psychiatric illness or on long-term medical leave were excluded.

Data Collection Tools: A structured questionnaire was used to collect socio-demographic and occupational data. The Perceived Stress Scale (PSS-10) was administered to assess psychological stress levels. Salt and caffeine intake were measured based on self-reported frequency per week. Physical activity was assessed using the IPAQ-Short Form. Screen time included TV, mobile, and computer use outside of work, dichotomized as ≤2 hours or >2 hours/day.

Anthropometric and Clinical Measurements: Height, weight, and waist circumference were measured using standardized protocols. BMI was calculated and categorized using WHO Asia-Pacific classification. Blood pressure was recorded using an automated sphygmomanometer after 5 minutes rest. Hypertension was defined as BP ≥140/90 mmHg or being on antihypertensives.

Statistical Analysis: Data were analyzed using SPSS v26. Descriptive statistics were computed. Chi-square tests assessed associations. Binary logistic regression was used to identify predictors of overweight/obesity and hypertension. P<0.05 was considered statistically significant.

Ethical Considerations: Ethical clearance was obtained from the Institutional Ethics Committee SKIMS Soura. Informed written consent was obtained from all participants.

Out of 450 bank employees surveyed, the mean age was 39.2 ± 8.6 years, with a male predominance (61%). Most participants (78%) were employed in urban branches and 52% in the private sector.

Lifestyle habits revealed that 64% of participants reported sleeping less than 6 hours per night, while 57% had daily screen exposure exceeding 4 hours. Approximately 70% consumed more than three cups of tea daily, and 52% reported high salt intake. Only 35% engaged in regular physical activity. The prevalence of overweight and obesity (BMI ≥25 kg/m²) was 49%.

Psychosocial stress was reported by 41% of respondents, with major contributors being long working hours (>10 hours/day), client pressure, and loan recovery responsibilities.

Chi-square analysis showed a significant association between screen time >4 hrs/day and poor sleep quality (p<0.01). Employees working >10 hours were more likely to report stress (OR=2.8, 95% CI: 1.6–4.9; p=0.002). High salt intake was also positively associated with perceived stress levels (p=0.04).

Participants who maintained regular sleep schedules and reported lower screen exposure had significantly lower BMI and stress levels.

Table 1: Descriptive Statistics of Key Lifestyle and Occupational Factors

Table 2: Association Between Screen Time and Poor Sleep Quality

Table 3: Association Between Working Hours and Reported Stress

This study confirms a high prevalence of modifiable lifestyle and occupational risk factors among bank employees in Kashmir. These findings echo prior regional studies that show similar vulnerabilities in sedentary workforce groups [1–4,6].

Uddin et al. [11] reported that over 60% of Bangladeshi office workers suffered from high BMI, stress, and reduced psychological well-being. This is consistent with our findings of 49% overweight/obesity and 41% stress.

Sleep deprivation affected 64% of our sample, aligning with observations by Islam et al. [13], who documented disrupted circadian cycles in office workers due to prolonged sitting.

Similar trends were seen by Khanal et al. [4] and Ahmed et al. [3], who linked work-related stress and poor physical activity with increased cardiometabolic risk. As Ghimire et al. [8] emphasized, psychosocial stress among working-class populations remains a dominant driver of cardiometabolic risk.

Masvosva [12] found comparable results in South Africa, where over 60% of administrative staff were obese or inactive, supporting the hypothesis of universal occupational health hazards in LMICs. Kumari et al. [9] found a strong co-occurrence of musculoskeletal complaints and job-related stress among banking professionals in Delhi.

Adeyemi et al. [14] demonstrated that inactive and overweight Nigerian adults had increased clinic visits, further emphasizing how inactivity correlates with early disease markers.

Guo et al. [15] highlighted that chronic stress and poor sleep are common denominators of metabolic syndrome in LMIC desk-based employees, supporting the interaction of screen exposure, stress, and poor sleep seen in our study. Thomas and Nair [10] highlighted how screen fatigue and poor work-life balance increase burnout and inactivity in banking populations.

Hamid [16] specifically studied Indian bank clerks and found strong correlations between long hours, caffeine intake, irregular meals, and hypertension — all mirrored in our dataset.

Thai et al. [17] advocated for workplace wellness tech solutions in LMICs to reduce sedentary risks, while Misra et al. [18] proposed precision-based cardiometabolic intervention strategies that could be adapted for high-risk occupational groups.

This breadth of literature reinforces that our study adds critical evidence from a conflict-sensitive zone, underscoring the need for context-specific interventions in occupational health policy.

Bank employees in Kashmir are significantly exposed to lifestyle and occupational health risks, including poor sleep, excessive screen time, high caffeine intake, and psychosocial stress. These factors contribute to elevated BMI, disrupted circadian rhythms, and early markers of chronic disease. Our findings underscore the urgent need for workplace-based preventive interventions that address behavioral, ergonomic, and psychosocial dimensions of occupational health.

Limitations

This study is cross-sectional and cannot establish causality. Reliance on self-reported data introduces potential bias. Absence of biochemical or clinical assessments may underestimate disease burden. However, this is one of the first studies to contextualize workplace NCD risk within a conflict-prone region such as Kashmir.

Recommendations

Ergonomic redesign and mental health screening programs, as proposed by Rahman et al. [7], should be considered integral to workplace health policies.

• Develop integrated occupational wellness policies targeting sleep hygiene, stress control, and screen exposure.
• Encourage regular physical activity through in-office wellness modules.
• Provide dietary and mental health counseling services within the banking sector.
• Tailor interventions to account for regional and sociopolitical stressors.
• Conduct future research incorporating biochemical assessments and longitudinal follow-up.

1. Gupta R, Yadav M, Joshi R. Occupational sedentary behavior and cardiometabolic risk among urban Indian professionals. Int J Environ Res Public Health. 2022;19(9):5381.
2. Tiwari A, Mehra S, Gupta V. Screen time, sleep disturbance and metabolic stress in Indian finance sector employees. BMC Public Health. 2023;23(1):120.
3. Ahmed T, Rahman M, Alam N. Occupational stress and non-communicable disease risk among Bangladeshi private-sector employees. Glob Health Action. 2021;14(1):1898342.
4. Khanal P, Dhungel S, Koirala R. Digital workload and BMI among Nepalese bank workers: A cross-sectional analysis. J Occup Health. 2022;64(2):e12318.
5. de Rezende LFM, Sá TH, Markozannes G, Rey-López JP, Naci H, Ioannidis JPA, et al. Sedentary behaviour and health outcomes: An overview of systematic reviews. BMJ. 2021;372:n293.
6. Singh K, Patel SA, Biswas S, et al. Multimorbidity in South Asian adults: prevalence, risk factors and mortality. J Public Health (Oxf). 2019;41(1):80–9.
7. Rahman MA, Ahsan GU, Chowdhury MRK. Job satisfaction and perceived health risk among Bangladeshi corporate employees. Health Qual Life Outcomes. 2024;22(1):37.
8. Ghimire S, Joshi C, Gyawali B, et al. Cardio-metabolic disease risk factors among South Asian labour migrants: a scoping review. Glob Health. 2019;15(1):33.
9. Kumari R, Sharma B, Singh M. Musculoskeletal disorders and job stress in banking professionals of Delhi. Indian J Occup Environ Med. 2023;27(2):115–9.
10. Thomas R, Nair V. Burnout, screen fatigue and physical inactivity among bank workers in Kerala. Asian J Psychiatr. 2021;61:102676.
11. Uddin R. Physical activity, sedentary behaviour and psychological wellbeing among young adults in Bangladesh: A one-year prospective study. CORE. 2019.
12. Masvosva B. NCD Risk Factors Among Administrative Staff in South Africa. CORE. 2022.
13. Islam R. Reducing occupational sitting in Bangladesh. UNSW; 2021.
14. Adeyemi SS et al. Physical Activity Among Obese Adults in Nigeria. AJARR. 2024.
15. Guo X et al. Chronic stress, poor sleep and obesity in LMICs. WUR. 2023.
16. Hamid SS. Occupational lifestyle disorders among bank employees in Hyderabad. FMSPJ. 2024.
17. Thai YC et al. Workplace digital wellness in LMICs. PLOS One. 2023;18(5):e0282118.
18.  Misra S et al. Precision medicine for cardiometabolic diseases in LMICs. Lancet Diabetes Endocrinol. 2023