Abstract Background Healthcare professionals working in hospitals during armed conflict are exposed to extreme psychological stress while maintaining clinical duties. Although psychological distress is well documented, the biological mechanisms linking wartime stress to functional outcomes such as workability remain insufficiently characterized. Objectives To investigate associations between psychological distress, perceived stress, workability, and inflammatory biomarkers among healthy hospital healthcare professionals working under acute wartime conditions. Methods A prospective observational study was conducted among 90 healthy healthcare professionals employed at a hospital in central Israel during the October 2023 missile attacks. Participants completed validated questionnaires assessing psychological distress, perceived stress, and workability. Blood samples were collected to measure inflammatory biomarkers. Associations between psychological measures, workability indices, and biomarker levels were analyzed using multivariable statistical models. Results Higher levels of psychological distress and perceived stress were significantly associated with reduced workability scores. Elevated stress measures correlated with increased levels of pro-inflammatory biomarkers, suggesting activation of inflammatory pathways. These biological changes partially mediated the relationship between psychological distress and impaired workability. Conclusions Acute wartime stress among hospital healthcare professionals is associated with both psychological impairment and measurable inflammatory responses, which may contribute to reduced functional capacity. These findings provide insight into the biological embedding of extreme occupational stress and underscore the need for targeted psychosocial and organizational interventions to protect healthcare workers operating under conflict conditions.
Jonathan et al. (Wed,) studied this question.