Background Occupational stress is a critical public health issue threatening the physical and mental well-being of workers. Identifying reliable biomarkers is of great significance for the assessment and intervention of occupational stress. Given their dual role in reflecting both physiological stress and pathological damage in the body, systemic inflammation indices derived from complete blood cell count may offer a novel perspective for biological evaluation of occupational stress.

Objective To explore the association between occupational stress and systemic inflammation indices derived from complete blood cell count, and to evaluate the value of these indices as objective biomarkers reflecting the potential health risks associated with occupational stress.

Methods A cross-sectional study was conducted from May to December 2024. Cluster sampling was used to recruit employees undergoing routine occupational health examinations at a tertiary hospital in Chengdu, representing two labor types (mental work and mixed physical-mental work). A self-administered questionnaire and the Chinese version of the Depression Anxiety Stress Scale (DASS-21) were used to collect basic demographic and occupational information, and to estimate occupational stress levels. Blood samples were collected to measure complete blood cell counts, and systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and systemic inflammatory aggregation index (AISI) were calculated. Logistic regression models were employed to analyze the association between high occupational stress and systemic inflammation indices derived from complete blood cell count.

Results A total of 1380 questionnaires were distributed, and 1210 valid questionnaires were collected, yielding an effective response rate of 87.68%. After excluding 37 participants with incomplete medical records, the final sample size was 1173. Among them, 499 (36.2%) exhibited high occupational stress. Statistically significant differences (P＜0.05) were observed in the postive rates of high occupational stress across gender, age, marital status, education level, body mass index (BMI), alcohol consumption frequency, occupational type, monthly income, work experience, weekly working hours, and night shift frequency. Occupational stress showed positive correlations with SIRI, AISI, and SII (P＜0.05). After adjusting for confounding factors, high occupational stress was associated with abnormally elevated AISI, with an odds ratio of 1.43 (95%CI: 1.08, 1.89) (P＜0.05).

Conclusion The systemic inflammation index AISI remains associated with high occupational stress after adjustment, providing preliminary evidence for further exploration of inflammatory changes induced by occupational stress. AISI may serve as a complementary indicator alongside questionnaires for long-term monitoring of health risks caused by psychological stress.