Objective  To explore the prevalence and early health effects of occupational stress among employees in a petrochemical enterprise for providing evidence to the implementation of relevant interventions in the employees.

  Methods  An online self-administered questionnaire survey was carried out among 4 066 working employees of a petrochemical enterprise in Nanjing, Jiangsu province during September – October 2021. The Core Occupational Stress Scale (COSS), Patient Health Questionnaire-9 (PHQ-9), Self-Rating Anxiety Scale (SAS), the Five-Item World Health Organization Well-Being Index (WHO-5), Self-Administrated Sleep Questionnaire (SSQ), and scales for fatigue accumulation and musculoskeletal disorders assessment were used in the survey.

  Results  For the 3 763 employees finally included in the analysis, 1 143 (30.4%) were assessed as having occupational stress. Among all the occupationally stressed employees, 607 (53.1%), 256 (22.4%), and 280 (24.5%) were judged as having mild, moderate, and severe occupational stress; the number (percentage) of the employees detected with abnormal conditions was 1 670 (44.4%) for depressive symptoms, 1 338 (35.6%) for anxiety symptoms, 2 016 (53.6%) for low life satisfaction, 1 548 (41.1%) for insomnia, 2 377 (63.2%) for fatigue accumulation, and 2 934 (78.0%) for musculoskeletal disorders, respectively. After adjusting for gender, age, education, marital status, average monthly income, job title, job type, working years of specific job type, weekly working hours, and work shift status, the results of unconditional multivariate logistic regression analysis showed that compared to those without occupational stress, the employees with occupational stress of different severity were at significantly increased risks of depressive symptoms (odds ratio OR = 3.582, 6.114 and 14.016 for the employees with mild, moderate or severe occupational stress), anxiety symptoms (OR = 4.268, 4.429 and 9.365), low life satisfaction (OR = 2.790, 2.896 and 7.849), insomnia symptoms (OR = 2.425, 3.033 and 5.218), fatigue accumulation (OR = 4.806,8.818 and 18.017), and musculoskeletal disorders (2.189, 2.381 and 4.367).

  Conclusion  The detection rate of occupational stress was relatively high and the stress exerted early adverse effects on health among employees of a petrochemical enterprise in Nanjing city .