well as sharpening of hearing and vision. Epinephrine is released into the blood. The HPA axis is activated. There is increased activity in the sympathetic nervous system. Cortisol levels are elevated. Energy-providing compounds of glucose and fatty acids are released into the bloodstream. The action immune and digestive systems are temporarily reduced. Studies have shown an association between occupational stress and "health risk behaviors". Occupational stress has shown to be linked with an increase in alcohol consumption among men and an increase in body weight. Occupational stress accounts for more than 10% of work-related health claims. Many studies suggest that psychologically demanding jobs that allow employees little control over the work process increase the risk of cardiovascular disease. Research indicates that job stress increases the risk for development of back and upper-extremity musculoskeletal disorders. Stress at work can also increase the risk of acquiring an infection and the risk of accidents at work. Occupational stress can lead to three types of strains: behavioral (e.g., absenteeism), physical (e.g., headaches), and psychological (e.g., depressed mood). Job stress has been linked to a broad array of conditions, including psychological disorders (e.g., depression, anxiety, post-traumatic stress disorder), job dissatisfaction, maladaptive behaviors (e.g., substance abuse), cardiovascular disease, and musculoskeletal disorders. Stressful job conditions can also lead to poor work performance, counterproductive work behavior, higher absenteeism, and injury. Chronically high levels of job stress diminish a worker's quality of life and increase the cost of the health benefits the employer provides. A study of short haul truckers found that high levels of job stress were related to increased risk of occupational injury. Research conducted in Japan showed a more than two-fold increase in the risk of stroke among men with job strain (combination of high job demand and low job control). The Japanese use the term karoshi to reflect death from overwork. High levels of stress are associated with substantial increases in health service utilization. For example, workers who report experiencing stress at work also show excessive health care utilization. In a 1998 study of 46,000 workers, health care costs were nearly 50% greater for workers reporting high levels of stress in comparison to "low risk" workers. The increment rose to nearly 150%, an increase of more than $1,700 per person annually, for workers reporting high levels of both stress and depression. Health care costs increase by 200% in those with depression and high occupational stress.