Abstract
Purpose
The aim of this study was to describe and compare salivary cortisol of ambulance personnel on days with different work demands as well as to correlate the individual perception of demands to the physiological outcome cortisol.
Methods
Diurnal cortisol profiles on a day in emergency service and on a day in patient transport were monitored for 24 subjects working in an urban ambulance station. Changes of cortisol were also observed during 42 operations in emergency service and 24 operations in patient transport and were compared to the individual perception of physical and emotional demands.
Results
Rise of cortisol in the morning on days in emergency service was significantly higher than in patient transport suggesting adjustment to forthcoming demanding tasks. There were only few situations with strong endocrine reaction in emergency service as well as in patient transport. The magnitude of this reaction was not related to the individual perception of demand.
Conclusion
Ambulance service personnel seem to be used to critical situations. There was few awareness of the “physiological” stress response indicating that stress is probably not perceived in work situations characterised by routines.
Similar content being viewed by others
References
Alderling M, Theorell T, de la Torre B, Lundberg I (2006) The demand control model and circadian saliva cortisol variations in a Swedish population based sample (The PART study). BMC Public Health 6:288
Baig A, Siddigqui I, Naqvi H, Sabir S, Jabbar J, Shahid M (2006) Correlation of serum cortisol levels and stress among medical doctors working in emergency departments. Coll Physicians Surg Pak 16(9):576–580
Eller NH, Netterstrøm B, Hansen AM (2006) Psychosocial factors at home and at work and levels of salivary cortisol. Biol Psychol 73(3):280–287. doi:10.1016/j.biopsycho.2006.05.003
Fischer JE, Calame A, Dettling AC, Zeier H, Fanconi S (2000) Experience and endocrine stress responses in neonatal and pediatric critical care nurses and physicians. Crit Care Med 28(9):3362–3362. doi:10.1097/00003246-200009000-00027
Garde AH, Persson R, Hansen AM, Osterberg K, Orbaek P, Eek F, Karlson B (2008) Effect of lifestyle factors on concentrations of salivary cortisol in healthy individuals. Scand J Clin Lab Invest 4:1–9
Gebhardt HJ, Klußmann A, Maßbeck P, Topp S, Steinberg U (2006) Sicherheit und Gesundheit im Rettungsdienst. Schriftenreihe der Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Dortmund, Berlin; Verlag für neue Wissenschaft GmbH
Harris A, Ursin H, Murison R, Eriksen HR (2007) Coffee, stress, and cortisol in nursing staff. Psychoneuroendocrinology 32:322–330. doi:10.1016/j.psyneuen.2007.01.003
Hellhammer J, Fries E, Schweisthal OW, Schlotz W, Stone AA, Hagemann D (2007) Several daily measurements are necessary to reliably assess the cortisol rise after awakening: state- and trait components. Psychoneuroendocrinology 32(1):80–86. doi:10.1016/j.psyneuen.2006.10.005
Karlson B, Carlsson EF, Hansen AM, Garde AH, Österberg K, Orbaek P (2006) Diurnal cortisol pattern of shift workers on a workday and a day off. SJWEH (Suppl 2):27–34
Kirschbaum C, Hellhammer DH (2000) Salivary cortisol. Encyclopedia Stress 3:379–383
Kirschbaum C, Pirke KM, Hellhammer DH (1993) The ‘Trier Social Stress Test’—a tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology 28(1–2):76–81. doi:10.1159/000119004
Kudielka BM, Buchtal J, Uhde A, Wüst S (2007) Circadian cortisol profiles and psychological self-reports in shift workers with and without recent change in the shift rotation system. Biol Psychol 74(1):92–103. doi:10.1016/j.biopsycho.2006.08.008
Kunz-Ebrecht SR, Kirschbaum C, Marmot M, Steptoe A (2004) Differences in cortisol awakening response on workdays and weekends in women and men from the Whitehall II cohort. Psychoneuroendocrinology 29(4):516–528. doi:10.1016/S0306-4530(03)00072-6
Maina G, Palmas A, Filon FL (2008) Relationship between self-reported mental stressors at the workplace and salivary cortisol. Int Arch Occup Environ Health 81(4):391–400. doi:10.1007/s00420-007-0224-x
Pruessner JC, Kirschbaum C, Meinlschmid G, Hellhammer DH (2003) Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology 28(7):916–931. doi:10.1016/S0306-4530(02)00108-7
Rohleder N, Beulen SE, Chen E, Wolf JM, Kirschbaum C (2007) Stress on the dance floor: the cortisol stress response to social-evaluative threat in competitive ballroom dancers. Pers Soc Psychol Bull 33(1):69–84. doi:10.1177/0146167206293986
Sluiter JK, Frings-Dresen MHW, Meijman TF, van der Beek AJ (2000) Reactivity and recovery from different types of work measured by catecholamines and cortisol: a systematic literature overview. Occup Environ Med 57(5):298–315. doi:10.1136/oem.57.5.298
Sluiter JK, van der Beek AJ, Frings-Dresen MHW (2003) Medical staff in emergency situations: severity of patient status predicts stress hormone reactivity and recovery. Occup Environ Med 60:373–375. doi:10.1136/oem.60.5.373
Steptoe A, Cropley M, Griffith J, Kirschbaum C (2000) Job strain and anger expression predict early morning elevations in salivary cortisol. Psychosom Med 62:286–292
Sterud T, Ekeberg O, Hem E (2006) Health status in the ambulance services: a systematic review. BMC Health Serv 6:82–92. doi:10.1186/1472-6963-6-82
Weibel L, Gabrion I, Aussedat M, Kreutz G (2003) Work-related stress in an emergency medical dispatch center. Ann Emerg Med 41(4):500–506. doi:10.1067/mem.2003.109
Wüst S, Federenko IS, van Rossum EF, Koper JW, Hellhammer DH (2005) Habituation of cortisol responses to repeated psychosocial stress—further characterization and impact of genetic factors. Psychoneuroendocrinology 30(2):199–211. doi:10.1016/j.psyneuen.2004.07.002
Yang Y, Koh D, Ng V, Lee FC, Chan G, Dong F, Chia SE (2001) Salivary cortisol levels and work-related stress among emergency department nurses. Occup Environ Med 43(12):1011–1018
Conflict of interest statement
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Backé, E.M., Kaul, G., Klußmann, A. et al. Assessment of salivary cortisol as stress marker in ambulance service personnel: comparison between shifts working on mobile intensive care unit and patient transport ambulance. Int Arch Occup Environ Health 82, 1057–1064 (2009). https://doi.org/10.1007/s00420-009-0428-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00420-009-0428-3