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Burek K, Rabstein S, Kantermann T, Vetter C, Wang-Sattler R, Lehnert M, Pallapies D, Jöckel KH, Brüning T, Behrens T. Altered coordination between sleep timing and cortisol profiles in night working female hospital employees. Psychoneuroendocrinology 2024; 166:107066. [PMID: 38723404 DOI: 10.1016/j.psyneuen.2024.107066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 04/25/2024] [Accepted: 04/28/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Cortisol typically peaks in the morning after waking up and declines throughout the day, reaching its lowest levels during nighttime sleep. Shift work can cause misalignment between cortisol levels and sleep-wake timing. We analyzed this misalignment in female shift workers focusing on the timing and extent of these changes. METHODS We conducted a cross-sectional study involving 68 shift workers (aged 37 ± 10 years) and 21 non-shift workers (aged 45 ± 10 years) from a hospital. Shift workers were monitored through two day shifts and three night shifts, whereas non-shift workers were monitored during two day shifts. Each participant collected six to eight saliva samples (depending on their shift type) and provided sleep timing information, which was recorded via polysomnography and sleep diaries. Generalized additive mixed models were used to estimate shift-specific differences in cortisol smooth curves. Summary measures calculated for the cortisol smooth curves included cortisol awakening response, peak-to-bed slope, and total output. RESULTS Between shift workers and non-shift workers, we observed similar diurnal cortisol profiles with a steep negative diurnal slope during day shifts. In shift workers on night shifts, a flattened U-shaped cortisol profile after the post-awakening maximum was observed, with a peak-to-bed slope close to zero. When comparing night to day shifts in the group of shift workers, mean cortisol levels were lower between 42 and 56 minutes and 1.8-11.9 hours after waking up, and higher between 14.9 and 22 hours after waking up. CONCLUSION Our findings indicate altered cortisol profiles in female hospital employees on night shifts. Specifically, cortisol levels were lower at night when higher levels would typically be necessary for work activities, and higher at bedtime after a night shift, when levels should normally be low.
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Affiliation(s)
- Katarzyna Burek
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bochum, Germany.
| | - Sylvia Rabstein
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bochum, Germany
| | - Thomas Kantermann
- Institute for Labor and Personnel (IAP), University of Applied Sciences for Economics and Management (FOM), Essen, Germany; SynOpus, Bochum, Germany
| | - Céline Vetter
- Department of Integrative Physiology, University of Colorado, Boulder, CO, United States
| | - Rui Wang-Sattler
- Institute of Translational Genomics, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; German Center for Diabetes Research (DZD), München, Neuherberg, Germany
| | - Martin Lehnert
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bochum, Germany
| | - Dirk Pallapies
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bochum, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bochum, Germany
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bochum, Germany
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Tramel W, Schram B, Canetti E, Orr R. An Examination of Subjective and Objective Measures of Stress in Tactical Populations: A Scoping Review. Healthcare (Basel) 2023; 11:2515. [PMID: 37761712 PMCID: PMC10530665 DOI: 10.3390/healthcare11182515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/06/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
Persons working in tactical occupations are often exposed to high-stress situations. If this stress is to be measured, an understanding of the stress outcomes used in these occupations is needed. The aim of this review was to capture and critically appraise research investigating subjective and objective outcome measures of physiological stress in tactical occupations. Several literature databases (PubMed, EMBASE, EBsco) were searched using key search words and terms. Studies meeting inclusion criteria were critically evaluated and scored by two authors using the Joanne Briggs Institute (JBI) critical appraisal tool. Of 17,171 articles, 42 studies were retained. The Cohen's Kappa agreement between authors was 0.829 with a mean JBI Score of included studies of 8.1/9 ± 0.37 points. Multiple subjective and objective measures were assessed during a variety of high-stress tasks and environments across different occupations, including police officers, emergency service personnel, firefighters, and soldiers in the military. Common objective outcomes measures were heart rate, cortisol, and body temperature, and subjective measures were ratings of perceived exertion, and the Self Trait Anxiety Inventory. Often used in combination (i.e., subjective and objective), these outcome measures can be used to monitor stressors faced by tactical personnel undergoing on-the-job training.
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Affiliation(s)
- Whitney Tramel
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (B.S.); (E.C.); (R.O.)
| | - Ben Schram
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (B.S.); (E.C.); (R.O.)
- Tactical Research Unit, Bond University, Robina, QLD 4226, Australia
| | - Elisa Canetti
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (B.S.); (E.C.); (R.O.)
- Tactical Research Unit, Bond University, Robina, QLD 4226, Australia
| | - Robin Orr
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (B.S.); (E.C.); (R.O.)
- Tactical Research Unit, Bond University, Robina, QLD 4226, Australia
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3
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Cortisol and shiftwork: A scoping review. Sleep Med Rev 2021; 64:101581. [DOI: 10.1016/j.smrv.2021.101581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 11/20/2022]
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Minelli A, Di Palma M, Rocchi MBL, Ponzio E, Barbadoro P, Bracci M, Pelusi G, Prospero E. Cortisol, chronotype, and coping styles as determinants of tolerance of nursing staff to rotating shift work. Chronobiol Int 2021; 38:666-680. [PMID: 33827343 DOI: 10.1080/07420528.2021.1887883] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Hypothalamo-pituitary-adrenal axis activity and cortisol patterns are likely to play a role in shift work tolerance, i.e., ability to adapt to shift work without suffering stress-related consequences. Yet, the evidence is scanty. Here, salivary cortisol output during night shifts and leisure days was assessed in fast-forward rotating shift work nursing staff (N = 30), and possible links with a series of variables - gender (30% male), age (M = 39.6, SEM = 1.57 y), years of service (M = 12.43, SEM = 1.48 y), BMI (M = 23.29, SEM = 0.66 Kg/m2), self-rated chronotype, sleep quality, and psycho-behavioral factors - were investigated. Main results show that cortisol output during night shifts: i) is larger in morning-oriented chronotypes, thus affected by the circadian misalignment between biological and working rhythms; ii) associates with dysfunctional coping styles at work; iii) positively correlates with diurnal cortisol secretion on leisure days, i.e., individuals with larger cortisol output during shifts display higher cortisol secretion on non-working days. Chronotype and psycho-behavioral factors explain most of the correlational weight linking cortisol output during the night shift and off-days. In conclusion, we confirm salivary cortisol testing as a suitable objective marker of occupational stress and propose it as a valuable index for monitoring shift work tolerance, in combination with chronotype. Moreover, we emphasize the importance of evaluating psycho-behavioral factors in professional settings, because these modifiable variables can be addressed with tailored psychological interventions to ameliorate poor job satisfaction, reduce work-related distress, and avoid chronic cortisol excess experienced by shift workers.
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Affiliation(s)
- Andrea Minelli
- Department of Biomolecular Sciences (DISB), University of Urbino Carlo Bo, Urbino, Italy
| | - Michael Di Palma
- Department of Experimental and Clinical Medicine, Faculty of Medicine and Surgery, Università Politecnica Delle Marche, Ancona, Italy
| | | | - Elisa Ponzio
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica Delle Marche, Ancona, Italy
| | - Pamela Barbadoro
- Department of Experimental and Clinical Medicine, Faculty of Medicine and Surgery, Università Politecnica Delle Marche, Ancona, Italy
| | - Massimo Bracci
- Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Gilda Pelusi
- School of Nursing Science, Università Politecnica Delle Marche, Ancona, Italy
| | - Emilia Prospero
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica Delle Marche, Ancona, Italy
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Henry M, Thomas KGF, Ross IL. Sleep, Cognition and Cortisol in Addison's Disease: A Mechanistic Relationship. Front Endocrinol (Lausanne) 2021; 12:694046. [PMID: 34512546 PMCID: PMC8429905 DOI: 10.3389/fendo.2021.694046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/02/2021] [Indexed: 11/19/2022] Open
Abstract
Sleep is a critical biological process, essential for cognitive well-being. Neuroscientific literature suggests there are mechanistic relations between sleep disruption and memory deficits, and that varying concentrations of cortisol may play an important role in mediating those relations. Patients with Addison's disease (AD) experience consistent and predictable periods of sub- and supra-physiological cortisol concentrations due to lifelong glucocorticoid replacement therapy, and they frequently report disrupted sleep and impaired memory. These disruptions and impairments may be related to the failure of replacement regimens to restore a normal circadian rhythm of cortisol secretion. Available data provides support for existing theoretical frameworks which postulate that in AD and other neuroendocrine, neurological, or psychiatric disorders, disrupted sleep is an important biological mechanism that underlies, at least partially, the memory impairments that patients frequently report experiencing. Given the literature linking sleep disruption and cognitive impairment in AD, future initiatives should aim to improve patients' cognitive performance (and, indeed, their overall quality of life) by prioritizing and optimizing sleep. This review summarizes the literature on sleep and cognition in AD, and the role that cortisol concentrations play in the relationship between the two.
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Affiliation(s)
- Michelle Henry
- Centre for Higher Education Development, University of Cape Town, Cape Town, South Africa
- *Correspondence: Michelle Henry,
| | | | - Ian Louis Ross
- Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa
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Diurnal Cortisol Variation According to High-Risk Occupational Specialty Within Police: Comparisons Between Frontline, Tactical Officers, and the General Population. J Occup Environ Med 2020; 61:e260-e265. [PMID: 31167225 DOI: 10.1097/jom.0000000000001591] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to compare diurnal salivary cortisol among high-risk occupational police specialties and the general population (n = 18,698). METHODS Tactical and frontline officers provided salivary cortisol samples for 2 days (four times: wake, 30 minutes, 11 hours, and 17 hours post-awakening) and were compared with a general population sample of group field studies utilizing similar methodology. Samples were analyzed for free cortisol concentrations (nmol/L) using chemiluminescence immunoassay. RESULTS Repeated-measures mixed-model analysis of variance (ANOVA) revealed significantly greater salivary diurnal cortisol among tactical than frontline officers. Furthermore, both tactical and frontline officers had higher cortisol levels on average at all time points than the general population sample. CONCLUSION Results suggest that diurnal cortisol response may be associated with level of risk exposure in hazardous occupational subspecialties within policing compared with the general population.
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Giessing L, Oudejans RRD, Hutter V, Plessner H, Strahler J, Frenkel MO. Acute and Chronic Stress in Daily Police Service: A Three-Week N-of-1 Study. Psychoneuroendocrinology 2020; 122:104865. [PMID: 32961407 DOI: 10.1016/j.psyneuen.2020.104865] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 08/27/2020] [Accepted: 08/27/2020] [Indexed: 01/14/2023]
Abstract
On duty, police officers are exposed to a variety of acute, threatening stress situations and organizational demands. In line with the allostatic load model, the resulting acute and chronic stress might have tremendous consequences for police officers' work performance and psychological and physical health. To date, limited research has been conducted into the underlying biological, dynamic mechanisms of stress in police service. Therefore, this ecological momentary assessment study examined the associations of stress, mood and biological stress markers of a 28-year-old male police officer in a N-of-1 study over three weeks (90 data points). Four times a day (directly after waking up, 30 minutes later, 6 hours later, before going to bed), he answered questions about the perceived stress and mood using a smartphone application. With each data entry, he collected saliva samples for the later assessment of salivary cortisol (sCort) and alpha-amylase (sAA). In addition, data was collected after six police incidents during duty. sCort and sAA were not related to perceived stress in daily life and did not increase in police incidents. Regarding mood measures, deterioration of calmness, but not valence and energy was associated with perceived stress. The results suggest continued police service to constitute a major chronic stressor resulting in an inability to mount a proper response to further acute stress. As an indicator of allostatic load, psychological and biological hyporesponsivity in moments of stress may have negative consequences for police officers' health and behavior in critical situations that require optimal performance. Prospectively, this research design may also become relevant when evaluating the efficacy of individualized stress management interventions in police training.
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Affiliation(s)
- Laura Giessing
- Institute for Sport and Sport Sciences, Heidelberg University, Germany.
| | - Raôul R D Oudejans
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Institute for Brain and Behaviour Amsterdam, the Netherlands; Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, the Netherlands
| | - Vana Hutter
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Institute for Brain and Behaviour Amsterdam, the Netherlands
| | - Henning Plessner
- Institute for Sport and Sport Sciences, Heidelberg University, Germany
| | - Jana Strahler
- Faculty of Psychology and Sport Science, Justus-Liebig University, Gießen, Germany
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8
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Marti AR, Pedersen TT, Wisor JP, Mrdalj J, Holmelid Ø, Patil S, Meerlo P, Bramham CR, Grønli J. Cognitive function and brain plasticity in a rat model of shift work: role of daily rhythms, sleep and glucocorticoids. Sci Rep 2020; 10:13141. [PMID: 32753733 PMCID: PMC7403587 DOI: 10.1038/s41598-020-69969-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 07/14/2020] [Indexed: 02/06/2023] Open
Abstract
Many occupations require operations during the night-time when the internal circadian clock promotes sleep, in many cases resulting in impairments in cognitive performance and brain functioning. Here, we use a rat model to attempt to identify the biological mechanisms underlying such impaired performance. Rats were exposed to forced activity, either in their rest-phase (simulating night-shift work; rest work) or in their active-phase (simulating day-shift work; active work). Sleep, wakefulness and body temperature rhythm were monitored throughout. Following three work shifts, spatial memory performance was tested on the Morris Water Maze task. After 4 weeks washout, the work protocol was repeated, and blood and brain tissue collected. Simulated night-shift work impaired spatial memory and altered biochemical markers of cerebral cortical protein synthesis. Measures of daily rhythm strength were blunted, and sleep drive increased. Individual variation in the data suggested differences in shift work tolerance. Hierarchical regression analyses revealed that type of work, changes in daily rhythmicity and changes in sleep drive predict spatial memory performance and expression of brain protein synthesis regulators. Moreover, serum corticosterone levels predicted expression of brain protein synthesis regulators. These findings open new research avenues into the biological mechanisms that underlie individual variation in shift work tolerance.
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Affiliation(s)
- Andrea R Marti
- Bergen Stress and Sleep Group, Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Jonas Liesvei 91, 5009, Bergen, Norway. .,Bergen Stress and Sleep Group, Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Jonas Liesvei 91, 5009, Bergen, Norway.
| | - Torhild T Pedersen
- Bergen Stress and Sleep Group, Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Jonas Liesvei 91, 5009, Bergen, Norway
| | - Jonathan P Wisor
- College of Medicine, Washington State University, Spokane, WA, USA
| | - Jelena Mrdalj
- Bergen Stress and Sleep Group, Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Jonas Liesvei 91, 5009, Bergen, Norway
| | - Øystein Holmelid
- Bergen Stress and Sleep Group, Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Jonas Liesvei 91, 5009, Bergen, Norway
| | - Sudarshan Patil
- Department of Biomedicine, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Peter Meerlo
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, The Netherlands
| | - Clive R Bramham
- Department of Biomedicine, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Janne Grønli
- Bergen Stress and Sleep Group, Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Jonas Liesvei 91, 5009, Bergen, Norway
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Lim GY, Jang TW, Sim CS, Ahn YS, Jeong KS. Comparison of Cortisol level by Shift Cycle in Korean Firefighters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4760. [PMID: 32630691 PMCID: PMC7370292 DOI: 10.3390/ijerph17134760] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 12/22/2022]
Abstract
(1) Study Objectives: By investigating the change of cortisol levels during shift cycles among professional firefighters in Korea, this study aims to evaluate the difference between individuals' stress response and the recovery of their circadian rhythm after working night shifts. (2) Methods: A total of 325 shift firefighters, who were working in 3, 6, 9, or 21 day cycles, participated in the study. Their urinary and serum cortisol levels were measured during the day (09-18), during the night (18-09), and every 24 h (09-09) per shift cycle, and adjustments were made for confounding factors. (3) Results: Serum cortisol levels were significantly increased after working during the night or for 24 h compared with that of working throughout the day. However, whether working night or 24 h shifts, the serum cortisol levels were undoubtedly different based on the 3, 6, 9, or 21 day cycles. In all shift cycles, the urinary cortisol level decreased during the night or throughout the 24 h shifts compared with sleeping during this time, but this was considered to be significantly applicable only to those working in 21 day cycles. Additionally, in serial measurements, the recovery of urinary cortisol secretion after a night or 24 h shift was successful for individuals working in 9 day cycles, but the recovery was delayed for those working in 6 or 21 day cycles. (4) Conclusions: After analyzing the urine cortisol levels, the study indicates that only subjects working in 9 day cycles fully recovered their circadian rhythm while those working in 6 day or 21 day cycles did not completely recover. Therefore, it is important to recognize how stressful night shifts can be, and it is crucial to enhance firefighters' current shift cycles in order to allow sufficient recovery of their circadian rhythm as well as the prevention of disrupting their circadian rhythm after working at night. Further research is necessary to take into account the amount of work load, the challenges of being sleep deprived, and the individual's capacity to overcome sleepiness.
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Affiliation(s)
- Ga-Young Lim
- Department of Public Health, Hanyang University, Seoul 04763, Korea;
| | - Tae-Won Jang
- Department of Occupational and Environmental Medicine, College of Medicine, Hanynag University, Seoul 04763, Korea;
| | - Chang-Sun Sim
- Department of Occupational and Environmental Medicine, College of Medicine, University of Ulsan, Ulsan 44033, Korea;
| | - Yeon Soon Ahn
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea;
| | - Kyoung Sook Jeong
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju 26426, Korea
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A systematic review of the Trier Social Stress Test methodology: Issues in promoting study comparison and replicable research. Neurobiol Stress 2020; 13:100235. [PMID: 33344691 PMCID: PMC7739033 DOI: 10.1016/j.ynstr.2020.100235] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/27/2022] Open
Abstract
Since its development in 1993, the Trier Social Stress Test (TSST) has been used widely as a psychosocial stress paradigm to activate the sympathetic nervous system and hypothalamic-pituitary-adrenal axis (HPAA) stress systems, stimulating physiological functions (e.g. heart rate) and cortisol secretion. Several methodological variations introduced over the years have led the scientific community to question replication between studies. In this systematic review, we used the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) to synthesize procedure-related data available about the TSST protocol to highlight commonalities and differences across studies. We noted significant discrepancies across studies in how researchers applied the TSST protocol. In particular, we highlight variations in testing procedures (e.g., number of judges, initial number in the arithmetic task, time of the collected saliva samples for cortisol) and discuss possible misinterpretation in comparing findings from studies failing to control for variables or using a modified version from the original protocol. Further, we recommend that researchers use a standardized background questionnaire when using the TSST to identify factors that may influence physiological measurements in tandem with a summary of this review as a protocol guide. More systematic implementation and detailed reporting of TSST methodology will promote study replication, optimize comparison of findings, and foster an informed understanding of factors affecting responses to social stressors in healthy people and those with pathological conditions.
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Strohmaier S, Devore EE, Huang T, Vetter C, Eliassen AH, Rosner B, Okereke OI, Austin SB, Schernhammer ES. Maternal rotating night shift work before pregnancy and offspring stress markers. Physiol Behav 2019; 207:185-193. [PMID: 31078673 DOI: 10.1016/j.physbeh.2019.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/18/2019] [Accepted: 05/08/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Recent studies suggest an intergenerational influence of stress such that maternal exposure even before pregnancy could impact offspring health outcomes later in life. In humans, investigations on the impact of maternal stressors on offspring health outcomes, including stress-sensitive biomarkers, have largely been limited to extreme stressors. Prior studies have not addressed more moderate maternal stressors, such as rotating night shift work, on offspring stress markers in young adulthood. METHODS We investigated the association between maternal rotating night shift work before conception and offspring salivary cortisol and alpha amylase (sAA) patterns in young adulthood among mothers enrolled in the Nurses' Health Study II (NHSII) and their offspring participating in the Growing Up Today Study 2 (GUTS2). Our sample included over 300 mother-child pairs where, between 2011 and 2014, the children provided 5 saliva samples over the course of one day. We used piecewise linear mixed models to compare awakening responses, overall slopes as well as several other diurnal patterns of cortisol and sAA between offspring born to shift working versus non-shift working mothers. RESULTS Offspring born to shift working mothers had a flattened late decline in cortisol (percent differences in slope (%D): 2.1%; 95%CI: 0.3, 3.8) and their sAA awakening response was steeper (%D -37.4%; 95%CI: -59.0, -4.4), whereas sAA increase before bedtime appeared less pronounced (%D -35.9%; 95%CI: -55.3, -8.3), compared to offspring born to mothers without shift work. For cortisol, we observed a significant difference in the Area Under the Curve (AUC) (%D 1.5%; 95%CI: 0.3, 2.7) with higher AUC for offspring of mothers who worked rotating night shifts. In offspring-sex-stratified analyses we found differences primarily among males. CONCLUSION Our results provide some - albeit modest - evidence that maternal rotating night shift work-a moderate stressor-influences offspring stress markers. Future studies with larger samples sizes, more detailed exposure assessment (particularly during maternal pregnancy), and multiple offspring biomarker assessments at different developmental stages are needed to further investigate these associations.
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Affiliation(s)
- S Strohmaier
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America; Department of Epidemiology, Center for Public Health, Medical University of Vienna, Austria
| | - E E Devore
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America
| | - T Huang
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America
| | - C Vetter
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America; Department of Integrative Physiology, University of Colorado, Boulder, CO, United States of America
| | - A H Eliassen
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - B Rosner
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America; Departments of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - O I Okereke
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America; Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston, MA, United States of America
| | - S B Austin
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States of America; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - E S Schernhammer
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America; Department of Epidemiology, Center for Public Health, Medical University of Vienna, Austria; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America.
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RITONJA J, ARONSON KJ, MATTHEWS RW, BOIVIN DB, KANTERMANN T. Working Time Society consensus statements: Individual differences in shift work tolerance and recommendations for research and practice. INDUSTRIAL HEALTH 2019; 57:201-212. [PMID: 30700671 PMCID: PMC6449641 DOI: 10.2486/indhealth.sw-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 12/18/2018] [Indexed: 05/13/2023]
Abstract
There is no standard definition of shift work universally, and no validated report of complete biological adjustment to shift work in workers. Similarly, the evidence for shift work tolerance is limited due to a small number of studies and a narrow range of outcome measures. This paper discusses evidence to date regarding individual differences in shift work tolerance and highlights areas for future research and recommendations for workplace practice. The few factors that are consistently associated with perceived or actual shift work tolerance are young age, low scores of morningness or being a late chronotype, low scores of languidity and neuroticism, high scores on extraversion, internal locus of control and flexibility and male sex. An important first step is to differentiate between factors that are potentially modifiable, such as those that are determined by lifestyle choices, and those factors specific to the working time arrangement. Identifying determinants of shift work tolerance and the ability to adjust to shift work, whether they are innate and/or acquired mechanisms, is important so workers who are less likely to tolerate shift work well can be self-identified and supported with appropriate harm/risk minimization strategies. This paper also identifies important areas for future research with the goal of increasing the evidence base on which we can develop evidence-based harm mitigation strategies for shift workers.
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Affiliation(s)
- Jennifer RITONJA
- Department of Public Health Sciences, and Division of Cancer
Care and Epidemiology, Cancer Research Institute, Queen’s University, Canada
| | - Kristan J. ARONSON
- Department of Public Health Sciences, and Division of Cancer
Care and Epidemiology, Cancer Research Institute, Queen’s University, Canada
| | - Raymond W. MATTHEWS
- Appleton Institute for Behavioural Science, CQUniversity,
Australia
- Department of Clinical Neuroscience, Karolinska Institute,
Sweden
| | - Diane B. BOIVIN
- Douglas Mental Health University Institute, McGill
University, Canada
| | - Thomas KANTERMANN
- University of Applied Sciences for Economics and Management
(FOM), Germany
- SynOpus, Germany
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13
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Li J, Bidlingmaier M, Petru R, Pedrosa Gil F, Loerbroks A, Angerer P. Impact of shift work on the diurnal cortisol rhythm: a one-year longitudinal study in junior physicians. J Occup Med Toxicol 2018; 13:23. [PMID: 30123312 PMCID: PMC6090626 DOI: 10.1186/s12995-018-0204-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/11/2018] [Indexed: 01/03/2023] Open
Abstract
Background Cumulative epidemiological evidence suggests that shift work exerts harmful effects on human health. However, the physiological mechanisms are not well understood. This study aimed to examine the impact of shift work on the dysregulation of the hypothalamic-pituitary-adrenal axis, i.e. diurnal cortisol rhythm. Methods Seventy physicians with a mean age 30 years participated in this one-year longitudinal study. Working schedules, either shift work or regular schedules with day shift, were assessed at baseline. Salivary cortisol samples were collected on two consecutive regular working days, four times a day (including waking, + 4 h, + 8 h, and + 16 h), at both baseline and the one-year follow-up. The diurnal cortisol decline (slope) and total cortisol concentration (area under the curve, AUC) were calculated. Results After adjusting for cortisol secretion at baseline and numerous covariates, shift work at baseline significantly predicted a steeper slope (p < 0.01) and a larger AUC (p < 0.05) of diurnal cortisol rhythm at follow-up in this sample of physicians. In particular, waking cortisol at follow-up was significantly higher among those engaged in shift work than day shift (p < 0.01). Conclusions Our findings support the notion that shift work changes the diurnal cortisol pattern, and is predictive of increased cortisol secretion consequently in junior physicians.
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Affiliation(s)
- Jian Li
- 1Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - Martin Bidlingmaier
- 2Endocrine Research Unit, Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-University, Munich, Germany
| | - Raluca Petru
- 3Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, WHO Collaborating Centre for Occupational Health, Ludwig-Maximilians-University, Munich, Germany
| | - Francisco Pedrosa Gil
- Clinic for Psychiatry, Psychotherapy and Psychosomatics, Helios Vogtland Clinical Center, Plauen, Germany
| | - Adrian Loerbroks
- 1Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - Peter Angerer
- 1Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany
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Ritonja J, Aronson KJ, Day AG, Korsiak J, Tranmer J. Investigating Cortisol Production and Pattern as Mediators in the Relationship Between Shift Work and Cardiometabolic Risk. Can J Cardiol 2018; 34:683-689. [DOI: 10.1016/j.cjca.2018.02.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/21/2018] [Accepted: 02/06/2018] [Indexed: 12/20/2022] Open
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The Impact of Shiftwork on Skeletal Muscle Health. Nutrients 2017; 9:nu9030248. [PMID: 28282858 PMCID: PMC5372911 DOI: 10.3390/nu9030248] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/26/2017] [Accepted: 03/03/2017] [Indexed: 01/11/2023] Open
Abstract
(1) Background: About one in four workers undertake shift rosters that fall outside the traditional 7 a.m.-6 p.m. scheduling. Shiftwork alters workers' exposure to natural and artificial light, sleep patterns, and feeding patterns. When compared to the rest of the working population, shiftworkers are at a greater risk of developing metabolic impairments over time. One fundamental component of metabolic health is skeletal muscle, the largest organ in the body. However, cause-and-effect relationships between shiftwork and skeletal muscle health have not been established; (2) Methods: A critical review of the literature was completed using online databases and reference lists; (3) Results: We propose a conceptual model drawing relationships between typical shiftwork consequences; altered light exposure, sleep patterns, and food and beverage consumption, and drivers of skeletal muscle health-protein intake, resistance training, and hormone release. At present, there is no study investigating the direct effect of shiftwork on skeletal muscle health. Instead, research findings showing that acute consequences of shiftwork negatively influence skeletal muscle homeostasis support the validity of our model; (4) Conclusion: Further research is required to test the potential relationships identified in our review, particularly in shiftwork populations. Part of this testing could include skeletal muscle specific interventions such as targeted protein intake and/or resistance-training.
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