Stress Salivary Biomarkers Variation during the Work Day in Emergencies in Healthcare Professionals

Abstract

Objective: The work of health professionals in hospital emergency rooms is highly demanding due to the decisions they must take. In the present study, we consider assessing stress response in emergency health workers, measuring related biomarkers such as cortisol, dehydroepiandrosterone (DHEA) and salivary α-amylase during the whole working day. Method: An analytical, descriptive and cross-sectional study was carried out. The study was conducted in the emergency rooms of two public hospitals. Ninety-seven professionals participated, 45 corresponding to one hospital and 52 to the other. Four salivary samples were obtained according to circadian rhythms: at 8:00, 12:00, 15:00 and 00:00 h/24 h. The data were subsequently analyzed. Results: Cortisol levels decreased throughout the working day, with minimum values being at 24 h. A similar pattern was observed in DHEA. The α-amylase levels increased throughout the working day, reaching its peak at 15:00 h, and decreasing at 24 h, compared to the data from the rest of the working day. Conclusions: Since reference/baseline values are not presented, this work is focused on a stress situation experienced during one regular working day in emergency rooms with no extreme situations. In this context, stress, measured through cortisol and α-amylase, is present in emergency room doctors and nurses. However, the increase in DHEA, due to its anabolic condition, could counteract their effect, suggesting a positive effect on their professional actions.

Variations in Salivary Stress Biomarkers and Their Relationship with Anxiety, Self-Efficacy and Sleeping Quality in Emergency Health Care Professionals

“…In a previous report, we have published the variations of α-amylase and DHEA through the working day in professionals working in hospital EDs. Salivary levels were determined at 8h, 12 h, 15 h and 24 h. α-amylase levels were low at 8-12 h reaching a significant peak at 15 h (302.35 ± 35.55 U/mL) and decreasing thereafter at 24 h. On the other hand, the levels of DHEA were significantly high at 8 h (301.85 ± 44.55 pg/mL), decreasing the rest of the day at 12, 15 and 24 h [38]. No differences were found when comparing men vs. women.…”

“…No significant differences were observed when comparing gender, professional status and hospitals (Table 2). However, α-amylase was significantly higher in medical doctors compared to nurses only at 15 h. In addition, α-amylase was significantly higher in the HCUV compared to the HSBS only at 8 and 12 h [38]. Since anxiety does not seem to be affected, we wanted to see if other psychological variables present changes in emergency health professionals.…”

“…Participants were not funded and were informed that they could withdraw from the study at any time with no explanations. See more details in [38]. For the assessment of physiological stress response, salivary measurements of αamylase and DHEA were performed from samples obtained in 4 moments of the day: 8 h, 12 h, 15 h and 24 h. Saliva samples were obtained using the Salivette commercial kit ® (Sarstedt International, Nombrecht, Germany).…”

“…Samples were maintained on ice and then at −20 • C. At the moment of analysis, samples were thawed and centrifuged at 3000 rpm for 5 min at 4 • C. ELISA immunoassay was performed for cortisol (SALV-2930 DRG, Marburg, Germany), α-amylase (EIA-5836 DRG, Marburg, Germany) and DHEA (SLV3012 DRG, Marburg, Germany) detection. Results have been published previously [38]. The day that saliva samples were collected to determine the different hormones, the psychologists of the team passed different specific tests.…”

“…The objective of the present report is to study how this particular pattern of stress biomarkers (particularly α-amylase and DHEA [37]) observed in emergency professionals, could influence anxiety, self-efficacy and sleeping quality. To this end, different specific tests were filled by these professionals the same day that saliva samples were collected to determine the different hormones [38]. The obtained results could give key information regarding the influence of these stress responses in working performance and professional actions.…”