Shift work parameters and disruption of diurnal cortisol production in female hospital employees

Hung, Eleanor; Aronson, Kristan J.; Leung, Michael; Day, Andrew G.; Tranmer, Joan

doi:10.1080/07420528.2016.1196695

Cited by 18 publications

(16 citation statements)

References 43 publications

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“…Both our study and one prior longitudinal study [ 44 ] identified higher waking cortisol by shift work, but many studies found shift work was associated with lower levels of waking cortisol [ 13 , 33 – 36 ]. Also, we observed shift work steepened the decline rate of cortisol rhythm, whereas flatter slope was reported by other studies [ 31 , 32 , 37 ]. Age might serve as one potential explanation.…”

Section: Discussioncontrasting

confidence: 49%

“…Also, a British study showed that shift work was associated with higher waking cortisol as well as total AUC in saliva [ 31 ]. By contrast, Hung et al reported lower cortisol AUC in shift workers [ 32 ]. In addition, five studies indicated negative associations between shift work and waking salivary cortisol [ 13 , 33 – 36 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, five studies indicated negative associations between shift work and waking salivary cortisol [ 13 , 33 – 36 ]. Regarding the decline rate of cortisol rhythm over the day, a flatter slope was demonstrated by three studies from the UK, US, and Canada, respectively [ 31 , 32 , 37 ]. By contrast, a Canadian study among paramedics did not find any relationships between shift work and cortisol secretion [ 38 ].…”

Section: Introductionmentioning

confidence: 99%

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Impact of shift work on the diurnal cortisol rhythm: a one-year longitudinal study in junior physicians

Bidlingmaier

Petru³

et al. 2018

J Occup Med Toxicol

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BackgroundCumulative 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.MethodsSeventy 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.ResultsAfter 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).ConclusionsOur 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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Section: Discussioncontrasting

confidence: 49%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of shift work on the diurnal cortisol rhythm: a one-year longitudinal study in junior physicians

Bidlingmaier

Petru³

et al. 2018

J Occup Med Toxicol

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“…In particular, According to Jian [ 11 ], the longer the shift workers worked on night shifts, the significantly higher the cortisol level, compared with that of day shift workers. On the other hand, the effect that night shift work has on urinary cortisol is associated with an acute reduction of urinary cortisol production [ 12 ]. The constant circadian disruption caused by shift work influences cortisol production, resulting in a flatter pattern over time [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Cortisol level by Shift Cycle in Korean Firefighters

Lim

Jang²,

Sim

et al. 2020

IJERPH

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(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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“…Cortisol is an important anti-inflammatory hormone in human physiology [36]. Shift work disrupts cortisol production, a marker of HPA axis activation under stress conditions, and may be an important cause of dry eye [37]. Poor sleep quality has been reported to be associated with lower testosterone levels, affecting the development of dry eye [38].…”

Section: Discussionmentioning

confidence: 99%

Function and Morphology of the Meibomian Glands Using a LipiView Interferometer in Rotating Shift Medical Staff

Zhang

Sun

et al. 2020

Journal of Ophthalmology

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Purpose. To investigate the function and morphology of meibomian glands (MG) in night shift medical staff (MS). Methods. Sixty-two eyes of 31 patients in the MS group and 59 eyes of 31 patients in the control group were consecutively enrolled. All participants completed Ocular Surface Disease Index (OSDI) and Standard Patient Dry Eye Evaluation (SPEED) questionnaires for dry eye severity, as well as Schirmer I and tear break-up time (TBUT) tests. LipiView® II Ocular Surface Interferometer was used for lipid layer thickness (LLT), MG dropout, and partial blink (PB) rate tests. MG expression was measured with an MG evaluator. Results. The OSDI score in the MS group was 22.39 ± 13.42, which was significantly higher than that in the control group (9.87 ± 6.64 Z = −3.997, P=0.001). The SPEED score in the MS group was 7.94 ± 3.81, which was significantly higher than in the control group (3.65 ± 2.11, Z = −4.766, P=0.001). There was no significant difference in Schirmer I test between the MS group and control group (Z = −1.346, P=0.178). TBUT in MS group was significantly shorter than that in the control group (Z = −5.201, P=0.001). The mean LLT of the MS group was 55.02 ± 21.17 nm significantly thinner than that of the control group 72.76 ± 21.62 nm (Z = −4.482, P=0.001). MG loss occurred in 45.16% of affected eyes in the MS group and 16.13% of affected eyes in the control group, and the difference was statistically significant (χ2 = 14.352, P=0.001). MG yielding liquid secretion and MG yielding secretion score were significantly lower in the MS group than in the control group (Z = −3.641, P=0.001; Z = −3.146, P=0.001, resp.). There was a negative correlation between mean LLT and SPEED score (Spearman r = −0.363, P=0.045). Conclusions. Night shift MS had a higher incidence of MGD compared to day workers.

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Shift work parameters and disruption of diurnal cortisol production in female hospital employees

Cited by 18 publications

References 43 publications

Impact of shift work on the diurnal cortisol rhythm: a one-year longitudinal study in junior physicians

Impact of shift work on the diurnal cortisol rhythm: a one-year longitudinal study in junior physicians

Comparison of Cortisol level by Shift Cycle in Korean Firefighters

Function and Morphology of the Meibomian Glands Using a LipiView Interferometer in Rotating Shift Medical Staff

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