The potential of using hair cortisol to measure chronic stress in occupational healthcare; a scoping review

Abstract

Objectives: Workplace-based selective prevention of mental health problems currently relies on subjective evaluation of stress complaints. Hair cortisol captures chronic stress responses and could be a promising biomarker for the early identification of mental health problems. The objective was to provide an overview of the state-of-the-art knowledge on the practical value of hair cortisol in the occupational setting. Methods: We performed a scoping review of cross-sectional and longitudinal studies in PubMed, Embase, and PsycINFO up to November 2019 assessing the relations of hair cortisol with work-related stressors, perceived stress, and mental health outcomes in healthy workers. Results: We found five longitudinal studies, of which two observed an increase in work-related stressors to be associated with higher hair cortisol, one found a relation with lower hair cortisol and one did not find a relationship. Findings of crosssectional studies were also mixed. The one available longitudinal study regarding mental health showed that hair cortisol was not related to depressive symptoms. Conclusions: Hair cortisol measurement within occupational health research is still in its early stage and more longitudinal studies are urgently needed to clarify its relationship with work-related stressors and perceived stress before hair cortisol can be used to identify workers at risk for mental health problems.

Hair cortisol change at COVID-19 pandemic onset predicts burnout among health personnel

“…In addition to the vast heterogeneity of published hair cortisol levels, most studies only report absolute levels, not relative change, making the comparison with our study challenging. Schaafsma et al published a scoping review in 2021 assessing the relation of hair cortisol with work-related stressors in healthy workers ( Schaafsma et al, 2021 ). They found five longitudinal and 17 cross-sectional studies, both study types showing mixed results.…”

Workplace stressors and their association with hair cortisol concentrations among ready-made garment workers in Bangladesh: A cross-sectional study

“…According to a scoping review, evidence on the link between work‐related stressors and HCC remains inconsistent in international cross‐sectional and longitudinal research 9 . The authors discuss, among others, small sample sizes and selection bias in recruiting participants as possible explanations for inconsistent findings.…”

Investigating Predictive Factors of Suicidal Re-attempts in Adolescents and Young Adults After a First Suicide Attempt, a Prospective Cohort Study. Study Protocol of the SURAYA Project

“…Accordingly, we will quantify blood cortisol levels as a measure of an acute stress provoked by the suicide attempt, and, in collaboration with the University Hospital of Bordeaux, we will assess hair cortisol, as a retrospective indicator of cumulative cortisol levels during the last 3 months preceding the attempt. To date, hair cortisol has been used in various settings as a reliable marker of long-term exposure to stress (46)(47)(48). A recent meta-analysis investigating the association between hair cortisol levels and depression found contradictory results (49).…”