Work stress and hair cortisol levels among workers in a Bangladeshi ready-made garment factory – Results from a cross-sectional study

Abstract

Evidence on the association of work stress with cortisol levels is inconsistent and mostly stems from Western countries, with limited generalizability to other regions of the world. These inconsistencies may partly be due to methodological limitations associated with the measurement of cortisol secretion in saliva, serum or urine. The present study set out to explore associations of work stress with long-term integrated cortisol levels in hair among 175 workers of an export oriented ready-made garment (RMG) factory in Dhaka, Bangladesh. Work-related demands (WD), interpersonal resources (IR) and work-related values (WV) were assessed using a psychometrically evaluated interview. WD consisted of four items on physical demands, time pressure, worries about mistakes and exposure to abusive language. IR comprised five items addressing support, recognition, adequate payment, workers' trust in the management, and the management's trust in workers, as perceived by the workers. WV captured job security, promotion prospects and job latitude by three items. Hair cortisol concentrations (HCC) were analyzed by liquid chromatography-mass spectrometry. Stepwise multivariable linear regression models (backward elimination of predictors) were used to estimate associations of HCC with the three work stress components. For significant work stress component(s), further multivariable linear regression analyses were conducted to explore whether, and if so, which individual item(s) contributed most. The mean HCC equaled 3.27 (SD 2.58) pg/mg. HCC were found to be significantly associated with WV (beta=0.209, p=0.021). Additional analyses of the three WV items revealed that this association was largely driven the item on "promotion prospects" (beta=0.230, p=0.007) implying that the perception of good promotion prospects was associated with higher HCC. The finding of elevated HCC with good promotion prospects may initially seem counter-intuitive, but is supported by research documenting that job promotion may result in poorer mental well-being. Moreover, being promoted in the Bangladeshi RMG industry may represent a stressful experience: job promotions are rare in this setting and are associated with the need to meet exceptional job-related demands. Further research from ethnic and culturally diverse occupational settings is needed to test this hypothesis, to shed light on the reproducibility of our findings and to improve our understanding of the psychobiological implications of psychosocial working conditions across cultures and contexts.

Hair cortisol and self-reported stress in healthy, working adults

“…This is somewhat contrary to findings from studies of non-Western populations that have explored this relationship (Qi et al, 2014;Steinisch et al, 2014). Qi et al (2014) reported a modest correlation linking higher HCC with higher ERI (r=.33, p=.006) in female, Chinese kindergarten teachers.…”

“…The partial correlations we observed (controlling for hair treatment) suggested that HCC was higher in employees who perceived less adequate promotion prospects or anticipated detrimental changes to their working situation. Similar to the Steinisch et al (2014) study, these suggest a link between HCC and expectations or optimism about one's personal working future. As the associations were no longer significant in our adjusted regression analysis, further examination in larger samples, with more statistical power might be warranted to discern if a genuine, independent association exists.…”

“…This might have improved the ability to detect associations through reducing possible confounders. Steinisch et al (2014) combined a seven-item ERI measure and five setting-specific items to explore work-related stress in a sample of Bangladeshi garment workers who had very low HCC levels (mean 3.27±2.58 pg/mg). 'Work-related values', a composite of items three items (job security, promotion prospects, and job latitude), was a significant predictor of HCC in regression analysis (β=.209, p=.021), which was largely explained by an association between HCC and promotion prospects (β=.230, p=.007).…”

“…There is not consistent evidence linking ERI with salivary cortisol measures (Eller et al, 2012). Only two studies to date have linked ERI with HCC; one in Chinese kindergarten teachers (Qi et al, 2014), and another study that found the perceived promotion prospects item within ERI was negatively associated with HCC in Bangladeshi garment workers (Steinisch et al, 2014).…”

Seasonal variation in cortisol biomarkers in Hispanic mothers living in an agricultural region

“…Furthermore, saliva cortisol patterns may also be affected by season(Persson, Garde et al 2008). Hair cortisol is a more stable measure of stress and higher concentrations have been correlated with unemployment(Dettenborn, Tietze et al 2010), negative life events(Staufenbiel, Koenders et al 2014) and work stress(Steinisch, Yusuf et al 2014). Given the increased susceptibility of Hispanic mothers to social stressors, it is especially important to characterize their cortisol patterns in the context of seasonal changes.…”