Cortisol, chronotype, and coping styles as determinants of tolerance of nursing staff to rotating shift work

Apr 8, 2021Chronobiology international

How stress hormone levels, sleep patterns, and coping methods relate to nurses' ability to handle rotating shift work

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Abstract

Salivary cortisol output during night shifts is larger in morning-oriented chronotypes.

Cortisol patterns may play a role in how well individuals adapt to shift work.
Higher cortisol output during night shifts is associated with dysfunctional coping styles at work.
Individuals with greater cortisol output during shifts tend to have increased cortisol secretion on their days off.
Chronotype and psycho-behavioral factors are significant in linking cortisol output during shifts to off-days.
Salivary cortisol testing is proposed as a reliable marker for monitoring occupational stress in shift workers.

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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 (= 30), and possible links with a series of variables - gender (30% male), age (= 39.6, SEM = 1.57 y), years of service (= 12.43, SEM = 1.48 y), BMI (= 23.29, SEM = 0.66 Kg/m), 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. N M M M2

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Cortisol, chronotype, and coping styles as determinants of tolerance of nursing staff to rotating shift work

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