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. 2018 Aug 14:13:23.
doi: 10.1186/s12995-018-0204-y. eCollection 2018.

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

Jian Li  1 , Martin Bidlingmaier  2 , Raluca Petru  3 , Francisco Pedrosa Gil  4 , Adrian Loerbroks  1 , Peter Angerer  1
Affiliations

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

Jian Li et al. J Occup Med Toxicol. .

Abstract

Background: Cumulative 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.

Methods: Seventy 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.

Results: After 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).

Conclusions: Our findings support the notion that shift work changes the diurnal cortisol pattern, and is predictive of increased cortisol secretion consequently in junior physicians.

Keywords: Cortisol; Hypothalamic-pituitary-adrenal axis; Longitudinal study; Occupational health; Shift work.

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Conflict of interest statement

The study was approved by the Committee on Ethics of Human Research of the Medical Faculty, Ludwig-Maximilians University Munich (No. 016/04), and participants signed a letter of informed consent. Not applicable. The authors declare that they have no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Diurnal pattern of cortisol secretion at follow-up according to shift work at baseline. (Solid line represents cortisol pattern at follow-up for physicians with shift work status “no” at baseline (N = 51); dashed line represents cortisol pattern at follow-up for physicians with shift work status “yes” at baseline (N = 19); Error bars represent standard errors of adjusted means (ng/ml) of four time points cortisol levels at follow-up)
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