MELATONIN EXCRETION AND SALIVARY CORTISOL IN HOSPITAL NURSES DURING 12-HOUR SHIFTS
Journal Title: Българско списание за обществено здраве (Bulgarian Journal of Public Health) - Year 2018, Vol 0, Issue 4
Abstract
Introduction: Prevalence of shift work and occupational stress is one of the highest in health care sector. Working as a nurse is intense, decision-rich and includes changing clinical environments under different shift schedules, including night work and extended shifts, with possible effect on circadian rhythms and stress system. The aim was to study the effect of night shift work on melatonin excretion and time-of-day variations of salivary cortisol in hospital nurses during 12-hour shifts. Methods: The study encompasses 32 hospital nurses of age 49.4±11.4 years, working 12-hour day and night shifts. 16 of the nurses were studied during the day shifts, and 16 during the night shifts. The melatonin excretion was followed by 6-sulphatoxymelatonin (aMT6s), the main melatonin metabolite, at the beginning and the end of the day and night shifts. The salivary cortisol and ratings of stress, sleepiness and fatigue were followed at four hour intervals during the shifts. A questionnaire concerning stress symptoms was filled at the end of the day and night shifts. aMT6s was determined with ELISA of IBL International, and salivary cortisol with ELISA of Euroimmun. The ratings concerning stress, sleepiness and fatigue included nine response categories. The questions for stress symptoms were pointed towards feeling of tension, irritation, exhaustion, time pressure, difficulties in concentration and whether the workload was high and the rests not enough. The statistical analyses were carried out with SPSS. Results and discussion: The melatonin retained the typical diurnal pattern with high morning and low afternoon values, but with lower excretion rates during the night shifts (F=6.181, p=0.018). The cortisol retained the typical diurnal rhythm in most of the nurses, but with indication for increased levels of stress. The sleepiness and fatigue increased with the time-of day, and were higher during the night shifts. Our data showed no significant differences between the day and night shift for the reported stress symptoms. The nurses felt rather tense and irritated and very exhausted at the end of the shifts. They found also that the work load was high and the rests during work not adequate. Conclusion: The excretion rates of aMT6s, the time of day variations of cortisol and self-reported stress and fatigue are indications for increased health risk.
Authors and Affiliations
Irina Cekova, Raliza Stoyanova, Katya Vangelova
Keywords
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