ABSTRACT
Background: Salivary cortisol is a useful biomarker in stress research, as a valid measure for HPA axis activity, whose deregulation is one of the ways that psychosocial risk factors at work, result to the creation of illness. Aim: The aim of this review was to summarize current literature of salivary cortisol as measures of work stress in healthy workers, so as to investigate the association between work stress and cortisol secretion as well as to identify specific work characteristics, that affect the cortisol secretion. Methods: We identified articles through PubMed using search terms related to salivary cortisol, HPA axis, work stress. Results: Many studies have shown that altered level of cortisol, appears to be associated with work related stress factors. Work shift, working hours, the nature of work, organizational characteristic of work (effort reward imbalance, high demand-low control, over-commitment, conflicts between home and work demands, and workload) as well as bulling at work, socio-demographic characteristics, financial strain, physical risk factors and social support at work are found to affect Cortisol levels. Though the relationship between the cortisol secretion and some of the above work stressors was found to be contradictory. Discussion: From the present study it is obvious that the researches present an inconsistency regarding the impact of work stressors on cortisol levels. It has been identified that increased cortisol levels in populations reporting increased distress couldn’t replicate this association. Among the reasons identified to be behind these inconsistent findings are the differences in the prevalence of potential confounders, differences in analytical approach and the duration of stressful stimulus. Conclusion: The detailed knowledge about factors that play pivotal role in measures of the cortisol secretion is very important, as the biomarkers have been demonstrated that can characterize and quantify the biological impact of psychological stress. Targeted prevention policy and evidence based interventions in workplace might include the identification of sources of occupational stress and this is the first that can affect cortisol secretion.