Psychosocial environment and health: methodological variability of the salivary cortisol measurements.

Salivary cortisol offers a novel approach to understand the relationship between psychosocial environment and health. This study examines the intra-individual relationships among indicators of the cortisol circadian rhythm and investigates the influence of determinants affecting the day-to-day variability of the cortisol measures. Over three weekdays, 87 healthy subjects (63 females and 24 males) collected saliva samples at seven time points to assess the cortisol awakening response (CAR), and to evaluate the post morning cortisol profile. The generalized estimating equations method was used to explore the relations between repeated cortisol measures and potential determinants (sociodemographic, health, and sampling factors) influencing salivary cortisol levels. Younger age, being smoker, and sampling on a working day were associated with higher at awakening and total cortisol excretion in the morning period. Higher overall cortisol excretion and cortisol increase in the first hour of the day were found for adherents to sampling procedure. Higher educational level was found associated with greater total cortisol excretion in the morning and post morning period, while a flatter diurnal slope was found in smokers. Results are consistent with the knowledge that the circadian cortisol rhythm is differentially determined by situational factors and that results obtained in the early morning hour are of crucial importance corroborating the evidence that the CAR is a highly state-dependent phenomenon. These data indicate that many confounding factors need to be controlled when using salivary cortisol as biomarker of the mind-health interrelationship.

[Algorithms for the evaluation of chemical risk: the Piedmont Region's experience]. / Gli algoritmi per la valutazione del rischio chimico: l'esperienza della Regione Piemonte.

The programme InfoRisk, proposed by the Piedmont Region in 2002, has been an important reference point for the evaluation of chemical risk, both for companies and the regional prevention system alike. Nowadays, it is still considered necessary to take advantage of simple methods for the evaluation of this risk. However, the Piedmontese model requires some modification so as to keep it in line with the national and international rules and regulations governing the question and to find some solutions to problems that have arisen in its practical application. Most of these problems are tied to the use of the section of the evaluation technique, which is base on the estimate and not on the measurement of the exposure. Indeed, it has been confirmed in some cases that it is not possible to discard a more accurate evaluation which is not only able to make a correct application of the scientific evidence available in a correct manner, but also one that is supported by environmental monitoring campaigns. The main modifications proposed to the model are herein presented. The Work Group has endeavoured to maintain, whenever possible, the previous logic processes of the algorithm, so as to conserve its "user friendly" aspects and clarity that have so often been reported and appreciated by the operators who applied it.

Job strain, effort-reward imbalance and ambulatory blood pressure: results of a cross-sectional study in call handler operators.

OBJECTIVES: To examine the association between two job stress models-the job strain (JDC) and the effort-reward imbalance (ERI) model-and ambulatory blood pressure monitoring in call handler operators. METHODS: Participants included 74 women (age, 34.9 ± 9.9 years) and 26 men (age 36.0 ± 10.8 years) who were monitored on 2 workdays for ambulatory blood pressure. Measures of both job stress models were related to blood pressure by the generalized estimating equations (GEE) method while adjusting for potential confounders (gender, age, cigarette smoking, alcohol consumption, educational level, marital status, time of day, and work schedule). RESULTS: Workshifts were associated with an increase of 3-4 and 14 mmHg in mean arterial pressure (MAP) compared with diurnal activities out of work and sleeping period, respectively (P < 0.001). Ambulatory blood pressure was also significantly related with work schedule preference: unpleasant work schedule was associated with an increase of 2 mmHg in MAP compared with pleasant work schedule (P = 0.013). In the ERI model, subjects scoring high in work stress have higher ambulatory blood pressure at work, at home, and during sleep. Work stress by time interaction was not longer significant when controlling for potential confounders: generalized estimating equations revealed that MAP was influenced by BMI (>25 vs. <25: 0.7 (0.2-1.1) mmHg), workshift preference (unpleasant vs. pleasant: 2 (0.4-3.6) mmHg), and time of day. Weak not significant relation was found between ABP and psychosocial factors evaluated by the JDC and ERI models. CONCLUSION: These results do not support work stress as a significant factor influencing ABP in a homogeneous group of call-handlers. Complementary information independently obtained from the two work stress models could provide more exhaustive explanations on the stress-related effects on blood pressure.

Associations between two job stress models and measures of salivary cortisol.

PURPOSE: To investigate the association between two job stress models-the job demand-control model and the effort-reward imbalance model-and repeated measures of salivary cortisol among male and female call-centre operators. METHODS: Daily cortisol profiles consisting of seven time points were measured across two workdays and one leisure day to determine the cortisol awakening response and the cortisol output in the day in 104 volunteers. The employees completed two self-administered questionnaire--the Karasek's demand-control questionnaire and the Siegrist's effort-reward imbalance questionnaire-to assess psychosocial hazards at work. The relations between the perceived workload measures and salivary cortisol levels were analyzed by means of generalized estimating equations method after adjusting for potential confounders (gender, age, educational level, marital status, morning awakening time, sleep duration and quality, weekdays, work schedule, adherence to sampling procedure). RESULTS: The total cortisol amount excreted in the awakening period was positively associated with the job strain measures (high strain vs. low strain: 1.4 (2.4-0.3) nmol/l). In contrast, individuals scoring higher in effort-reward imbalance at work had both lower cortisol awakening response (high imbalance vs. low imbalance: -0.7 (-1.3 to -0.2) nmol/l) and lower diurnal secretory activity (-9.2 (-17.7 to -0.7) nmol/l). Gender, weekday and adherence to sampling schedule significantly influenced the cortisol excretion in the morning period. CONCLUSIONS: Our results indicate that the two work stress models differentially affect salivary cortisol output. This finding suggests that combining the information from two complementary job stress models results in improved knowledge on the psychobiological correlates of the psychosocial work environment.

Salivary cortisol and psychosocial hazards at work.

BACKGROUND: Experimental and clinical evidence suggest that stress can lead to ill-health through the disregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Studies to date have produced equivocal results likely due to different methodologies and failure to account for confounding factors. This investigation aimed to assess the relation between self-reported work-related stressors and salivary cortisol and to clarify the role of the potential confounders. METHODS: Thirty-six call-handlers completed a self-administered job content questionnaire and collected seven daily salivary samples on two workdays and a weekend. The diurnal salivary cortisol output was expressed as cortisol awakening response (CAR), and cortisol output in the rest of the day. Salivary cortisol data were normalized by means of square root transformation. The generalized estimating equations method was used to assess the relation between job strain and cortisol levels after adjusting for gender, weekdays and adherence to the sampling schedule. RESULTS: Job strain significantly influenced the total amount of cortisol response to waking (high strain vs. low strain: 1.1 (0.3-2.0) nmol/L). The cortisol response to waking showed gender-specific differences [women excreting greater cortisol than men: 1.1 (0.3-1.9) nmol/L], and weekday differences [workdays vs. weekend: 1.0 (0.3-1.6) nmol/L]. Non-compliance with the sampling protocol was associated with lower salivary cortisol than in adherent subjects. CONCLUSIONS: Our results provide further evidence for the HPA axis involvement in the physiological response to work stress. The measure of the CAR showed to be the sensitive index to assess the physiological response to psychosocial factors. Gender, weekday, and protocol compliance were confounding factors.

Relationship between self-reported mental stressors at the workplace and salivary cortisol.

OBJECTIVE: To investigate the association between work stress measures and salivary cortisol excretion in working and weekend days. METHODS: In a sample of 68 healthy young call-centre operators dimensions of job stress from the demand-control model were related to repeated measures of salivary cortisol on seven samples (at awakening, +30 min, +60 min, + 3 h, +6 h, +9 h, and +12 h after awakening) at two working days and a weekend day. RESULTS: The cortisol excretion on work days was higher than during weekend day with gender-specific differences as women only showed higher significant values for area under the curve (AUC(G)) and Diurnal cycle (chi(2) (2) = 8.10, P < 0.05; chi(2) (2) = 15.75, P < 0.05, respectively). There were no associations between job demand, job control and cortisol excretion, while the sociodemographic characteristics of the call-centre operators showed linear relation with the diurnal pattern of cortisol secretory activity. CONCLUSIONS: The hypothalamic-pituitary adrenocortical axis activation was higher in working day than in weekend day. This activation measured by salivary cortisol was not related to self-reported mental stressors assessed with job strain model. The availability of more specific psychometric scales would be useful to explore the relationship between salivary cortisol levels and measures of mental stress at workplace.

Risk assessment of occupational exposure to polycyclic aromatic hydrocarbons by means of urinary1-hydroxypyrene.

Polycyclic aromatic hydrocarbons have mutagenic and carcinogenic properties and some of them are classified as probable or possible human carcinogens. Aim of this study was to evaluate the genotoxic risk in workers exposed to diesel exaust. Environmental and biological monitoring exposure to polycyclic aromatic hydrocarbons was carried out on fifty-two workers exposed to diesel exhaust. Urinary 1-hydroxypyrene was employed as a biomarker of internal dose. Significant urinary 1-hydroxypyrene differences between smokers and non-smokers were found. Twenty per cent of urinary 1-hydroxypyrene values exceeded benchmark level for genotoxic effect, while the results of environmental monitoring excluded the existence of exposure to polycyclic aromatic hydrocarbons. In the absence of greater knowledge about the relationship between urinary 1-hydroxypyrene and genotoxic effects under the conditions of very low exposure, extreme caution is recommended when this biomarker of internal dose is employed as an indicator of genotoxic risk.