Abstract
In their line of duty, Emergency Medical Services (EMS) personnel are exposed to chronically stressful working conditions and recurrent traumatic events, which increase their risk for detrimental health outcomes. Here, we investigated whether this risk is due to altered regulation of the hypothalamus–pituitary–adrenal (HPA) axis and the endocannabinoid system. Therefore, 1 cm hair strands were collected from a cohort of 72 German EMS personnel in order to measure concentrations of cortisol, endocannabinoids [i.e., anandamide (AEA), 2-arachidonoylglycerol (2-AG)], and N-acylethanolamines [i.e., stearoylethanolamide (SEA), oleoylethanolamide (OEA), and palmitoylethanolamide (PEA)]. Rank correlation analyses were conducted to test associations of cortisol, endocannabinoid, and N-acylethanolamine concentrations with the EMS personnel’s workload, lifetime trauma exposure, and mental and physical health problems. We found a negative correlation between cortisol and 2-AG concentrations in hair. Higher hair cortisol was associated with higher workload. Reported traumatic stress during childhood and later in life as well as more severe depressive and physical stress symptoms were associated with elevated 2-AG, SEA, OEA, and PEA concentrations. Future longitudinal research needs to address the prospect of tracing biomolecular markers of glucocorticoid, endocannabinoid, and N-acylethanolamine activity as a predicting value of the long-term course of mental and physical well-being.
Highlights
Emergency Medical Services (EMS) personnel play an essential role in our society
We anticipated to find (i) increased hair concentrations of cortisol (HCC) among EMS personnel with higher quantitative workload, and (ii) HCC to be associated with the personnel’s lifetime exposure to potentially traumatic events experienced either in private life or in the line of duty. (iii) We explored the association between HCC and childhood maltreatment (CM) exposure as well as (iv) the associations between HCC and the severity of posttraumatic, depressive, and physical stress symptoms. (v) we explored the associations between the concentrations of endocannabinoids and NAEs in the EMS personnel’s hair and their workload, lifetime trauma exposure, and stress-related symptoms. (vi) In line with aforementioned conceptual models[6,7,11,12,28], we expected to find negative correlations of cortisol with AEA and 2-AG concentrations in hair
HCC was not linked to CM exposure, exposure to potentially traumatic events in private life or on duty, or the severity of mental and physical stress symptoms
Summary
Emergency Medical Services (EMS) personnel play an essential role in our society. due to their work nature, they are constantly exposed to mental and physical stressors, i.e. (i) chronic stress due to adverse work conditions such as shift work including regular night shifts, as well as (ii) recurrent encounters of potentially traumatic events at mission sites[1,2,3]. The central role of endocannabinoids, NAEs, and glucocorticoids in regulating the body’s short- and longterm stress adaptation as well as immune activity points towards the relevance to investigate their mutual dependency in the aetiology of stress and trauma-related disorders[6,7,20,24,25]. Hair concentrations are considered to retrospectively represent the intra-corporeal activity of measured biomolecules in the course of several weeks to m onths[10,26,27,28] Such studies provide evidence for altered hair concentrations of cortisol (HCC), endocannabinoids, and NAEs associated with exposure to chronic and traumatic stress as well as related health problems. A meta-analysis[9] indicated a marginal negative association between HCC and the severity of posttraumatic stress symptoms, whereas no consistent association was found with depressive symptoms
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