Relationship between Salivary Cortisol, Salivary Immunoglobulin A, Serum Oxidative Stress Indices, and Job Stress among Healthcare Workers in A Nigerian Tertiary Hospital

Abstract

Background: Healthcare workers (HCWs) are highly susceptible to job-related and psychological stress. The current study evaluated the physiological reactions to stress and its biochemical correlates which could add objective evidence to a perception of job stress among HCWs. Methodology: This was a prospectively designed cross-sectional study to compare stress markers amongst 84 healthy male HCW in a tertiary hospital. They were recruited from various hospital units and categorized as rated by survey responses using Karasek’s Job Content Questionnaires as follows: (1) based on job demand (JD): high and low JD; (2) based on job control (JC): low and high JC; (3) based on job strain (JS): no and high JS. Stress markers evaluated were salivary cortisol, salivary immunoglobulin A (IgA), and oxidative stress indices (Malondialdehyde [MDA], Ascorbic Acid, and Total Antioxidant Capacity [TAC]). All laboratory analyses including statistical protocols were carried out according to well-established standard guidelines. Result: Salivary cortisol was higher in low JC than high JC (p=0.003) subgroups while salivary IgA was higher in high JS compared to the no JS (p=0.041) subgroups. Additionally, JC inversely correlated (r= -0.268; p=0.014) with salivary cortisol. However, other biochemical variables did not differ significantly across categorized groups. However, while the medical doctors had higher MDA compared to other HCWs, the radiographers had higher TAC compared to others; this may indicate oxidative stress among these HCWs (p<0.05). Conclusion: From the foregoing, HCWs with high JS are under higher stress with low JC which stimulates the HPA axis as an adaptive mechanism. Hence, efforts to promote low JS with high JC are highly recommended among HCWs for optimal service delivery.