Stress and salivary cortisol in emergency medical dispatchers: A randomized shifts control trial
Identifieur interne : 000080 ( Pmc/Checkpoint ); précédent : 000079; suivant : 000081Stress and salivary cortisol in emergency medical dispatchers: A randomized shifts control trial
Auteurs : Sarah Bedini [France] ; François Braun [France] ; Laurence Weibel [France] ; Michel Aussedat [France] ; Bruno Pereira [France] ; Frédéric Dutheil [France, Australie]Source :
- PLoS ONE [ 1932-6203 ] ; 2017.
Abstract
Stress at work is a public health concern. Phone operators in emergency medical dispatch centers are particularly at risk. We aimed to demonstrate that the most stressful time for emergency medical dispatchers is the shift when they receive emergency incoming calls, with cortisol as a biomarker of stress. For each emergency medical dispatcher, we measured outcomes over a control day and during three types of shift:
Url:
DOI: 10.1371/journal.pone.0177094
PubMed: 28505199
PubMed Central: 5432068
Affiliations:
- Australie, France
- Alsace (région administrative), Auvergne (région administrative), Auvergne-Rhône-Alpes, Grand Est, Île-de-France
- Clermont-Ferrand, Paris, Strasbourg
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PMC:5432068Le document en format XML
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<front><div type="abstract" xml:lang="en"><p>Stress at work is a public health concern. Phone operators in emergency medical dispatch centers are particularly at risk. We aimed to demonstrate that the most stressful time for emergency medical dispatchers is the shift when they receive emergency incoming calls, with cortisol as a biomarker of stress. For each emergency medical dispatcher, we measured outcomes over a control day and during three types of shift: <italic>Incoming emergency call</italic>
, <italic>Dispatch</italic>
and <italic>Re-assessment</italic>
. The pattern of shifts was randomized. Saliva was sampled every 15 minutes for 2 hours, i.e. 6 consecutive times, starting 15 minutes after the first life-and-death incoming emergency call between 2 and 5 pm during three types of shift. We measured saliva cortisol every 2 hours over a control day, from 7am to 9pm. Perceived stress was assessed by a visual analog scale. We recruited 22 phone operators aged 36.4+/-10.8 years old (14 women and 8 men). Cortisol values were higher during the <italic>Incoming emergency call</italic>
shift than during the <italic>Dispatch</italic>
(p = .04) and <italic>Re-assessment</italic>
(p = .04) shifts. The increase in cortisol levels was greater in men than in women (p = .009). There were no differences between control values and those of the three shifts. The kinetics of cortisol increased with greater perceived stress overall (p < .001) and for each type of shift (<italic>Incoming emergency call</italic>
, p = .02; <italic>Dispatch</italic>
p = .03; <italic>Re-assessment</italic>
: p < .001). The kinetics of cortisol in response to incoming emergency calls was greater when the call was an absolute emergency (p = .03), and also tended to further increase when a subsequent absolute incoming emergency call was received (p = 0.07). In conclusion, the incoming emergency call shift carries particular risk for dispatchers, who have greater perceived stress and a greater increase in cortisol levels.</p>
</div>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
<journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosone</journal-id>
<journal-title-group><journal-title>PLoS ONE</journal-title>
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<issn pub-type="epub">1932-6203</issn>
<publisher><publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, CA USA</publisher-loc>
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<article-meta><article-id pub-id-type="pmid">28505199</article-id>
<article-id pub-id-type="pmc">5432068</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0177094</article-id>
<article-id pub-id-type="publisher-id">PONE-D-16-42705</article-id>
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<subj-group><subject>Biochemistry</subject>
<subj-group><subject>Hormones</subject>
<subj-group><subject>Lipid Hormones</subject>
<subj-group><subject>Hydrocortisone</subject>
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<subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject>
<subj-group><subject>Biochemistry</subject>
<subj-group><subject>Hormones</subject>
<subj-group><subject>Steroid Hormones</subject>
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<subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject>
<subj-group><subject>Anatomy</subject>
<subj-group><subject>Body Fluids</subject>
<subj-group><subject>Saliva</subject>
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<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Anatomy</subject>
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<subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject>
<subj-group><subject>Physiology</subject>
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<subj-group><subject>Saliva</subject>
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<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Physiology</subject>
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<subj-group><subject>Saliva</subject>
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<subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject>
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<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Health Care</subject>
<subj-group><subject>Health Care Providers</subject>
<subj-group><subject>Medical Doctors</subject>
<subj-group><subject>Physicians</subject>
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<subj-group subj-group-type="Discipline-v3"><subject>People and Places</subject>
<subj-group><subject>Population Groupings</subject>
<subj-group><subject>Professions</subject>
<subj-group><subject>Medical Doctors</subject>
<subj-group><subject>Physicians</subject>
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<subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject>
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</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Health Care</subject>
<subj-group><subject>Primary Care</subject>
</subj-group>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Stress and salivary cortisol in emergency medical dispatchers: A randomized shifts control trial</article-title>
<alt-title alt-title-type="running-head">Stress and cortisol in emergency medical dispatchers</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Bedini</surname>
<given-names>Sarah</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor001">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Braun</surname>
<given-names>François</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Weibel</surname>
<given-names>Laurence</given-names>
</name>
<xref ref-type="aff" rid="aff003"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Aussedat</surname>
<given-names>Michel</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pereira</surname>
<given-names>Bruno</given-names>
</name>
<xref ref-type="aff" rid="aff004"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Dutheil</surname>
<given-names>Frédéric</given-names>
</name>
<xref ref-type="aff" rid="aff005"><sup>5</sup>
</xref>
<xref ref-type="aff" rid="aff006"><sup>6</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff001"><label>1</label>
<addr-line>The Mercy Regional Hospital Centre (CHR) of Metz-Thionville, Emergency department, Ars-Laquenexy, France</addr-line>
</aff>
<aff id="aff002"><label>2</label>
<addr-line>SAMU-Urgences de France, Paris, France</addr-line>
</aff>
<aff id="aff003"><label>3</label>
<addr-line>The CARSAT Alsace, Strasbourg, France</addr-line>
</aff>
<aff id="aff004"><label>4</label>
<addr-line>University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Clinical Research Direction, Clermont-Ferrand, France</addr-line>
</aff>
<aff id="aff005"><label>5</label>
<addr-line>Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, Clermont-Ferrand, France</addr-line>
</aff>
<aff id="aff006"><label>6</label>
<addr-line>Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia</addr-line>
</aff>
<contrib-group><contrib contrib-type="editor"><name><surname>Atkin</surname>
<given-names>Stephen L.</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1"><addr-line>Weill Cornell Medical College Qatar, QATAR</addr-line>
</aff>
<author-notes><fn fn-type="COI-statement" id="coi001"><p><bold>Competing Interests: </bold>
The authors have declared that no competing interests exist.</p>
</fn>
<fn fn-type="con"><p><list list-type="simple"><list-item><p><bold>Conceptualization:</bold>
SB LW MA.</p>
</list-item>
<list-item><p><bold>Data curation:</bold>
SB LW.</p>
</list-item>
<list-item><p><bold>Formal analysis:</bold>
FD BP.</p>
</list-item>
<list-item><p><bold>Funding acquisition:</bold>
SB LW MA FB.</p>
</list-item>
<list-item><p><bold>Investigation:</bold>
SB.</p>
</list-item>
<list-item><p><bold>Methodology:</bold>
SB LW.</p>
</list-item>
<list-item><p><bold>Project administration:</bold>
SB MA FB.</p>
</list-item>
<list-item><p><bold>Resources:</bold>
SB FD FB.</p>
</list-item>
<list-item><p><bold>Software:</bold>
FD BP.</p>
</list-item>
<list-item><p><bold>Supervision:</bold>
SB.</p>
</list-item>
<list-item><p><bold>Validation:</bold>
SB.</p>
</list-item>
<list-item><p><bold>Visualization:</bold>
SB FD BP.</p>
</list-item>
<list-item><p><bold>Writing – original draft:</bold>
SB FD.</p>
</list-item>
<list-item><p><bold>Writing – review & editing:</bold>
SB FD LW.</p>
</list-item>
</list>
</p>
</fn>
<corresp id="cor001">* E-mail: <email>sarah.bedini3@gmail.com</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>15</day>
<month>5</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="collection"><year>2017</year>
</pub-date>
<volume>12</volume>
<issue>5</issue>
<elocation-id>e0177094</elocation-id>
<history><date date-type="received"><day>26</day>
<month>10</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>19</day>
<month>4</month>
<year>2017</year>
</date>
</history>
<permissions><copyright-statement>© 2017 Bedini et al</copyright-statement>
<copyright-year>2017</copyright-year>
<copyright-holder>Bedini et al</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:href="pone.0177094.pdf"></self-uri>
<abstract><p>Stress at work is a public health concern. Phone operators in emergency medical dispatch centers are particularly at risk. We aimed to demonstrate that the most stressful time for emergency medical dispatchers is the shift when they receive emergency incoming calls, with cortisol as a biomarker of stress. For each emergency medical dispatcher, we measured outcomes over a control day and during three types of shift: <italic>Incoming emergency call</italic>
, <italic>Dispatch</italic>
and <italic>Re-assessment</italic>
. The pattern of shifts was randomized. Saliva was sampled every 15 minutes for 2 hours, i.e. 6 consecutive times, starting 15 minutes after the first life-and-death incoming emergency call between 2 and 5 pm during three types of shift. We measured saliva cortisol every 2 hours over a control day, from 7am to 9pm. Perceived stress was assessed by a visual analog scale. We recruited 22 phone operators aged 36.4+/-10.8 years old (14 women and 8 men). Cortisol values were higher during the <italic>Incoming emergency call</italic>
shift than during the <italic>Dispatch</italic>
(p = .04) and <italic>Re-assessment</italic>
(p = .04) shifts. The increase in cortisol levels was greater in men than in women (p = .009). There were no differences between control values and those of the three shifts. The kinetics of cortisol increased with greater perceived stress overall (p < .001) and for each type of shift (<italic>Incoming emergency call</italic>
, p = .02; <italic>Dispatch</italic>
p = .03; <italic>Re-assessment</italic>
: p < .001). The kinetics of cortisol in response to incoming emergency calls was greater when the call was an absolute emergency (p = .03), and also tended to further increase when a subsequent absolute incoming emergency call was received (p = 0.07). In conclusion, the incoming emergency call shift carries particular risk for dispatchers, who have greater perceived stress and a greater increase in cortisol levels.</p>
</abstract>
<funding-group><funding-statement>Recipient of the first prize of clinical research grant from the Mercy Regional Hospital Centre (CHR) of Metz-Thionville, Emergency department, Metz, France. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement>
</funding-group>
<counts><fig-count count="5"></fig-count>
<table-count count="0"></table-count>
<page-count count="15"></page-count>
</counts>
<custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name>
<meta-value>All relevant data are within the paper and its Supporting Information files.</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes><title>Data Availability</title>
<p>All relevant data are within the paper and its Supporting Information files.</p>
</notes>
</front>
</pmc>
<affiliations><list><country><li>Australie</li>
<li>France</li>
</country>
<region><li>Alsace (région administrative)</li>
<li>Auvergne (région administrative)</li>
<li>Auvergne-Rhône-Alpes</li>
<li>Grand Est</li>
<li>Île-de-France</li>
</region>
<settlement><li>Clermont-Ferrand</li>
<li>Paris</li>
<li>Strasbourg</li>
</settlement>
</list>
<tree><country name="France"><noRegion><name sortKey="Bedini, Sarah" sort="Bedini, Sarah" uniqKey="Bedini S" first="Sarah" last="Bedini">Sarah Bedini</name>
</noRegion>
<name sortKey="Aussedat, Michel" sort="Aussedat, Michel" uniqKey="Aussedat M" first="Michel" last="Aussedat">Michel Aussedat</name>
<name sortKey="Braun, Francois" sort="Braun, Francois" uniqKey="Braun F" first="François" last="Braun">François Braun</name>
<name sortKey="Braun, Francois" sort="Braun, Francois" uniqKey="Braun F" first="François" last="Braun">François Braun</name>
<name sortKey="Dutheil, Frederic" sort="Dutheil, Frederic" uniqKey="Dutheil F" first="Frédéric" last="Dutheil">Frédéric Dutheil</name>
<name sortKey="Pereira, Bruno" sort="Pereira, Bruno" uniqKey="Pereira B" first="Bruno" last="Pereira">Bruno Pereira</name>
<name sortKey="Weibel, Laurence" sort="Weibel, Laurence" uniqKey="Weibel L" first="Laurence" last="Weibel">Laurence Weibel</name>
</country>
<country name="Australie"><noRegion><name sortKey="Dutheil, Frederic" sort="Dutheil, Frederic" uniqKey="Dutheil F" first="Frédéric" last="Dutheil">Frédéric Dutheil</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>
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