Is There an Association between Work Stress and Diurnal Cortisol Patterns? Findings from the Whitehall II Study

OBJECTIVE The evidence on whether there is work stress related dysregulation of the hypothalamic-pituitary-adrenal axis is equivocal. This study assessed the relation between work stress and diurnal cortisol rhythm in a large-scale occupational cohort, the Whitehall II study. METHODS Work stress was assessed in two ways, using the job-demand-control (JDC) and the effort-reward-imbalance (ERI) models. Salivary cortisol samples were collected six times over a normal day in 2002-2004. The cortisol awakening response (CAR) and diurnal cortisol decline (slope) were calculated. RESULTS In this large occupational cohort (N = 2,126, mean age 57.1), modest differences in cortisol patterns were found for ERI models only, showing lower reward (β = -0.001, P-value = 0.04) and higher ERI (β = 0.002, P-value = 0.05) were related to a flatter slope in cortisol across the day. Meanwhile, moderate gender interactions were observed regarding CAR and JDC model. CONCLUSIONS We conclude that the associations of work stress with cortisol are modest, with associations apparent for ERI model rather than JDC model.