Health  Vol.6 No.15 , August 2014
Effects of Prolonged Night Shifts on Salivary α-Amylase, Secretory Immunoglobulin, Cortisol, and Chromogranin A Levels in Nurses
Abstract: Prolonged night shift is associated with high burnout rate, but the physiological effects of a 16 h shift remain undetermined. Here we evaluated fatigue and stress via salivary assays to determine the correlation between stress and fatigue and prolonged night shifts. Twenty-five nurses (9 men, 16 women; 16 h night shift (n = 13), 8 h day shift (n = 12)) from Juntendo University Koshigaya Hospital were evaluated for four consecutive workdays separated by off days. Salivary samples were collected upon waking and before sleep on non-working days, before and after the day and night shifts, and before and after the break during the nocturnal schedule, and analyzed for levels of cortisol, chromogranin A, α-amylase activity and secretory immunoglobulin A (sIgA). On non-working days, cortisol levels showed similar kinetic pattern in both nurses. On working days, day-time nurses’ cortisol levels showed normal circadian pattern throughout the shift. Night nurses’ cortisol levels at the beginning of the shift were comparable to that of the normal morning elevation. α-Amylase activity in the night shift nurses was higher than day shift nurses through each period. No significant differences in chromogranin A and sIgA levels were detected between day and night shift workers. A 16 h night shift may cause marked circadian misalignment in cortisol levels.
Cite this paper: Morita, Y. , Aida, H. , Yamaguchi, T. , Azuma, M. , Suzuki, S. , Suetake, N. , Yukishita, T. , Lee, K. and Kobayashi, H. (2014) Effects of Prolonged Night Shifts on Salivary α-Amylase, Secretory Immunoglobulin, Cortisol, and Chromogranin A Levels in Nurses. Health, 6, 2014-2025. doi: 10.4236/health.2014.615236.

[1]   Oriyama, S., Miyakoshi, Y., et al. (2011) Influence of Night-Shift Work on Nurses. Journal of the Japan Society for Healthcare Administration, 48, 147-156.

[2]   Yang, Y., Koh, D., Ng, V., Lee, C.Y., Chang, G., Dong, F., Goh, S.H., Anantharaman, V. and Chia, S.E. (2002) Self Perceived Work Related Stress and the Relation with Salivary IgA and Lysozyme among Emergency Department Nurses. Occupational and Environmental Medicine, 59, 836-841.

[3]   Fujimaru, C., Okamura, H., Kawasaki, M., Kakuma, T., Yoshii, C. and Matsuishi, T. (2012) Self-Perceived Work-Related Stress and Its Relation to Salivary IgA, Cortisol and 3-Methoxy-4-Hydroxyphenyl Glycol Levels among Neonatal Intensive Care Nurses. Stress Health, 28, 171-174.

[4]   Sato, K. and Amano, A. (2000) Investigation of Relation between Working Conditions and Accumulative Fatigue in Nurses. Journal of Oita Nursing and Health Sciences, 2, 1-7.

[5]   Motomura, Y. and Yatsushiro, R. (2010) Factors Relating to Nurse Burnout. Japanese Society of Occupational Medicine and Traumatology, 58, 120-127.

[6]   Soo-Quee Koh, D. and Choon-Huat Koh, G. (2007) The Use of Salivary Biomarkers in Occupational and Environmental Medicine. Occupational and Environmental Medicine, 64, 202-210.

[7]   Izawa, S., Shirotsuki, K., Sugaya, N., Ogawa, N., Suzuki, K. and Nomura, S. (2007) The Application of Saliva to an Assessment of Stress: Procedures for Collecting and Analyzing Saliva and Characteristics of Salivary Substances. Japanese Journal of Complementary and Alternative Medicine, 4, 91-101.

[8]   Miyauchi, F., Kimura, K., et al. (2012) Effects of Working at Night on Plasma Cortisol Concentrations and BMI in Female Nurses. Japanese Society of Occupational Medicine and Traumatology, 60, 348-352.

[9]   Harris, A., Waage, S., Ursin, H., Hansen, A.M., Bjorvatn, B. and Eriksen, H.R. (2010) Cortisol, Reaction Time Test and Health among Offshore Shift Workers. Psychoneuroendocrinology, 35, 1339-1347.

[10]   Pruesser, J.C., Wolf, O.T., Hellhammer, D.H., Buske-Kirschbaum, A., von Auer, K., Jobst, S., Kaspers, F. and Kirschbaum, C. (1997) Free Cortisol Levels after Awakening: A Reliable Biological Marker for the Assessment of Adrenocortical Activity. Life Sciences, 61, 2539-2549.

[11]   Clow, A., Thorn, L., Evans, P. and Hucklebridge, F. (2004) The Awakening Cortisol Response: Methodological Issues and Significance. Stress, 7, 29-37.

[12]   Hucklebridge, F., Clow, A. and Evans, P. (1998) The Relationship between Salivary Secretory Immunoglobulin A and Cortisol: Neuroendocrine Response to Awakening and the Diurnal Cycle. International Journal of Psychophysiology, 31, 69-76.

[13]   Nater, U.M., Rohlder, N., Schlotz, W., Ehlert, U. and Kirschbaum, C. (2007) Determinants of the Diurnal Course of Salivary Alpha-Amylase. Psychoneuroendocrinology, 32, 392-401.

[14]   Den, R., Toda, M., Nagasawa, S., Kitamura, K. and Morimoto, K. (2007) Circadian Rhythm of Human Salivary Chromogranin A. Biomedical Research, 28, 57-60.

[15]   Shirakawa, T., Mitome, M. and Oguchi, H. (2004) Circadian Rhythms of S-IgA and Cortisol in Whole Saliva-Compensatory Mechanism of Oral Immune System for Nocturnal Fall of Saliva Secretion. Pediatric Dental Journal, 14, 115-120.

[16]   Ohira, T., Okada, M. and Shimamoto, T. (2004) Effects of Foot Baths on Peripheral Skin Temperature, Blood Flow, and Salivary Cortisol. Biomedical Thermology, 23, 181-185.

[17]   Kahn, J.P., Rubinow, D.R., Davis, C.L., Kling, M. and Post, R.M. (1988) Salivary Cortisol: A Practical Method for Evaluation of Adrenal Function. Biological Psychiatry, 23, 335-349.

[18]   Hellhammer, D.H., Wüst, S. and Kudielka, B.M. (2009) Salivary Cortisol as a Biomarker in Stress Research. Psycho-neuroendocrinology, 34, 163-171.

[19]   Tsunoda, T. (2008) Salivary Chromogranin A as Index of Psychosomatic Stress Response. The Journal of Meikai Dental Medicine, 37, 42-49.

[20]   Takatsuji, K., Sugimoto, Y., Ishizaki, S., Ozaki, Y., Matsuyama, E. and Yamaguchi, Y. (2008) The Effects of Examination Stress on Salivary Cortisol, Immunoglobulin A, and Chromogranin A in Nursing Students. Biomedical Research, 29, 221-224.

[21]   Li, T.L. and Gleeson, M. (2004) The Effect of Signal and Repeated Bouts of Prolonged Cycling and Circadian Variation on Saliva Flow Rate, Immunoglobulin A and Al-pha-Amylase Response. Journal of Sports Sciences, 22, 1015-1024.

[22]   Jemmott, J.B., Borysenko, J.Z., Borysenko, M., McClelland, D.C., Chapman, R., Meyer, D. and Benson, H. (1983) Academic Stress, Power Motivation, and Decrease in Salivary Immunoglobulin A Secretion Rate. Lancet, 321, 1400-1402.

[23]   McClelland, D.C., Alexander, C. and Marks, E. (1982) The Need for Power, Stress, Immune Function and Illness among Male Prisoners. Journal of Abnormal Psychology, 91, 61-70.

[24]   Evans, P., Bristow, M., Hucklebridge, F., Clow, A. and Walters, N. (1993) The Relationship between Secretory Immunity: Mood and Life Events. British Journal of Clinical Psychology, 32, 227-236.

[25]   Zeier, H., Brauchli, P. and Joller-Jemelka, H.I. (1996) Effects of Work Demands on Immunoglobulin A and Cortisol in Air Traffic Controllers. Biological Psychology, 42, 413-423.

[26]   Bristow, M., Hucklebridge, F., Clow, A., Evans, P. and Philip, D. (1997) Modulation of Secretory Immunoglobulin A in Saliva in Relation to an Acute Episode of Stress and Arousal. Journal of Psychophysiology, 11, 248-255.

[27]   Carroll, D., Ring, C., Shrimpton, J., Evans, P., Willemsen, G. and Hucklebridge, F. (1996) Secretory Immunoglobulin A and Cardiovascular Responses to Acute Psychological Challenge. International Journal of Behavioral Medicine, 3, 266-279.

[28]   Willemsen, G., Ring, C., Carroll, D., Evans, P., Clow, A. and Hucklebridge, F. (1998) Secretory Immunoglobulin A and Cardiovascular Reactions to Mental Arithmetic and Cold Pressor. Psychophysiology, 35, 252-259.

[29]   Kugler, J., Reintjes, F., Tewes, V. and Schedlowski, M. (1996) Competition Stress in Soccer Coaches Increased Salivary Immunoglobulin A and Salivary Cortisol Concentration. Journal of Sports Medicine and Physical Fitness, 36, 117-120.

[30]   Ring, C., Harrison, L.K., Winzer, A., Carroll, D., Drayson, M. and Kendall, M. (2000) Secretory Immunoglobulin A and Cardiovascular Reactions to Mental Arithmetic, Cold Pressor, and Exercise: Effects of Alpha-Adrenergic Blockade. Psychophysiology, 37, 634-643.