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Medical staff in emergency situations: severity of patient status predicts stress hormone reactivity and recovery
  1. J K Sluiter1,2,
  2. A J van der Beek1,2,
  3. M H W Frings-Dresen1,2
  1. 1Coronel Institute for Occupational and Environmental Health, AmCOGG Amsterdam
  2. 2Centre for Research into Health and Health Care, Academic Medical Centre/University of Amsterdam, Amsterdam, Netherlands
  1. Correspondence to:
 Dr J K Sluiter, Coronel Institute for Occupational and Environmental Health, Academic Medical Centre/University of Amsterdam, PO Box 22700, 1100 DD Amsterdam, Netherlands;


Background: Although repetitive exposure to stressful situations is thought to habituate the physical stress responses, work stress is experienced by medical personnel in emergency and intensive care units; performance should, however, remain stable over time.

Aims: To investigate the neuroendocrine reactions (reactivity during and recovery after work) in experienced emergency caregivers during emergency situations.

Methods: A within subjects pre-post design was studied in the natural work environment of 20 municipal Dutch emergency caregivers. A stress protocol was developed in which the biomarker cortisol was measured in saliva at baseline, during the emergency period, and during recovery. Four scenarios were tested between subjects in which the severity of the emergency situation and the time of day were taken into account.

Results: Greater endocrine reactions were shown during and after the handling of patients in direct life threatening situations during morning hours compared to the handling of patients who were not in direct life threatening situations.

  • work stress
  • emergency unit
  • paramedic personnel
  • cortisol
  • recovery

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  • This project was partly funded by Netherlands Organisation of Scientific Research (NWO), Netherlands