Assessment of salivary cortisol as stress marker in ambulance service personnel: comparison between shifts working on mobile intensive care unit and patient transport ambulance

Purpose The aim of this study was to describe and compare salivary cortisol of ambulance personnel on days with different work demands as well as to correlate the individual perception of demands to the physiological outcome cortisol. Methods Diurnal cortisol profiles on a day in emergency service and on a day in patient transport were monitored for 24 subjects working in an urban ambulance station. Changes of cortisol were also observed during 42 operations in emergency service and 24 operations in patient transport and were compared to the individual perception of physical and emotional demands. Results Rise of cortisol in the morning on days in emergency service was significantly higher than in patient transport suggesting adjustment to forthcoming demanding tasks. There were only few situations with strong endocrine reaction in emergency service as well as in patient transport. The magnitude of this reaction was not related to the individual perception of demand. Conclusion Ambulance service personnel seem to be used to critical situations. There was few awareness of the "physiological" stress response indicating that stress is probably not perceived in work situations characterised by routines.