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Throughout medical history, measurement of hormones and other physiological parameters have been used in clinical settings with the purpose of detecting and monitoring progress of disease. During the past three or four decades, however, hormones and other physiological effect markers have been increasingly used in occupational settings for purposes of assessing the effects of psychosocial circumstances and of occupational stress. Accordingly, the focus has partly drifted from detecting and monitoring disease to including the detection and monitoring of precursors of disease and risk factors for poor health in otherwise healthy subjects before medical manifests. Because the majority of the workforce is in good health, differences in hormonal and other physiological parameters are often expected to be less pronounced than the differences that typically render clinical interest. Salivary cortisol has increasingly been used in the study of the responsiveness of the hypothalamic pituitary adrenal (HPA) axis in occupational stress studies and employed in both field studies and experimental studies (for review see (Chida & Steptoe, 2009)). The reason for the increasing use of salivary cortisol in occupational settings is that it is a simple, non-invasive, harm-free and pain-free measure that allows the longitudinal study of HPA-axis activity without substantial interference with the subject’s normal habits and environment. Since cortisol in saliva is stable for at least two week, it provides the possibility of self-sampling and mailing the samples by post (Garde & Hansen, 2005b). This chapter will use salivary cortisol as an example of a biomarker of adverse effects of work stress.

Physiological Response as Biomarkers of Adverse Effects of the Psychosocial Work Environment