interleukin-8 and Burnout--Professional

Emergency physicians are exposed to greater stress during a 24-hour shift (24 hS) than a 14-hour night shift (14 hS), with an impact lasting several days. Interleukin-8 (IL-8) is postulated to be a chronic stress biomarker. However, no studies have tracked IL-8 over several shifts or used it for monitoring short-term residual stress. The IL-8 response to the shifts may also increase with age. Conveniently, IL-8 can be measured non-intrusively from urine.. We conducted a shifts-randomized trial comparing 17 emergency physicians' urinary IL-8 levels during a 24 hS, a 14 hS, and a control day (clerical work on return from leave). Mean levels of IL-8 were compared using a Wilcoxon matched-pairs test. Independent associations of key factors including shifts, stress, and age with IL-8 levels were further assessed in a multivariable generalized estimating equations model.. Mean urinary IL-8 levels almost doubled during and after a 24 hS compared with a 14 hS or a control day. Furthermore, IL-8 levels failed to return to control values at the end of the third day after the shift despite a rest day following the 24 hS. In the multivariable model, engaging in a 24 hS, self-reported stress, and age were independently associated with higher IL-8 levels. A 24 hS significantly increased IL-8 levels by 1.9 ng (p = .007). Similarly, for every unit increase in self-reported stress, there was a 0.11 ng increase in IL-8 levels (p = .003); and for every one year advance in age of physicians, IL-8 levels also increased by 0.11 ng (p = .018).. The 24 hS generated a prolonged response of the immune system. Urinary IL-8 was a strong biomarker of stress under intensive and prolonged demands, both acutely and over time. Because elevated IL-8 levels are associated with cardiovascular disease and negative psychological consequences, we suggest that emergency physicians limit their exposure to 24 hS, especially with advancing age.

Topics: Adult; Age Factors; Aging; Biomarkers; Burnout, Professional; Emergency Service, Hospital; Fatigue; Female; Follow-Up Studies; Humans; Interleukin-8; Male; Multivariate Analysis; Physicians; Regression Analysis; Sleep; Stress, Psychological

Cytokines, such as interleukin (IL)-8, have been shown to be related to depressive symptoms or inflammatory diseases and may be useful as stress biomarkers.. This study was to assess whether urinary IL-8 levels were reliable indicators of stress among acute care department (AD) nurses.. A total of 118 nurses participated in the study. Urinary IL-8 levels of 49 AD nurses were compared with levels of a control group of 69 chronic care department (CD) nurses.. The urinary IL-8 levels of AD nurses, who reported a higher level of professional stress, were higher than the levels of CD nurses (P < 0.01).. Measurement of urinary IL-8 may be an appropriate biomarker for stress assessment in nurses.

Topics: Acute Disease; Adult; Attitude to Health; Biomarkers; Burnout, Professional; Chi-Square Distribution; Chronic Disease; Creatinine; Cross-Sectional Studies; Female; Humans; Hydrocortisone; Interleukin-8; Japan; Middle Aged; Nursing Methodology Research; Nursing Staff, Hospital; Risk Factors; Statistics, Nonparametric; Surveys and Questionnaires; Work Schedule Tolerance