The aim of this study was to evaluate the physiological effects of changes in work organization due to the outsourcing of bus routes. Twenty bus drivers served as the study group. They were voluntarily transferred to work for another bus company after this company had won a tender from their former employer. Twenty drivers from the former employer served as the control group. At baseline, one month before the transfer, all were monitored for 2 days: blood pressure was measured every 2 hours while awake. On the first day, urine samples were collected in order to detect adrenaline, noradrenaline and cortisol, and blood samples were taken for the detection of lipids, glycated haemoglobine (HbA1c), fibrinogen, dehydroepiandrosteronsulfat (DHEA-S) and prolactin. In addition, all participants filled out a questionnaire on health and work related items. Eight and 12 months later, a similar data collection took place in the study group. During the follow-up period, seven drivers in the study group left their job due to dissatisfaction with the working conditions and the remaining 13 drivers changed their attitude to the work place. In accordance with this, the drivers scored worse on questions regarding job satisfaction. After 12 months the following changes in physiological measures were detected: increase in HbA1c (4.4–4.7 per cent; p<0.001), urinary cortisol (7.3–12.1 nmol/mmol cretatinine; p=0.04) and systolic blood pressure at work (129.4–134.1; p=0.04). In addition, a decrease in DHEA-S (8.8–7.6 nmol/l; p=0.06) was observed. The changes in systolic blood pressure and DHEA-S were even higher after 8 months. The physiological changes were, as expected, in agreement with the assumption that metabolism turns to a catabolic direction during a period of perceived stress.
The implications of the findings, which should be noted with caution due to the small size of the study and the selection during the follow-up first suggest that outsourcing and other radical changes in the psychosocial work environment may lead to prolonged stress among employees. Second, that urinary cortisol, HbA1c, DEAH-S and ambulatory measurements of blood pressure are useful measures of chronic stress. Copyright © 2000 John Wiley & Sons, Ltd.