Associations between biomarkers and the psychophysiological impacts of teacher stress: a systematic review

Extensive literature demonstrates associations between occupational stress and adverse mental and physical health outcomes. Findings are inconsistent regarding the impacts of occupational stress on specific biomarkers/physiological systems among teachers. We conducted a PRISMA systematic electronic search to evaluate associations between biomarkers and occupational stress in teachers across education levels and identify gaps in the field. 38 papers met inclusion criteria from the initial search (N=3,290). Most papers were cross-sectional, with a subset using longitudinal or experimental designs (n=12). For Hypothalamic Pituitary Adrenal (HPA) axis biomarkers (n =29; salivary or hair cortisol), a third of studies found no association between stress and physiological alterations; the remaining HPA axis studies found associations between higher chronic stress (burnout) and blunted/hyporeactive HPA axis activation, and positive associations between acute stress (job strain, perceived stress) and increased HPA axis activation (higher diurnal cortisol, higher reactivity). Cardiovascular findings were mixed, with inconsistent relations between stress and cardiac function (n=10; HR, BP, HRV). For immunological studies (n=6; immune assays), chronic work stress was associated with increased pro-inflammatory and less effective anti-inflammatory activity, and mixed associations between burnout and inflammatory markers. Both acute and chronic occupational stress (burnout, perceived stress, job strain), negatively impact teacher health processes. More research will clarify associations between facets of occupational stress and physiology. We conclude with recommendations for improved methodology, a call for more experimental and intervention work, and more focus placed on teacher health and how teacher health impacts both teacher and child outcomes.