In the study burnout and number psychosomatic complaints (H1), hair steroids including cortisol, cortisone, dehydroepiandrosterone [DHEA], testosterone as well as progesterone (H2), and work engagement (H3) are analyzed as outcomes (see Table Table11 and Table Table2,2, Additional file 1 for detailed information).

To identify burnout, psychosomatic complaints, and work engagement the DearEmployee-Survey [28] was used in the study. Specific psychosomatic complaints were addressed in the questionnaire (headache, neck or back discomfort, gastrointestinal complaints, cardiovascular complaints, dizziness, restlessness, fear, panic, tight feeling in the throat, sleep problems, nightmares, concentration problems, strong weight changes, facial muscle twitching). In the study, the number of psychosomatic complaints specified in the answers serves as an outcome variable in H1. To measure steroids, hair samples were taken and analyzed by Liquid Chromatography–Mass Spectrometry (LC-MC/MS) [36, 44] in a specialized laboratory. A more specific method description is given in a previous article [51].

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