Chula Researchers Find Chemicals in Sweat That Can Reveal “Extreme Stress and Depression” and Successfully Test Firefighters’ Mental Health for the First Time! 

A team of researchers from the Faculty of Medicine and Faculty of Science, Chulalongkorn University, have found chemicals in sweat that indicate high stress and depression. The pilot study of firefighters in Bangkok yielded the results with 90% accuracy, so they are poised to conduct mental health screening in other high-stress, and high-risk groups of professions hoping to reduce mental health problems and violence in society.

Sweat tells you more than you think: 

During the COVID-19 pandemic, Assistant Professor Dr. Chadin Kulsing, Department of Chemistry, Faculty of Science, and research teams from both Chulalongkorn University and the private sector successfully researched and developed screening tools for COVID-19 from the scents of certain chemicals in sweat, and went to the field to provide screening for communities, markets, and schools in Bangkok. This time, Asst. Prof. Dr. Chadin continued his research and collaborated with Dr. Patthrarawalai Sirinara, MD, MPH, Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, to find “chemicals that indicate stress from sweat” by conducting a pilot study with over 1,000 firefighters from 47 fire stations around Bangkok. 

For the first time, certain chemicals in sweat are found to be an indicator of the stress level of Bangkok’s population!  

The Significance of the Discovery of Stress Chemicals in Sweat

In the past, we have heard the news of the perpetrators of violent “mass shootings” without prior conflict.  Many of them work in the professions that need to care for people in society. The news report also reveals that the cause of violence comes from stress from work and mental health problems that have accumulated over time. 

This seems to be consistent with recent statistics from the Department of Mental Health stating that around 1.5 million Thais have mental health problems which are on an upward trend.  About 49.36% or half of them have work-related stress and depression, especially those with high-risk occupations being responsible for public safety or having to make decisions under pressure and urgency such as police, military, firefighters, etc. 

“People whose occupations are responsible for public safety will usually receive annual physical and mental health examinations, but this is not enough. Some people may experience stress or depression during the year, but find it difficult to gain access to a psychiatrist due to the limited number of psychiatric practitioners in Thailand. In addition, the approach to screening and diagnosis by interview is at the discretion of the psychiatrist and psychologist, making the diagnosis results subjective and could be inaccurate,” said Doctor Patthrarawalai MD, MPH, about the limitations of mental healthcare for people in high-risk professions. 

“So we tried to find an innovative, highly effective, and affordable way to screen for mental conditions before seeing a psychiatrist. We found a method of detecting chemicals from the sweat to be interesting because it is not necessary to draw blood and cause pain while measuring results from tangible things with few discrepancies.” 

This became the beginning of a collaborative project between the Department of Preventive and Social Medicine, the Faculty of Medicine and the Department of Chemistry, and the Faculty of Science, Chulalongkorn University to research stress chemicals from sweat in firefighters across Bangkok under the support of a research grant from the Medical Council of Thailand and funding support for the equipment from SciSpec Co., Ltd. with Dr. Nuttanee Tungkijanansin conducting the experiment. 

Sweat odor can reveal stress and depression

According to Asst. Prof. Dr. Chadin, this research project is the first time a group of stress chemicals (volatile) has been detected in the sweat of a large group of people pursuing the same occupation, and it is a cumulative stress that naturally arises from work and everyday life. It is not a controlled or simulated stress like other studies. 

“In principle, people with the same disease often share the same group of chemicals.  Similarly, people with too much or too little of these chemicals can be said to have high stress or are depressed. The accuracy of identifying the results from the past sample is approximately 90%”   

The method of screening for stress and depression from sweat is convenient and fast. The test can be conducted for several people at a time and does not take long. 

Asst. Prof. Dr. Chadin explained the process of collecting sweat samples, “We insert sterilized cotton swabs under the left and right armpits and leave them for 10-15 minutes. Then we put the sweat swabs in a sterile vial with a lid, and send the sample to the lab to be examined with an odor chemical analyzer.  Air from within the sample vial will be injected into the machine and wait for the analyzer for 10-15 minutes. The results will be displayed in a fingerprint of the chemicals in each sample.” 

Timely detection of stress ensures timely treatment 

A study of 1,084 firefighters in Bangkok during February-December 2022 revealed a trend in mental health with a high number of stress and sleep problems. 

Dr. Patthrarawalai said that the group of firefighters with moderate to severe risk will enter the verification process by psychiatry professors again.  This research project is honored to have the collaboration from Professor Dr. Michael Maes, MD, Ph.D. Dr. Chavit Tunvirachaisakul, MD, Ph.D., Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, as research team to confirm the final results of the study. The volatile chemical analysis experiments were conducted by Dr Nuttanee Tungkijanansin using gas chromatography-ion mobility spectrometry gifted from the Sci Spec Company Limited, Thailand. 

“Participants will know the results of their own tests. In high-stress cases, they can see a psychiatrist at King Chulalongkorn Memorial Hospital right away. All test results and medical information will be kept confidential. The research team will not disclose information or notify the supervisor to give the patients their peace of mind that the results may affect their work,” said Dr. Patthrarawalai. 

Poised to expand mental health screening to other stressful professions 

Firefighters who participated in the study unanimously agreed that the program was good and helpful, giving them access to mental health screenings and knowing their own state of mind. Some commented that the mental health tests they used to do were psychological tests that they looked at pictures and wrote responses based on their understanding.  Once they had done these tests for many years, they could remember what to answer, or sometimes they looked for the answers on the Internet. 

“These questionnaire results may not reflect the truth, while chemical measurements are more unbiased.” said Dr. Patthrarawalai. 

Although sweat tests are quite accurate, Dr. Patthrarawalai emphasized that psychiatrists are still required to make the final diagnosis of their mental health issues. 

Based on the success of the research with firefighters, the research team expands the screening to include other high-stress occupations, such as nurses, nationwide. Sweat samples have been first collected from the Phra Nakhon Si Ayudhya Hospital. The research has received funding support from the Health Systems Research Institute (HSRI). 

“Next, we will expand the stress screening to other safety-sensitive professions that face high pressure and high risk of mental health problems, particularly those involving public safety or gun violence.  This will provide them with quick access to objective mental health screening and early detection for those who require timely treatment,” Dr. Patthrarawalai concluded. 

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