Chronic work stress and decreased vagal tone impairs decision making and reaction time in jockeys

•ERI related to increased CAR in low stress period.•ERI related to decreased CAR in high stress period.•ERI scores >1 associated with substantive decrements in decision-making.•LF/HF ratio moderates association between ERI and decision-making.•Chronic stress more related to LF/HF ratio and decision-making than acute stress. The inverse relationship between acute stress and decision-making is well documented, but few studies have investigated the impact of chronic stress. Jockeys work exhaustive schedules and have extremely dangerous occupations, with safe performance requiring quick reaction time and accurate decision-making. We used the effort reward imbalance (ERI) occupational stress model to assess the relationship of work stress with indices of stress physiology and decision-making and reaction time. Jockeys (N=32) completed computerised cognitive tasks (Cogstate) on two occasions; September and November (naturally occurring lower and higher stress periods), either side of an acute stress test. Higher ERI was correlated with the cortisol awakening responses (high stress r=−0.37; low stress r=0.36), and with decrements in decision-making comparable to having a blood alcohol concentration of 0.08 in the high stress period (p