Hsiu-Hao Lee1,2, Shih-Hsiang Lo2, Bing-Yu Chen1, Yen-Hung Lin3, Dachen Chu2, Tsun-Jen Cheng1, Pau-Chung Chen1,4, Yue-Liang Guo5,6,7. 1. Institution of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan. 2. Taipei City Hospital, Zhongxing Branch, Taipei, Taiwan. 3. Department of Cardiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. 4. Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan. 5. Institution of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan. leonguo@ntu.edu.tw. 6. Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan. leonguo@ntu.edu.tw. 7. Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine, 1, Sec. 1, Jen-Ai Road, Taipei, 100, Taiwan. leonguo@ntu.edu.tw.
Abstract
PURPOSE: Night duty has been recognized as a significantly harmful stressor for physicians. However, the relationship between various levels of duty loading and stress response is unknown. This study examined whether duty load increases cardiovascular stress indicators in a dose-dependent manner. METHODS: An unallocated prospective observational study was conducted among physicians performing various levels of duties in a secondary referral medical center between 2011 and 2012. Heart rate variability (HRV), blood pressure (BP), and other stress markers of 12 attending physicians were compared during different duty loads: non-duty day (NDD), duty day with one duty area and three wards (1DD), and duty day with two duty areas and six wards (2DD). RESULTS: During the regular sleep time (i.e., 11 p.m. to 5 a.m.), the relative sympathetic modulations measured using the HRV were 59.0 ± 9.3, 61.6 ± 10.4, and 64.4 ± 8.9 for NDD, 1DD, and 2DD, respectively (p = 0.0012); those for relative parasympathetic modulations were 37.4 ± 9.4, 34.8 ± 9.8, and 32.0 ± 8.8 for NDD, 1DD, and 2DD, respectively (p = 0.0015). The percentages of abnormal systolic BPs were 9.7 ± 13.2 %, 25.3 ± 21.8 %, and 31.5 ± 21.0 % for NDD, 1DD, and 2DD, respectively (p = 0.003), and the percentages of abnormal diastolic BP were 6.7 ± 11.0 %, 18.3 ± 11.1 %, and 27.1 ± 30.9 % for NDD, 1DD, and 2DD, respectively (p = 0.002). Total sleep time was negatively associated with sympathetic/parasympathetic balance and the percentage of abnormal diastolic BP. Admitting new patients was positively associated with the percentages of abnormal systolic BP. CONCLUSIONS: This observational analysis suggests that the dose-dependent stress responses of the cardiovascular system in physicians were caused by the duty load.
PURPOSE: Night duty has been recognized as a significantly harmful stressor for physicians. However, the relationship between various levels of duty loading and stress response is unknown. This study examined whether duty load increases cardiovascular stress indicators in a dose-dependent manner. METHODS: An unallocated prospective observational study was conducted among physicians performing various levels of duties in a secondary referral medical center between 2011 and 2012. Heart rate variability (HRV), blood pressure (BP), and other stress markers of 12 attending physicians were compared during different duty loads: non-duty day (NDD), duty day with one duty area and three wards (1DD), and duty day with two duty areas and six wards (2DD). RESULTS: During the regular sleep time (i.e., 11 p.m. to 5 a.m.), the relative sympathetic modulations measured using the HRV were 59.0 ± 9.3, 61.6 ± 10.4, and 64.4 ± 8.9 for NDD, 1DD, and 2DD, respectively (p = 0.0012); those for relative parasympathetic modulations were 37.4 ± 9.4, 34.8 ± 9.8, and 32.0 ± 8.8 for NDD, 1DD, and 2DD, respectively (p = 0.0015). The percentages of abnormal systolic BPs were 9.7 ± 13.2 %, 25.3 ± 21.8 %, and 31.5 ± 21.0 % for NDD, 1DD, and 2DD, respectively (p = 0.003), and the percentages of abnormal diastolic BP were 6.7 ± 11.0 %, 18.3 ± 11.1 %, and 27.1 ± 30.9 % for NDD, 1DD, and 2DD, respectively (p = 0.002). Total sleep time was negatively associated with sympathetic/parasympathetic balance and the percentage of abnormal diastolic BP. Admitting new patients was positively associated with the percentages of abnormal systolic BP. CONCLUSIONS: This observational analysis suggests that the dose-dependent stress responses of the cardiovascular system in physicians were caused by the duty load.
Authors: Markus Rauchenzauner; Florian Ernst; Florian Hintringer; Hanno Ulmer; Christoph F Ebenbichler; Marie-Therese Kasseroler; Michael Joannidis Journal: Eur Heart J Date: 2009-07-14 Impact factor: 29.983
Authors: Noelia Durán-Gómez; Jorge Guerrero-Martín; Demetrio Pérez-Civantos; Casimiro Fermín López-Jurado; Jesús Montanero-Fernández; Macarena C Cáceres Journal: Int J Environ Res Public Health Date: 2021-11-13 Impact factor: 3.390