@article{ref1,
title="Increased night duty loading of physicians caused elevated blood pressure and sympathetic tones in a dose-dependent manner",
journal="International archives of occupational and environmental health",
year="2015",
author="Lee, Hsiu-Hao and Lo, Shih-Hsiang and Chen, Bing-Yu and Lin, Yen-Hung and Chu, Dachen and Cheng, Tsun-Jen and Chen, Pau-Chung and Guo, Yue-Liang",
volume="89",
number="3",
pages="413-423",
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. <br><br>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). <br><br>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. <br><br>CONCLUSIONS: This observational analysis suggests that the dose-dependent stress responses of the cardiovascular system in physicians were caused by the duty load.<p /> <p>Language: en</p>",
language="en",
issn="0340-0131",
doi="10.1007/s00420-015-1080-8",
url="http://dx.doi.org/10.1007/s00420-015-1080-8"
}