%0 Journal Article %T Increased night duty loading of physicians caused elevated blood pressure and sympathetic tones in a dose-dependent manner %J International archives of occupational and environmental health %D 2015 %A Lee, Hsiu-Hao %A Lo, Shih-Hsiang %A Chen, Bing-Yu %A Lin, Yen-Hung %A Chu, Dachen %A Cheng, Tsun-Jen %A Chen, Pau-Chung %A Guo, Yue-Liang %V 89 %N 3 %P 413-423 %X 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.

Language: en

%G en %I Holtzbrinck Springer Nature Publishing Group %@ 0340-0131 %U http://dx.doi.org/10.1007/s00420-015-1080-8