ESPE Abstracts

Background: Working as a physician is accompanied by emotional and physical stress.

Objective and hypotheses: Our study aimed to investigate the effect of working day and night in a children’s hospital on catecholamine excretion as a marker for acute stress and to work out possible gender differences.

Methods: 22 paediatricians (ten females, 12 males) aged 27–41 years collected four 12-h urine samples: two during a 24 h-shift at the Children’s Hospital Giessen (‘on-duty’) – the first sample from 0800 till 2000 h the second from 2000 till 0800 h the following morning – and another two on a free weekend (‘off-duty’). Urinary excretion rates (ER) per m² body surface (BS) for epinephrine (EPI), norepinephrine (NEPI), normethanephrine (NMN), metanephrine (MN), dopamin (DA), and 3-methoxythyramine (MTY) were determined by liquid chromatography–mass spectrometry (LC–MS).

Results: The group of physicians as a whole had significantly higher nightly ERs for all metabolites ‘on duty’ than ‘off duty’ (EPI, NMN, P<0.001; NEPI, MN, P<0.01; MTY: P<0.05), except DA. Comparing the ERs during the day ‘on duty’ with those ‘off duty’, only the ER of EPI was significantly higher ‘on duty’ (P<0.001). When divided into a ‘male’ and a ‘female’ group, there were significant differences between days ‘on’ compared to ‘off duty’ in the male group detectable for EPI (P=0.001) and MN (P<0.001), whereas the females showed no differences at all. Similar results gave the comparison of the nights ‘on’ and ‘off duty’: there was a significant difference for all ERs except DA in the male group (EPI, NMN, NEPI P<0.01; MN, MTY P<0.05), but in the female group only EPI was higher ‘on duty’ (P<0.05).

Conclusion: Working in a children’s hospital, especially overnight activates the adrenal medulla resulting in increased catecholamine excretion. Female physicians react differently from males, possible indicating a higher stress resistance to acute stress.