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 childrens 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 2741 years collected four 12-h urine samples: two during a 24 h-shift at the Childrens 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 chromatographymass spectrometry (LCMS).
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 childrens 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.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology