Physiological restitution after night-call duty in anaesthesiologists: impact on metabolic factors.
BACKGROUND
Several studies have shown impaired mental well-being and performance in physicians work on call, but knowledge of the physiological effects is scarce. The aims of the present study were to investigate if there was a metabolic stress response in the restitutional phase after night-call duty, indicating potential negative health effects, and determine whether there were differences between physician specialities.


METHODS
Anaesthesiologists (n = 19) were compared with paediatricians/ear, nose and throat (ENT) surgeons (n = 18). On an ordinary workday, 1 and 3 days after work on night call, blood samples were taken for analysis of glucose, thyroid-stimulating hormone (TSH), free thyroxine, testosterone, insulin growth factor-1 (IGF-1), high- and low-density lipoprotein cholesterol (HDL and LDL), triglycerids (TG) and insulin. Saliva cortisol was sampled on an ordinary working day, a day including 16-h night call, the third day following, and for anaesthesiologists also on a day off work.


RESULTS
TSH differed significantly between days in both groups, with a 26% lower level 1 day after on-call duty (P < 0.001). A 48% cortisol rise in the morning preceding night duty was found for paediatricians/ENT surgeons (P < 0.01).


CONCLUSIONS
The significant dip in TSH level 24 h after night-call duty indicates a metabolic effect of working on night call and should be studied further. However, the levels were within the normal range and the overall results do not imply any serious metabolic changes and only minor differences were seen between specialist groups.
Malmberg
B
B
Department of Occupational and Environmental Medicine, Lund University Hospital, Lund, Sweden. birgitta.malmberg@med.lu.se
Persson
R
R
Jönsson
B A G
BA
Erfurth
E-M
EM
Flisberg
P
P
Ranklev
E
E
Orbaek
P
P
D000328:Adult; D000776:Anesthesiology; D015415:Biomarkers; D005260:Female; D006728:Hormones / Q000097:blood / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008511:Medicine; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010036:Otolaryngology; D010372:Pediatrics; D010561:Personnel Staffing and Scheduling; D012463:Saliva / Q000737:chemistry / Q000378:metabolism; D013038:Specialization; D013315:Stress, Psychological / Q000209:etiology / Q000378:metabolism*; D013972:Thyrotropin / Q000097:blood / Q000378:metabolism; D000078329:Workforce
D015415:Biomarkers; D006728:Hormones; D007328:Insulin; D008055:Lipids; D013972:Thyrotropin; D006854:Hydrocortisone