Comparison of vital parameters of employees of intensive cardiac care unit during work and rest – pilot study
Introduction: Working in emergency and intensive care is one of the most common occupations that face high levels of occupational stress, which has been shown to have a major impact on the development of early cardiovascular disease. Prolonged exposure to stressors at work increases cardiovascular risk (CVR) (1,2). The aim of this research is to determine, by measuring vital parameters, whether there is a certain influence of professional stressors on the increase in arterial pressure and pulse and on pathological variations in the electrocardiogram record of health personnel working in intensive cardiac care unit.
Participants and Methods: Observational case control study conducted on adult health professionals aged 18-65 years, both sexes, working in the Intensive Cardiac Care Unit of the Sestre Milosrdnice University Hospital Centre. Duration of the research was 4 months.
Results: In the total sample of 17 respondents, the female gender predominated with a share of 70.6%. The average systolic pressure was 128.47 mmHg (standard deviation, SD 8.70), while the average diastolic pressure was 82.65 mmHg (SD 7.31). There was a trend of increasing pressure during the working night (2.57%, SD 6.01), and a decreasing trend during non-working nights (-12.42%, SD 4.55). By comparing diastolic pressure during working and non-working 24 hours, a statistically significant difference was observed with an average value of 8.18 mmHg (p<0.001) increasing during work. By comparing systolic pressure during working and non-working 24 hours, a statistically significant difference was observed with an average value of 7.18 mmHg (p<0.001) increasing during work. In addition, statistical significance was observed in the average difference in the number of QRS, minimum frequency and pressure changes during the night by comparing working and non-working hours all increasing during work (Table 1).
TABLE 1 Comparison of investigated parameters by t test for paired samples.
| Paired Samples Test |
|---|
| Mean | Paired Differences | t | df | P |
| Std. Deviation | Std. Error Mean | 95% CI of the Difference | |
| Lower | Upper | |
| Pair 1 | Mean SBP- work day (mmHg) - Mean SBP-free day (mmHg) | 4.11 | 8.14 | 1.97 | -0.07 | 8.29 | 2.08 | 16 | 0.054 |
| Pair 2 | Mean DBP- work day (mmHg) - Mean DBP-free day (mmHg) | 5.31 | 6.71 | 1.63 | 1.86 | 8.77 | 3.26 | 16 | 0.005 |
| Pair 3 | Mean SBP- work night (mmHg) - Mean SBP-free night (mmHg) | 10.22 | 7.79 | 1.89 | 6.21 | 14.22 | 5.41 | 16 | 0.000 |
| Pair 4 | Mean DBP- work night (mmHg) - Mean DBP-free night (mmHg) | 10.78 | 5.72 | 1.39 | 7.84 | 13.72 | 7.78 | 16 | 0.000 |
| Pair 5 | Mean DBP- working 24h (mmHg) - Mean DBP-free 24h (mmHg) | 8.18 | 4.18 | 1.01 | 6.03 | 10.33 | 8.07 | 16 | 0.000 |
| Pair 6 | Mean SBP- working 24h(mmHg) - Mean SBP-free 24h (mmHg) | 7.18 | 5.26 | 1.28 | 4.48 | 9.88 | 5.63 | 16 | 0.000 |
| Pair 7 | QRS number work day - QRS number free day | 5785.57 | 8926.99 | 2385.84 | 631.28 | 10939.86 | 2.42 | 13 | 0.031 |
| Pair 8 | QRS number work night - QRS number free night | 5305.07 | 7800.63 | 2084.81 | 801.12 | 9809.02 | 2.54 | 13 | 0.024 |
| Pair 9 | QRS number 24h work - QRS number 24h free | 9499.79 | 13398.92 | 3581.01 | 1763.48 | 17236.09 | 2.65 | 13 | 0.020 |
| Pair 10 | Minimum frequency work day - Minimum frequency free day | 6.07 | 20.53 | 5.49 | -5.78 | 17.93 | 1.11 | 13 | 0.289 |
| Pair 11 | Maximum frequency work day - Maximum frequency free day | 6.86 | 18.76 | 5.01 | -3.98 | 17.69 | 1.37 | 13 | 0.195 |
| Pair 12 | Minimum frequency work night - Minimum frequency free night | 7.14 | 8.65 | 2.31 | 2.15 | 12.13 | 3.09 | 13 | 0.009 |
| Pair 13 | Maximum frequency work night - Maximum frequency free night | 6.50 | 17.73 | 4.74 | -3.74 | 16.74 | 1.372 | 13 | 0.193 |
| Pair 14 | Minimum frequency 24h work - Minimum frequency 24h free | 7.07 | 7.25 | 1.94 | 2.89 | 11.26 | 3.651 | 13 | 0.003 |
| Pair 15 | Maximum frequency 24h work – Maximum frequency 24h free | -0.29 | 14.35 | 3.84 | -8.57 | 8.00 | -0.074 | 13 | 0.942 |
| Pair 16 | VES number work day - VES number work night | 2.00 | 7.04 | 1.88 | -2.06 | 6.06 | 1.063 | 13 | 0.307 |
| Pair 17 | VES number free day - VES number free night | -0.29 | 0.99 | 0.27 | -0.86 | 0.29 | -1.075 | 13 | 0.302 |
| Pair 18 | VES number 24 h work day - VES number 24h free day | 2.79 | 7.59 | 2.03 | -1.60 | 7.17 | 1.374 | 13 | 0.193 |
| Pair 19 | SVES number work day - SVES number free day | -0.29 | 2.23 | 0.60 | -1.58 | 1.00 | -0.479 | 13 | 0.640 |
| Pair 20 | SVES number work night - SVES number free night | -0.50 | 1.83 | 0.49 | -1.56 | 0.56 | -1.023 | 13 | 0.325 |
| Pair 21 | SVES number 24h work - SVES number 24h free | -0.71 | 3.77 | 1.01 | -2.89 | 1.46 | -0.709 | 13 | 0.491 |
| Pair 22 | Blood pressure fluctuations during work night (%) - Blood pressure fluctuations during free night (%) | 14.99 | 8.82 | 2.14 | 10.45 | 19.53 | 7.003 | 16 | 0.000 |
| SBP = systolic blood pressure; DBP = diastolic blood pressure; VES = ventricular premature beats; SVES= supraventricular premature beats |
Conclusion: The research proved the adverse impact of professional stressors on the cardiovascular system of intensive cardiac care unit employees, which increases their cardiovascular risk profile in the long term. It would be desirable to conduct a larger multicenter study with a larger number of respondents, including a larger number of doctors, and a longer follow-up time that would confirm the results of this study.
