Acta clinica Croatica, Vol. 58. No. 2., 2019.
Original scientific paper
https://doi.org/10.20471/acc.2019.58.02.11
Effects of Occupational Stress on the Activation of Hemostatic and Inflammatory System
Hana Matijaca
; Division of Hematology, Department of Internal Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Petar Gaćina
; Division of Hematology, Department of Internal Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Goran Rinčić
; Division of Hematology, Department of Internal Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Ana Matijaca
; Division of Endocrinology, Department of Internal Medicine, Dubrava University Hospital, Zagreb, Croatia
Josipa Josipović
; Division of Nephrology, Department of Internal Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Sanja Stojsavljević
; Division of Gastroenterology, Department of Internal Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Abstract
A 24-hour shift is one of the major stressors for physicians because, apart from causing fatigue and circadian rhythm disorders, it often requires making vital decisions for patients within a short time frame. It is known that workplace stress leads to the activation of the coagulation
system, which can result in imbalance of the coagulation and fibrinolysis system. The state of stress can also generate proinflammatory mediators. The aim of this study was to examine the effect of 24-hour
shift on global coagulation tests of D-dimers and fibrinolysis, and on C-reactive protein (CRP) as an acute inflammatory agent and proatherosclerotic factor. Sixty physicians (residents) aged 25-35 participated in this study (30 participants in the experimental group and 30 participants in the control group). In experimental group, blood samples were collected on three occasions: shortly before 24-hour shift, twelve hours after the shift had begun, and at the end of the shift. Blood samples were collected from control group participants at the same time points. The results showed that there was no statistically significant difference in the values of D-dimer and fibrinolysis between the experimental and control groups. CRP values were statistically significantly higher in the experimental (1.57, 1.49 and 1.50) than in the control group (0.79, 0.75 and 0.84) on all three measurements (p=0.024, p=0.020 and p=0.030, respectively). These results confirmed the existence of proinflammatory changes in the endothelium of blood vessels, which is a factor associated with accelerated atherosclerosis.
Keywords
Occupational stress; Shift work schedule; Medical staff, hospital; Fibrinolysis; C-reactive protein; Atherosclerosis
Hrčak ID:
224448
URI
Publication date:
1.6.2019.
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