| Summary: | A research report submitted to the Faculty of Health Sciences,
University of the Witwatersrand, in partial fulfillment for the
degree of Master of Medicine (Emergency Medicine)
Johannesburg 2017. === Objective
The positive impact of physical activity and exercise on health is well known;
conversely a lack of physical activity has been clearly demonstrated to increase the
risk of several non-communicable diseases. Individuals who walk 10 000 steps per
day or more are likely to meet recommended physical activity guidelines. Very little
is known about the physical activity levels of doctors at work, in particular those
working in busy Emergency Departments (ED). Our primary objective was to
determine how many steps per shift doctors working in a South African ED took. The
secondary objectives were to assess what factors influenced the number of steps
taken.
Methods
This was a prospective observational cohort study undertaken at Helen Joseph
Hospital ED, Johannesburg, South Africa over a one-month period. The 32
participating doctors wore pedometers during their day shifts in the ED and the
number of steps taken during their shifts were measured; as well as the number and
triage category of patients seen; and whether chest compressions were performed.
Results
The median number of steps taken per shift was 6328 (Interquartile Range [IQR]
4646-8409). This was significantly less than the 10 000 recommended steps per day
(p<0.0001). In only 11.7% (37/317) of shifts did the number of steps taken exceed
the target of 10 000 steps. Factors which significantly increased the number of steps
taken included shift duration and the performance of chest compressions. Each
additional hour of shift led to a mean increase of 600 steps (95% CI: 548-772 steps).
The mean number of steps for shift with chest compressions was 8308 (95% CI:7479-
9137) while the mean number of steps for shifts without chest compressions was
6503 (95% CI: 6121-6885). A low patient per hour rate was shown with an average
rate, for all participants over the one month period of 0.9.
Conclusions
The results show that doctors working in the ED are not achieving the recommended
number of daily steps while at work. Failing to meet the current physical activity
guidelines can be explained by the overall low rate of patients seen per hour as well
as the general layout of the ED. With little time outside of working hours for exercise
and further physical activity, achieving the desired steps per day seems unlikely,
which could potentially increase the risk of ill health and burnout. === LG2018
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