Let’s get physical: A prospective pedometer study of doctors working in a South African emergency department

Abstract

Physical inactivity has been referred to as a pandemic and is the fourth leading contributing cause of mortality worldwide. [1] The positive impact of physical activity on health is well known, and lack thereof is known to increase the risk of several non-communicable diseases such as hypertension, coronary artery disease and type 2 diabetes. [1,2] This increased risk has local significance, as South Africans have been found to be among the least active people on the African continent. [3] South Africans' physical inactivity unfortunately extends to healthcare professionals. Kunene and Taukobong [4] evaluated the level of physical activity of a mixture of healthcare professionals at Estcourt Hospital, KwaZulu-Natal Province, South Africa (SA). Despite potentially having more insight into the risks of physical inactivity than patients, 69% of these healthcare professionals were found to have moderate to low physical activity levels. [4] This finding is echoed in the limited international research that has been published on the physical activity of doctors specifically. [5-7] The recommendation to walk at least 10 000 steps per day is seen as an appropriate activity target for healthy adults, and achieving this goal is a predictor of good health. [8] However, to date, none of the studies assessing doctors' physical activity levels at work have shown that they achieve this suggested target. [5-7,9-16] The emergency department (ED) is a fast-paced and busy working environment, and emergency medicine is regarded as one of the most stressful specialties in medicine. [17] It was therefore surprising that this shortfall in achieving 10 000 steps also applied to ED doctors. [9,10] Objectives To determine whether failure to achieve the above physical activity target also holds true in the SA context. We hypothesised that ED doctors would walk well over the 10 000-step mark because of our busy, overburdened and understaffed departments. [18] Our primary objective was to determine how many steps per shift were taken by doctors in an SA ED. The secondary objectives were to assess what factors influenced the number of steps taken. Methods Study design and setting We undertook a prospective observational cohort study over a 1-month period at a tertiary academic teaching hospital in Johannesburg. The ED sees ~65 000 patients per annum and has 2 500 m 2 of floor space. It includes a 7-bed resuscitation area, a 6-bed acute observation area, an 8-bed 'surgical' area and an 8-bed 'medical' area, as well as triage, orthopaedic, psychiatric and radiology sections. Ethics approval was obtained from the Human Research Ethics Committee of the University of the Witwatersrand (ref. no. M150405). Participants Medical officers (MOs) and emergency medicine registrars working various day shifts in the ED made up the study population. Written informed consent was obtained from each participant prior to enrolment in the study. This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

The Physical Activity Level of Ophthalmologists at Work: A Pedometer-Based Study

“…In this study, participants averaged only 360 SPH during morning clinic sessions. A review of the literature suggested that this step number was the lowest among all medical disciplines that have been evaluated similarly; cardiologists, cardiothoracic surgeons, anesthesiologists, emergency physicians, internists, and others, averaged between 430 and 744 SPH in previous pedometer-based studies (Abd et al, 2012; Atkinson et al, 2005; Beringer et al, 2020; Conzett-Baumann et al, 2009; Cuthill et al, 2008; Peters et al, 2020).…”

“…It has been postulated that this recommendation is fairly equivalent to the contemporary goal of 10,000 daily steps (Tudor-Locke & Bassett, 2004). Although physicians are more likely to achieve the above fitness goals than the general population (Stanford et al, 2012), workplace-associated limitations present a significant challenge toward reaching recommended levels of daily PA, even in relatively “active” specialties (Beringer et al, 2020; Williams et al, 2015). Based on reviews done by the authors, this study is the first to document pedometer-measured PA levels among ophthalmologists in the workplace.…”

“…Only a small number of studies have evaluated the PA levels of physicians during work hours, and even fewer pedometer-based studies have been conducted on practicing physicians (Abd et al, 2012; Atkinson et al, 2005; Beringer et al, 2020; Conzett-Baumann et al, 2009; Cuthill et al, 2008; Peters et al, 2020). To the best of our knowledge, no study has investigated the physical activity of ophthalmologists in the workplace.…”

The Feasibility of a Text-Messaging Intervention Promoting Physical Activity in Shift Workers: A Process Evaluation

“…For shift workers, lack of time and work-related fatigue may explain workers’ low levels of physical activity [ 20 ]. According to a study conducted in shift working South African doctors, more steps were reported when working longer shifts, thus resulting in more physical activity at work [ 21 ]. The factors influencing the implementation and effectiveness of health promotion programs in both shift and regular day workers need to be understood to improve workers’ health.…”