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Lim GY, Jung NY, Jun KY, Kang JY, Kim MK, Lee HE, Kim MH, Song J, Kim I, Kim YM. Pregnancy loss and Income in the Republic of Korea using National Health Insurance Service Data, 2008-2014. BMC Public Health 2022; 22:188. [PMID: 35086510 PMCID: PMC8796511 DOI: 10.1186/s12889-022-12588-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 01/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Although unintentional pregnancy loss is common, national representative statistics are lacking in high-income East Asian countries undergoing rapid demographic changes. It is necessary to confirm the income inequality of pregnancy loss even in universal national health insurance. Method Using National Health Insurance Service data between 2008 and 2014, the annual prevalence of pregnancy loss was enumerated, and differences in pregnancy loss according to age and income levels were assessed by multivariable Poisson regression. Joint-point regression was used to examine the trend of pregnancy loss. Result On average, there was a 15.0% annual pregnancy loss among 3,941,020 pregnancy cases from 2008 to 2014. Pregnancy loss inequality increased stepwise with income levels except for the highest income group. After adjusting for income levels, the annual percent change of age-standardized prevalence significantly increased by 2.6% every year since 2011. Conclusion Even in high-income countries with universal national health insurance, income inequality in pregnancy loss is observed. Further appraisal is needed to explain the increasing trend of pregnancy loss between 2011 and 2014 even after adjusting income.
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Affiliation(s)
- Ga-Young Lim
- Department of Public Health, Hanyang University Graduate School, Seoul, South Korea.,Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Na Young Jung
- Incheon Communicable Diseases Center, Incheon, South Korea
| | - Kyo Yeon Jun
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Incheon, South Korea
| | - Ji Yeon Kang
- Korea National Enterprise for Clinical Trials, Seoul, South Korea
| | - Mi Kyung Kim
- Department of Public Health, Hanyang University Graduate School, Seoul, South Korea.,Department of Preventive Medicine, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, South Korea.,Hanyang University School of Public Health, Seoul, South Korea
| | - Hye-Eun Lee
- Korea Institute of Labor Safety and Health, Seoul, South Korea.,Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, South Korea
| | - Myoung-Hee Kim
- Research Institute of Public Health, National Medical Center, Seoul, South Korea
| | - Jaechul Song
- Department of Public Health, Hanyang University Graduate School, Seoul, South Korea.,Hanyang University School of Public Health, Seoul, South Korea.,Department of Occupational and Environmental Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Inah Kim
- Department of Public Health, Hanyang University Graduate School, Seoul, South Korea.,Hanyang University School of Public Health, Seoul, South Korea.,Department of Occupational and Environmental Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Yu-Mi Kim
- Department of Public Health, Hanyang University Graduate School, Seoul, South Korea. .,Department of Preventive Medicine, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, South Korea. .,Hanyang University School of Public Health, Seoul, South Korea.
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Feitosa-Assis AI, Santana VS. Occupation and maternal mortality in Brazil. Rev Saude Publica 2020; 54:64. [PMID: 32609276 PMCID: PMC7304881 DOI: 10.11606/s1518-8787.2020054001736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/13/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To estimate maternal mortality ratio according to occupation in Brazil. METHODS This is a mortality study conducted with national data from the Mortality Information System (SIM) and the Live Birth Information System (SINASC) in 2015. Maternal mortality ratios were estimated according to the occupation recorded in death certificates, using the Brazilian Classification of Occupation (CBO), version 2002. RESULTS A total of 1,738 maternal deaths records were found, corresponding to a maternal mortality ratio of 57.6/100,000 live births. It varied among occupational groups, with higher estimates among service and agricultural workers, particularly for domestic workers (123.2/100,000 live births), followed by general agricultural workers (88.3/100,000 live births). Manicurists and nursing technicians also presented high maternal mortality ratio. Maternal occupation was not reported in 17.0% of SIM registers and in 13.2% of SINASC data. Inconsistent records of occupation were found.“Housewife” prevailed in SIM (35.5%) and SINASC (39.1%). CONCLUSIONS Maternal mortality ratio differs by occupation, suggesting a work contribution, which requires further research focusing occupational risk factors. Socioeconomic factors are closely related to occupation, and their combination with work exposures and the poor access to health services need to be also addressed.
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Affiliation(s)
- Ana Isabela Feitosa-Assis
- Universidade Federal da Bahia. Instituto de Saúde Coletiva. Programa de Pós-Graduação em Saúde Coletiva. Salvador, BA, Brasil.,Universidade Federal da Bahia. Instituto de Saúde Coletiva. Programa Integrado em Saúde Ambiental e do Trabalhador (PISAT). Salvador, BA, Brasil
| | - Vilma Sousa Santana
- Universidade Federal da Bahia. Instituto de Saúde Coletiva. Programa Integrado em Saúde Ambiental e do Trabalhador (PISAT). Salvador, BA, Brasil
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Lee W, Jung SW, Lim YM, Lee KJ, Lee JH. Spontaneous and repeat spontaneous abortion risk in relation to occupational characteristics among working Korean women: a cross-sectional analysis of nationally representative data from Korea. BMC Public Health 2019; 19:1339. [PMID: 31640649 PMCID: PMC6805676 DOI: 10.1186/s12889-019-7728-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 10/09/2019] [Indexed: 11/30/2022] Open
Abstract
Background The association between spontaneous abortion (SA) and occupational characteristics among working women is not well-studied. This study aimed to assess the risk of SA and occupational factors such as occupational classification, working hours, and work schedules among working Korean women aged > 19 years. Methods In this cross-sectional study, 4078 working women were identified from among 25,534 workers in the Korea National Health and Nutrition Examination Surveys V (2010–2012) database, to obtain data on SA history and the number of SAs. Odds ratios (ORs) and 95% confidence intervals (CIs) for SA were calculated using multiple logistic regression models after adjusting for age, education, household income, cigarette smoking, alcohol consumption, and obesity status. The weighted prevalence for the number of SAs was calculated according to occupational characteristics to demonstrate the SA status among working Korean women. Results SA occurrence was reported in 5.7% of the study participants. The ORs (95% CIs) for SA were significantly higher in pink-, green-, and blue-collared workers than in white-collared workers. Regarding weekly working hours, compared with ≤50 h spent working, the ORs (95% CIs) for 51–60, 61–70, and > 70 h per week were 1.26 (0.87–1.84), 1.63 (1.04–2.56), and 1.73 (1.10–2.70), respectively. A significantly higher weighted prevalence of repeat SAs was observed in pink- and green-collared workers and in those who worked long hours. Conclusion We found a significant association between SA, repeat SA, and occupational characteristics among working Korean women.
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Affiliation(s)
- Wanhyung Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Sung Won Jung
- Department of Occupational & Environmental Medicine, Soonchunhyang University Hospital, Seoul, Republic of Korea
| | - Young-Mee Lim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Woman's University, Seoul, Republic of Korea
| | - Kyung-Jae Lee
- Department of Occupational & Environmental Medicine, Soonchunhyang University Hospital, Seoul, Republic of Korea
| | - June-Hee Lee
- Department of Occupational & Environmental Medicine, Soonchunhyang University Hospital, Seoul, Republic of Korea.
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Runkle J, Flocks J, Economos J, Tovar-Aguilar JA, McCauley L. Occupational risks and pregnancy and infant health outcomes in Florida farmworkers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:7820-40. [PMID: 25101767 PMCID: PMC4143835 DOI: 10.3390/ijerph110807820] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 07/24/2014] [Accepted: 07/25/2014] [Indexed: 11/16/2022]
Abstract
The agricultural industry has some of the highest incidence rates and numbers of occupational injuries and illnesses in the United States. Injuries and illnesses in agriculture result from accidents, falls, excessive heat, repetitive motion and adverse pesticide exposure. Women working in agriculture are exposed to the same hazards and risks as their male counterparts, but can face additional adverse impacts on their reproductive health. Yet, few occupational risk assessment studies have considered the reproductive health of female farmworkers. The objective of this community-based participatory research study was to conduct a retrospective, cross-sectional survey to collect information on workplace conditions and behaviors and maternal, pregnancy and infant health outcomes among a sample of female nursery and fernery farmworkers in Central Florida. Survey results showed that nursery workers were more likely to report health symptoms during their pregnancy than fernery workers. We also observed a self-reported increased risk of respiratory illness in the first year of life for infants whose mothers worked in ferneries. Our findings confirm that agricultural work presents potential reproductive hazards for women of childbearing age.
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Affiliation(s)
- Jennifer Runkle
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA.
| | - Joan Flocks
- Center for Governmental Responsibility, Levin College of Law, University of Florida, Gainesville, FL 32611, USA.
| | | | | | - Linda McCauley
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA.
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Bonde JP, Jørgensen KT, Bonzini M, Palmer KT. Miscarriage and occupational activity: a systematic review and meta-analysis regarding shift work, working hours, lifting, standing, and physical workload. Scand J Work Environ Health 2012; 39:325-34. [PMID: 23235838 DOI: 10.5271/sjweh.3337] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Previous studies have indicated that shift work, long working hours, and prevalent workplace exposures such as lifting, standing, and physical workload increase the risk of miscarriage, but the evidence is conflicting. We conducted a systematic review of original research reports. METHODS A search in Medline and EMBASE 1966-2012 identified 30 primary papers reporting the relative risk (RR) of miscarriage according to ≥1 of 5 occupational activities of interest. Following an assessment of completeness of reporting, confounding, and bias, each risk estimate was characterized as more or less likely to be biased. Studies with equivalent measures of exposure were pooled to obtain a weighted common risk estimate. Sensitivity analyses excluded studies most likely to be biased. RESULTS Working fixed nights was associated with a moderately increased risk of miscarriage (pooled RR 1.51 [95% confidence interval (95% CI) 1.27-1.78, N=5), while working in 3-shift schedules, working for 40-52 hours weekly, lifting >100 kg/day, standing >6-8 hours/day and physical workload were associated with small risk increments, with the pooled RR ranging from 1.12 (3-shift schedule, N=7) to 1.36 (working hours, N=10). RR for working hours and standing became smaller when analyses were restricted to higher quality studies. CONCLUSIONS These largely reassuring findings do not provide a strong case for mandatory restrictions in relation to shift work, long working hours, occupational lifting, standing, and physical workload. Considering the limited evidence base, however, it may be prudent to advise women against work entailing high levels of these exposures and women with at-risk pregnancies should receive tailored individual counseling.
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Affiliation(s)
- Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
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