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Marsters CM, Stafl L, Bugden S, Gustainis R, Nkunu V, Reimer R, Fletcher S, Smith S, Bruton Joe M, Hyde C, Dance E, Ruzycki SM. Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping review. BMJ Open 2023; 13:e064483. [PMID: 36813500 PMCID: PMC9950931 DOI: 10.1136/bmjopen-2022-064483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE Evidence is needed to guide organisational decision making about workplace accommodations for pregnant physicians. Our objective was to characterise the strengths and limitations of current research examining the association between physician-related occupational hazards with pregnancy, obstetrical and neonatal outcomes. DESIGN Scoping review. DATA SOURCES MEDLINE/PubMed, EMBASE, CINAHL/ EBSCO, SciVerse Scopus and Web of Science/Knowledge were searched from inception to 2 April 2020. A grey literature search was performed on 5 April 2020. The references of all included articles were hand searched for additional citations. ELIGIBILITY CRITERIA English language citations that studied employed pregnant people and any 'physician-related occupational hazards', meaning any relevant physical, infectious, chemical or psychological hazard, were included. Outcomes included any pregnancy, obstetrical or neonatal complication. DATA EXTRACTION AND SYNTHESIS Physician-related occupational hazards included physician work, healthcare work, long work hours, 'demanding' work, disordered sleep, night shifts and exposure to radiation, chemotherapy, anaesthetic gases or infectious disease. Data were extracted independently in duplicate and reconciled through discussion. RESULTS Of the 316 included citations, 189 were original research studies. Most were retrospective, observational and included women in any occupation rather than healthcare workers. Methods for exposure and outcome ascertainment varied across studies and most studies had a high risk of bias in data ascertainment. Most exposures and outcomes were defined categorically and results from different studies could not be combined in a meta-analysis due to heterogeneity in how these categories were defined. Overall, some data suggested that healthcare workers may have an increased risk of miscarriage compared with other employed women. Long work hours may be associated with miscarriage and preterm birth. CONCLUSIONS There are important limitations in the current evidence examining physician-related occupational hazards and adverse pregnancy, obstetrical and neonatal outcomes. It is not clear how the medical workplace should be accommodated to improve outcomes for pregnant physicians. High-quality studies are needed and likely feasible.
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Affiliation(s)
- Candace M Marsters
- Department of Neurology, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Lenka Stafl
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sarah Bugden
- Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | | | - Victoria Nkunu
- Department of Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Renee Reimer
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarah Fletcher
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephanie Smith
- Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Moss Bruton Joe
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christine Hyde
- Department of Pediatrics, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Erica Dance
- Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Shannon M Ruzycki
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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Uechi K, Arakaki S, Sasaki S. Characteristics of women who dropped out from pregnancy register in Okinawa, Japan: Findings from a retrospective cohort study. J Obstet Gynaecol Res 2023; 49:164-174. [PMID: 36220630 DOI: 10.1111/jog.15461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/16/2022] [Accepted: 09/29/2022] [Indexed: 01/19/2023]
Abstract
AIM There is little evidence regarding women who cannot register live births after pregnancy. We aimed to clarify the difference in baseline characteristics between women who registered live births and those who did not (i.e., dropout). METHODS We assessed the birth cohort data of 1976 Japanese women who registered their pregnancies between July 2013 and March 2014 in Naha and Urasoe City, Okinawa, Japan. The database consisted of anthropometric data, reproductive history, sociodemographic characteristics, and dietary intake. We estimated the prevalence ratio to examine the associations of baseline characteristics with dropout by multivariable-adjusted Poisson regression with robust standard error estimation. RESULTS We identified 272 dropouts (13.8%) in the pregnancy registry. About 15% of women reported experience of alcohol drinking preceding 1 month of pregnancy registration. Most participants' vitamin B1 (92.1%) and folate (74.7%) consumption was inadequate considering the dietary reference intake for Japanese pregnant women, but it was not associated with a high prevalence of dropout. The prevalence of dropout was significantly higher in teenagers (prevalence ratio [PR] = 2.06, 95% confidence interval [CI] 1.38-3.07) and early 20s (PR = 1.42, 95% CI 1.04-1.93) than in women in late 20s. In addition, alcohol consumption was potentially associated with a high prevalence of dropout (adjusted prevalence ratio [aPR] = 1.31, 95% CI 0.99-1.73). Participants who experienced one or more live births (aPR = 0.43, 95% CI 0.28-0.66) were less likely to dropout. CONCLUSION We found that the potential risk factors for dropout from pregnancy registration were young maternal age, no childbirth experience, and alcohol consumption.
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Affiliation(s)
- Ken Uechi
- Division of Community Health Nursing, Faculty of Health Science, Toho University, Funabashi, Chiba, Japan
| | - Sugano Arakaki
- Okinawa Branch Office, Japan Health Insurance Association, Naha, Okinawa, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Kim K, Sung HK, Jang J, Suh EE, Lee K, Park SK. Health Status, Health-Related Factors and Work Environment in Korean Semiconductor Workers between 1984–2012: A Qualitative Study and a Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106286. [PMID: 35627823 PMCID: PMC9140394 DOI: 10.3390/ijerph19106286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 12/03/2022]
Abstract
Background: The environment of semiconductor facilities and exposure status has undergone changes. To identify changes in the work environment, health status, and risk factors, a qualitative and cross-sectional study was conducted. Methods: For the qualitative study, 38 current and retired workers who worked for at least 10-years were studied; for the cross-sectional study, 306 current workers who worked for at least 5-years based on JEM strata from Samsung Electronics were selected. Participants were asked about occupational history, cancer-relating risk factors during the working period, medical history, dietary habits for the past year, and hematological cancer-relating infection. Results: In the qualitative study, fabrication workers reported bladder cystitis, dermatitis in hands, gastritis/ulcer, and dry eye as frequent symptoms during work environment changes (manual to automatic process). In the cross-sectional study, there were no abnormal findings for infection biomarkers related to hematological cancer and spontaneous abortion, and their general health status was no different from the general population. Also, questionnaire feasibility was evaluated for the applicability in the prospective cohort. Conclusion: Current semiconductor workers’ health status was good compared to other populations. For lifelong health assessment, a cohort study is needed which considers health worker effects and current environments.
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Affiliation(s)
- Kyungsik Kim
- Department of Preventive Medicine, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea; (K.K.); (J.J.)
- Department of Biomedical Science, Seoul National University Graduate School, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea
| | - Ho Kyung Sung
- Institute for Public Healthcare, National Medical Center, Eulji-ro 245, Jung-gu, Seoul 04564, Korea;
- National Emergency Medical Center, National Medical Center, Eulji-ro 245, Jung-gu, Seoul 04564, Korea
| | - Jieun Jang
- Department of Preventive Medicine, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea; (K.K.); (J.J.)
- Gyeongnam Center for Infectious Disease Control and Prevention, Jungang-daero 300, Uichang-gu, Changwon 51154, Korea
| | - Eunyoung E. Suh
- College of Nursing Research Institute of Nursing Science, Seoul National University, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea;
| | - Kwan Lee
- Department of Preventive Medicine, Dongkuk University College of Medicine, Gyeongju 38066, Korea;
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea; (K.K.); (J.J.)
- Cancer Research Institute, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-2-740-8338; Fax: +82-2-747-4830
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Ahn J, Lee SH, Park MY, Oh SH, Lee W. The Association Between Long Working Hours and Infertility. Saf Health Work 2021; 12:517-521. [PMID: 34900371 PMCID: PMC8640650 DOI: 10.1016/j.shaw.2021.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 06/04/2021] [Accepted: 07/07/2021] [Indexed: 12/05/2022] Open
Abstract
Background This study aimed to investigate whether working long hours was related to infertility among female Korean workers, while taking age into consideration. Methods We used data from the 2018 National Survey on Fertility and Family Health and Welfare in Korea that is a cross-sectional, nationally representative, and population-based survey. Infertility was defined as women who were not pregnant after regular unprotected intercourse for a year. Working long hours was classified as ≥52 hours, and subgroups as per age were classified on the basis of being younger or older than 40 years of age. Differences in infertility risk between the long working hour group and none were estimated in crude and fully adjusted logistic regression models with age-group stratification. Results Of 5,909 Korean female workers, the crude and adjusted odds ratios (95% confidence intervals) of infertility for working long hours were 1.295 (0.948–1.737) and 1.303 (0.921–1.809), respectively. In the subgroup of patients below 40 years of age, the crude and adjusted odds ratios (95% confidence interval) were 1.957 (1.216–3.039) and 1.921 (1.144–3.120), whereas those aged 40 years or older had 0.994 (0.647–1.471) and 0.939 (0.560–1.501), respectively. The weighted prevalence of infertility increased as weekly working hours increased only for the younger than 40-year subgroup. Conclusions Infertility is associated with working long hours, especially in young-aged workers. Thus, the working schedule must be structured to better suit young female workers.
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Affiliation(s)
- Joonho Ahn
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang Ha Lee
- Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Min Young Park
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Soo Hyun Oh
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Wanhyung Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
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Francis F, Johnsunderraj SE, Divya KY, Raghavan D, Al-Furgani A, Bera LP, Abraham A. Ergonomic Stressors Among Pregnant Healthcare Workers: Impact on pregnancy outcomes and recommended safety practices. Sultan Qaboos Univ Med J 2021; 21:e172-e181. [PMID: 34221463 PMCID: PMC8219330 DOI: 10.18295/squmj.2021.21.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/01/2020] [Accepted: 09/13/2020] [Indexed: 11/16/2022] Open
Abstract
Workplace environment can have a considerable impact on the physical, psychological and maternal health of pregnant healthcare workers. This article aimed to summarise the impact of work-related ergonomic stressors on pregnancy outcomes for healthcare workers, along with potential interventions to resolve these stressors. A narrative review analysis using the Pearl Growing Strategy was conducted between February 2019 and June 2020 to identify English-language articles published between 2000 and 2020. A total of 89 studies were identified from the SCOPUS (Elsevier, Amsterdam, Netherlands), MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA) databases and Google Scholar (Google LLC, Menlo Park, California, USA). The results indicated that poor work-related ergonomics had detrimental effects on pregnancy outcomes, resulting in spontaneous abortions, preterm delivery, low birth weight babies and infertility. Policymakers and employers should conduct ergonomic assessments and implement appropriate practices to ensure the safety of pregnant healthcare workers.
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Affiliation(s)
- Frincy Francis
- Department of Maternal & Child Health, Sultan Qaboos University, Muscat, Oman
| | | | - K. Y. Divya
- Department of Community & Mental Health, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Divya Raghavan
- Department of Maternal & Child Health, Sultan Qaboos University, Muscat, Oman
| | - Atiya Al-Furgani
- Department of Maternal & Child Health, Sultan Qaboos University, Muscat, Oman
| | - Lily P. Bera
- Department of Maternal & Child Health, College of Nursing, All India Institute of Medical Sciences, Bhopal, India
| | - Aniamma Abraham
- Directorate of Nursing, Sultan Qaboos University Hospital, Muscat, Oman
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Ye HX, Li L, Dong YJ, Li PH, Su Q, Guo YH, Lu YR, Zhong Y, Jia Y, Cheng JQ. miR-146a-5p improves the decidual cytokine microenvironment by regulating the toll-like receptor signaling pathway in unexplained spontaneous abortion. Int Immunopharmacol 2020; 89:107066. [PMID: 33059199 DOI: 10.1016/j.intimp.2020.107066] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 02/08/2023]
Abstract
Spontaneous abortion (SA) is a common pregnancy failure, but the cause of numerous cases remains unexplained. Decidual immune cells (DICs)-mediated cytokine microenvironment is involved in pregnancy and regulated by many microRNAs, but whether microRNA-146a-5p (miR-146a) regulate the decidual cytokine microenvironment and the potential mechanisms in unexplained SA pathogenesis have rarely been reported. In this study, the levels of cytokines and miR-146a in healthy and unexplained SA deciduae were first investigated, and the correlation between them was analyzed. Then, the effect of miR-146a inhibitor on cytokines was assessed in healthy deciduae-derived DICs. Third, the downstream targets and related molecular mechanisms of miR-146a were analyzed by bioinformatics, and the levels of the predicted targets in deciduae were assessed, followed by the correlation analysis between the levels of miR-146a and the targets. Finally, the effect of miR-146a on the predicted targets and inflammatory cytokines was validated in unexplained SA deciduae-derived DICs. As a result, decreased miR-146a correlated with the cytokine disorder in unexplained SA deciduae, and inhibition of miR-146a promoted pro-inflammatory response in healthy deciduae-derived DICs. One hundred four target genes and related molecular mechanisms of miR-146a were predicted, among which the toll-like receptor (TLR) pathway might be associated with the decidual cytokine regulation. Upregulation of miR-146a inhibited the expression of the predicted molecules enriched in the TLR pathway and improved the cytokine disorder in unexplained SA deciduae-derived DICs. Collectively, miR-146a improves the decidual cytokine microenvironment by regulating the TLR pathway in unexplained SA, providing novel potential targets for further therapeutic research.
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Affiliation(s)
- Hong-Xia Ye
- Key Laboratory of Transplant Engineering and Immunology and National Clinical Research Centre for Geriatrics, West China Hospital, Sichuan University, No 37 Guoxue Road, Chengdu 610041, Sichuan, China; Department of Reproductive Immunology, Chengdu Xi'nan Gynecology Hospital, No 66 and 88 Bisheng Road, Chengdu 610066, Sichuan, China; Chengdu Jinjiang Hospital for Maternal & Child Health Care, No 3 Sanguantang Street, Chengdu 610066, Sichuan, China
| | - Lan Li
- Key Laboratory of Transplant Engineering and Immunology and National Clinical Research Centre for Geriatrics, West China Hospital, Sichuan University, No 37 Guoxue Road, Chengdu 610041, Sichuan, China
| | - Ya-Jun Dong
- Department of Reproductive Immunology, Chengdu Xi'nan Gynecology Hospital, No 66 and 88 Bisheng Road, Chengdu 610066, Sichuan, China
| | - Peng-Hao Li
- Jinxin Research Institute for Reproductive Medicine and Genetics, Chengdu Xi'nan Gynecology Hospital Co., Ltd., No 66 and 88 Bisheng Road, Chengdu 610066, Sichuan, China
| | - Qin Su
- Department of Reproductive Immunology, Chengdu Xi'nan Gynecology Hospital, No 66 and 88 Bisheng Road, Chengdu 610066, Sichuan, China
| | - Yan-Hua Guo
- Department of Reproductive Immunology, Chengdu Xi'nan Gynecology Hospital, No 66 and 88 Bisheng Road, Chengdu 610066, Sichuan, China
| | - Yan-Rong Lu
- Key Laboratory of Transplant Engineering and Immunology and National Clinical Research Centre for Geriatrics, West China Hospital, Sichuan University, No 37 Guoxue Road, Chengdu 610041, Sichuan, China
| | - Ying Zhong
- Department of Reproductive Immunology, Chengdu Xi'nan Gynecology Hospital, No 66 and 88 Bisheng Road, Chengdu 610066, Sichuan, China
| | - Yan Jia
- Department of Reproductive Immunology, Chengdu Xi'nan Gynecology Hospital, No 66 and 88 Bisheng Road, Chengdu 610066, Sichuan, China.
| | - Jing-Qiu Cheng
- Key Laboratory of Transplant Engineering and Immunology and National Clinical Research Centre for Geriatrics, West China Hospital, Sichuan University, No 37 Guoxue Road, Chengdu 610041, Sichuan, China.
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Lee W, Jung SW, Lim YM, Lee KJ, Lee JH. Correction to: 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; 19:1679. [PMID: 31842839 PMCID: PMC6915854 DOI: 10.1186/s12889-019-8034-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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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