Physical hazards in employment and pregnancy outcome

Prediction of pregnancy disorders in female workers in the industrial sector

Context

As female workers face a higher risk of exposure to workplace hazards than women in general, it is imperative that measures be put in place in the workplace to ensure safe and healthy pregnancies.

Objectives

This study aimed to analyze the effects of occupational hazards in the workplace environment on the potential for pregnancy disorders experienced by female workers.

Methods

This was an analytical, observational study with a case-control design. The participants were female workers who worked in industrial environments in both formal and nonformal industries. The inclusion criteria used in this study were female workers who had been or were pregnant at the time of the study, had worked in the industrial sector for at least one year, and did not smoke or consume alcohol. The samples were collected from 144 female workers. Midwives assisted in collecting data and conducting examinations of female workers. This study was conducted in Surabaya and Sidoarjo between June and December 2020. Data were analyzed descriptively, and a multivariable logistic regression test was performed. The study was conducted in accordance with the health protocols and prevention of COVID-19.

Results

The results showed that occupational hazards in the workplace environment that affect pregnancy disorders include workload (p = 0.004, OR = 28.676 (2.979-276.076); hot working environment (p = 0.014, OR = 3.077 (1.254-7.552); strong odors (p = 0.017, OR = 7.640 (1.436-40.656); shift work (p = 0.023, OR = 8.063 (1.337-48.623); irregular shift work (p = 0.018, OR = 7.371 (1.409-38.557); and night shift work (p = 0.015, OR = 11.780 (1.605-86.450).

Conclusions

Companies are expected to pay special attention to female workers regarding various workplace controls to prevent potential pregnancy-related disorders.

A Comprehensive Review on Hot Ambient Temperature and its Impacts on Adverse Pregnancy Outcomes

INTRODUCTION

High workplace/ambient temperatures have been associated with Adverse Pregnancy Outcomes (APO). Millions of women working in developing nations suffer due to the rising temperatures caused by climate change. There are few pieces of research linking occupational heat stress to APO, and fresh evidence is required.

METHODOLOGY

We used databases including PubMed, Google Scholar, and Science Direct to search for research on high ambient/workplace temperatures and their effects. Original articles, newsletters, and book chapters were examined. The literature we analysed was categorised as follows: Heat, strain, and physical activity harming both mother and fetus. After categorising the literature, it was examined to identify the major results.

RESULTS

We found a definite association between heat stress and APOs such as miscarriages, premature birth, stillbirth, low birthweight, and congenital abnormalities in 23 research articles. Our work provides important information for future research into the biological mechanisms that create APOs and various prevention measures.

CONCLUSION

Our data suggest that temperature has long-term and short-term effects on maternal and fetal health. Though small in number, this study stressed the need for bigger cohort studies in tropical developing countries to create evidence for coordinated policies to safeguard pregnant women.

A Comparative Study of Work Stress among Working Females Getting Paid and Working Women Unpaid (Housewives) During Pregnancy

Introduction

The potential impact of employment on pregnancy is an important issue as several occupational factors have been reported to be associated with adverse pregnancy outcomes through increased work stress. The current study was undertaken among pregnant women to understand the difference in pregnancy-related stress among pregnant working women getting paid (WWP) and working women unpaid (WWU) (housewives) and to assess workplace stress among working WWP.

Methods

A total of 426 study participants which included 213 participants in each group were recruited from a tertiary care hospital in Chennai. All the study participants were interviewed using an A-Z scale to understand pregnancy-related stress while WWP were also interviewed using Workplace Stress Questionnaire (WSQ).

Results

It was observed that the mean score of WWP was significantly higher than the mean scores of WWU (t = 94.63; df = 1, P = 0.000). Those WWP who were working for >8 h daily had higher scores as compared to those working for ≤8 h.

Conclusion

The study shows that the WWP had work stress in addition to background pregnancy-related stress.

Occupational Factors Affecting Women Workers’ Sexual and Reproductive Health Outcomes in Oil, Gas, and Mining Industry: A Scoping Review

Objectives: Globally, female workers workforce in Oil, Gas, and Mining (OGM) industry have increased significantly. The complexities of the OGM operations and the extensive exposure to workplace hazards potentially affect the health status of workers, including sexual and reproductive health (SRH) outcomes of female workers. Yet, the current state of knowledge on SRH issues in OGM contexts seems to be limited and fragmented. This scoping review aims to identify the occupational factors that influence women’s SRH outcomes in OGM industry.

Methods: This scoping review followed the Joanna Briggs Institute’s guidelines (PRISMA) and was conducted in five databases, including the citation chaining via Google Scholar and manual search through relevant organisations and Government websites. Sixteen articles met the inclusion criteria and were analysed.

Results: Despite the scarcity of evidence, chemical and physical are found to be the predominant factors greatly influencing women workers’ SRH outcomes in OGM. Most studies showed menstrual and cycle disorders, and risky pregnancy as key SRH issues. However, menstruation disorder was considerably linked with psychological and organisational factors.

Conclusion: This review suggests further empirical research on the relationship between OGM occupational hazards and women workers’ SRH. This will contribute to improvements in workplace safety legislations, measures, policies, and management systems taking into account women’s needs.

Victimizations and surviving of workplace violence against waitresses in southern Ethiopia

Women are obliged to take on vulnerable forms of employment that fail to protect their basic labor rights. Exposure to workplace violence is especially high for those women who work within the agriculture, the hotels, restaurants and catering, the transport as well as the manufacturing sectors. In this context, we explored workplace violence against women working as waitresses in various hotels, restaurants, cafeterias and grocery stores of Wolaita Sodo town, southern Ethiopia. Cross-sectional study was undertaken with descriptive and exploratory study designs. Qualitative data were collected by using in-depth interview method in which 16 waitresses were interviewed. Data were voice recorded, transcribed, and analyzed searching themes and patterns in the data. While we found that waitresses are highly exposed to workplace violence, the level of exposure to the violence varies across various circumstances, including working in large and small towns, the situation of the owners/supervisors, public's insight of the position, waitresses' ability to speak the local language, the role of the waitresses, customers' behavior and the specific context in which waitresses work. Waitresses were generally exposed to all forms of violence including spitting, throwing objects, simple physical assault, touching on private parts, and intimidation, among which verbal abuse and emotional exploitations are found to be the most common. Furthermore, the results revealed that though waitresses rarely experienced violence from female customers, the most common perpetrators involved in the practice were males. Amid widespread exposure of waitresses to all forms of workplace violence, ignorance, mostly motivated by fear of losing one's job, has been the common way waitresses respond to the violence. The study implies the vulnerability state of waitresses partly due to lack of adequate awareness regarding the rights and obligations expected of an employee when working in such organizations. This is again exacerbated by the lack of formal employment procedures in such organizations. Therefore, awareness creation and supervisory activities are expected from the media, workers' and social security office of the government, police and other concerned bodies.

The Determinants of Four or More Antenatal Care Visits Among Working Women in Indonesia

This study aimed to analyze the determinants of four or more antenatal care (ANC) visits among working women in Indonesia. The researchers extracted data from the Indonesian Demographic and Health Survey 2017 and obtained a sample size of 8239 working women aged between 15 and 49 years. Women’s residence, age, marital status, education level, parity, economic status, and health insurance were selected as the independent variables. Binary logistic regression was used for the analysis. Older working women, married working women, educated working women, those in higher economic status, and those with health insurance were more likely to complete four or more of their ANC visits. The more children the working women had, the less likely they would complete their ANC visits. In conclusion, age, marital status, education, parity, economic status, and health insurance are the determinants for completing ANC visits among working women in Indonesia. At the same time, place of residence does not affect the frequency of ANC visits.

Ergonomic Stressors Among Pregnant Healthcare Workers: Impact on pregnancy outcomes and recommended safety practices

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.

Stunting at birth and associated factors among newborns delivered at the University of Gondar Comprehensive Specialized Referral Hospital

Background

Stunting at birth is a chronic form of undernutrition majorly attributable to poor prenatal nutrition, which could persist in children’s later life and impact their physical and cognitive health. Although multiple studies have been conducted in Ethiopia to show the magnitude of stunting and factors, all are concentrated on children aged between 6 to 59 months. Therefore, this study was done to determine the prevalence and associated factors of stunting at birth among newborns delivered at the University of Gondar Comprehensive Specialized Referral Hospital, Northwest, Ethiopia.

Methods

An institution-based cross-sectional study was conducted from February 26^th to April 25^th/2020. A systematic random sampling technique was used, to select a total of 422 newborn-mother pairs. The binary logistic regression was employed to identify factors associated with stunting and all independent variables were entered into the multivariable logistic regression model to adjust for confounders. Variables that had significant association were identified based on p-value < 0.05 and the adjusted odds ratio with its respective 95% confidence interval was applied to determine the strength as well as the direction of the association.

Results

About 30.5% (95% CI: 26.3%, 35.1%) of newborns were stunted at birth. Being male [Adjusted odds ratio (AOR) = 2.9(1.62, 5.21)], newborns conceived in Kiremt(rainy season) [AOR = 2.7(1.49, 4.97)], being low birth weight [AOR = 3.1(1.64, 6.06)] were factors associated with stunting at birth. Likewise, newborns born to short stature mothers [AOR = 2.8(1.21, 6.62)] and chronically malnourished mothers [AOR = 15.3(8.12, 29.1)] were at greater risk of being stunted.

Conclusion

Just under a third of newborns are stunted at birth, implying a pressing public health problem. Newborns born to chronically malnourished and short stature mothers were more stunted. Besides, stunting was prevalently observed among male neonates, newborns conceived in Kiremet, and being low birth weight. Thus, policymakers and nutrition programmers should work on preventing maternal undernutrition through nutrition education to reduce the burden of low birth weight and stunting. Further, paying due attention to newborns conceived in Kiremet season to improve nutritional status is recommended.

Pregnancy disorders in female workers at the industrial area of Sidoarjo, Indonesia

Background: The number of female workers in Indonesia has increased and female workers have been discovered to be very vulnerable to several hazards and health problems in the workplace environment linked to their menstrual cycle and pregnancy. Therefore, this study was conducted to analyze risk factors associated with pregnancy disorders in female workers. Design and Methods: The research was conducted through the use of a cross-sectional design with 307 female workers using simple random sampling. Furthermore, a descriptive analysis was conducted to describe the conditions of the respondents during pregnancy to childbirth process. Results: The results showed 45% of respondents had pregnancy disorders, 16% had miscarriages, and despite the fact most of the prenatal care processes was assisted by doctors or midwives, 2.6% of the respondents consulted Traditional Birth Attendants, who were also recorded and was found to account for 2.9% of the deliveries. Moreover, the risk factors associated with pregnancy disorders include vibrations (P=0.004), irritants (P=0.002) and repetitive works (P=0.009). Conclusions: It is recommended that companies should provide maternal and child health protection and control for any risk associated with female workers.

Pregnant Women's Experiences of Social Roles: An Ethnophenomenological Study

Background:

The role of women and men is changing across the world, and women, including pregnant women, are adopting newer roles in traditional societies like Iran. This study aimed to explore the meaning of pregnant women's experiences regarding their social roles in the sociocultural context of Iran.

Materials and Methods:

This study was carried out using an ethnophenomenological approach. Participants included 16 pregnant women who attended health centers, hospitals, and private obstetric clinics in Mashhad, Iran, between 2016 and 2017 and were selected based on purposive sampling. In-depth semistructured interviews, vignette interviews, participant observations, and field notes were used to collect data. To analyze data, six-step van Manen's (1997) descriptive-interpretive phenomenological approach was used.

Results:

Through data analysis, the overarching theme of “selection, management, and adjustment of various roles to play social roles” was emerged. This was consisted of four themes: “Mother's perspective regarding out-of-home employment, incompatibility between pregnancy and social roles, mother's management strategies to play different roles, and husband's authority regarding mother's employment.”

Conclusions:

The consequence of reciprocal endeavors of pregnant women along with their husbands as well as their work environment expectations tends to selection, management, and adjustment of feminine roles. Since the employment of pregnant women leads to their more physical and psychological involvement, not only the problems of working women but also the expectations and rules of the workplaces as well as the requests of their husbands should be taken into account.

Manual handling of burdens as a predictor of birth outcome-a Finnish Birth Register Study

Background

Negative effects of manual handling of burdens on pregnancy outcomes are not elucidated in Finland. This study examines the association between perinatal outcomes and occupational exposure to manual handling of burdens.

Methods

The study cohort was identified from the Finnish Medical Birth Register (MBR, 1997-2014) and information on exposure from the Finnish job-exposure matrix (FINJEM) 1997-2009. The cohort included all singleton births of mothers who were classified as 'service and care workers' representing the exposure group (n=74 286) and 'clerks' as the reference (n=13 873). Study outcomes were preterm birth (PTB) (<37 weeks), low birthweight (LBW) (<2500 g), small for gestational age (<2.5th percentile), perinatal death (stillbirth or early neonatal death within first seven days) and eclampsia. We used logistic regression analysis to calculate odds ratio (OR) and adjusted for maternal age, marital status, BMI, parity and smoking during pregnancy.

Results

The risks of PTB [OR 1.16, 95% confidence interval (CI) 1.06-1.27], LBW (OR 1.12, 95% CI 1.01-1.25) and perinatal death (OR 1.51, 95% CI 1.09-2.09) were significantly higher among the high exposure group than in the reference group. All adverse outcomes were statistically insignificant among primiparous women except perinatal death (OR=1.95, 95% CI 1.13-3.39).

Conclusions

The study indicates that the risk of adverse pregnancy outcomes might be more common among women that are highly exposed to occupational manual handling of burdens. The results should be interpreted with caution due to the use of occupational level exposure. Further studies with information on individual level exposure and start of maternity leave are recommended.

A Liftless Intervention to Prevent Preterm Birth and Low Birthweight Among Pregnant Ghanaian Women: Protocol of a Stepped-Wedge Cluster Randomized Controlled Trial

Background

Preterm birth (PTB) is a leading cause of infant morbidity and mortality worldwide. Every year, 20 million babies are born with low birthweight (LBW), about 96% of which occur in low-income countries. Despite the associated dangers, in about 40%-50% of PTB and LBW cases, the causes remain unexplained. Existing evidence is inconclusive as to whether occupational physical activities such as heavy lifting are implicated. African women bear the transport burden of accessing basic needs for their families. Ghana’s PTB rate is 14.5%, whereas the global average is 9.6%. The proposed liftless intervention aims to decrease lifting exposure during pregnancy among Ghanaian women. We hypothesize that a reduction in heavy lifting among pregnant women in Ghana will increase gestational age and birthweight.

Objective

To investigate the effects of the liftless intervention on the incidence of PTB and LBW among pregnant Ghanaian women.

Methods

A cohort stepped-wedge cluster randomized controlled trial in 10 antenatal clinics will be carried out in Ghana. A total of 1000 pregnant participants will be recruited for a 60-week period. To be eligible, the participant should have a singleton pregnancy between 12 and 16 weeks gestation, be attending any of the 10 antenatal clinics, and be exposed to heavy lifting. All participants will receive standard antenatal care within the control phase; by random allocation, two clusters will transit into the intervention phase. The midwife-led 3-component liftless intervention consists of health education, a take-home reminder card mimicking the colors of a traffic light, and a shopping voucher. The primary outcome are gestational ages of <28, 28-32, and 33-37 weeks. The secondary outcomes are LBW (preterm LBW, term but LBW, and postterm), compliance, prevalence of low back and pelvic pain, and premature uterine contractions. Study midwives and participants will not be blinded to the treatment allocation.

Results

Permission to conduct the study at all 10 antenatal clinics has been granted by the Ghana Health Service. Application for funding to begin the trial is ongoing. Findings from the main trial are expected to be published by the end of 2019.

Conclusions

To the best of our knowledge, there has been no randomized trial of this nature in Ghana. Minimizing heavy lifting among pregnant African women can reduce the soaring rates of PTB and LBW. The findings will increase the knowledge of the prevention of PTB and LBW worldwide.

Trial Registration

Pan African Clinical Trial Register (PACTR201602001301205); http://apps.who.int/trialsearch/ Trial2.aspx?TrialID=PACTR201602001301205 (Archived by WebCite at http://www.webcitation.org/71TCYkHzu)

Registered Report Identifier

RR1-10.2196/10095

A Communicative Model of Mothers' Lifestyles During Pregnancy with Low Birth Weight Based on Social Determinants of Health: A Path Analysis

OBJECTIVES

Low birth weight (LBW) is one of the major health problems worldwide. It is important to identify the factors that play a role in the incidence of this adverse pregnancy outcome. This study aimed to develop a tool to measure mothers' lifestyles during pregnancy with a view to the effects of social determinants on health and develop a correlation model of mothers' lifestyles with LBW.

METHODS

This study was conducted using methodological and case-control designs in four stages by selecting 750 mothers with infants weighing less than 4000 g using multistage sampling. The questionnaire contained 160 items. Face, content, criterion, and construct validity were used to study the psychometrics of the instrument.

RESULTS

After psychometrics, 132 items were approved in six domains. Test results indicated the utility and the high fitness of the model and reasonable relationships adjusted for variables based on conceptual models. Based on the correlation model of lifestyle, occupation (-0.263) and social relationships (0.248) had the greatest overall effect on birth weight.

CONCLUSIONS

The review of lifestyle dimensions showed that all of the dimensions directly, indirectly, or both affected birth weight. Thus, given the importance and the role of lifestyle as a determinant affecting birth weight, attention, and training interventions are important to promote healthy lifestyles.

A Grounded Theory Study of How Nurses Integrate Pregnancy and Full-Time Employment: Becoming Someone Different

BACKGROUND

A holistic exploration of the experience of how nurses integrate pregnancy and employment is lacking among the global nursing literature.

OBJECTIVE

The purpose of this research was to explore how primiparous U.S. nurses integrated pregnancy and full-time employment.

METHODS

Using a grounded theory approach, 20 nurses from the United States, who were pregnant and delivered their first baby-while employed full time on 12-hour work shifts-provided a firsthand account of how they incorporated pregnancy with professional nursing employment.

RESULTS

The basic social process, "becoming someone different," emerged to explain how U.S. nurses integrated pregnancy and full-time employment in early and late stages. Four core categories were: (a) "looking different, feeling different,"(b) "expectations while expecting," (c) "connecting differently," and (d) "transitioning labor."

DISCUSSION

Within early and late stages, pregnant nurses becoming someone different navigate through various social interactions with peers and patients alike, with meaning assigned to those experiences. Research with pregnant nurses from other countries, nurses working in settings other than acute care, and multiparous nurses is needed to further expand on these findings.

Prenatal, perinatal and neonatal risk factors of Autism Spectrum Disorder: a comprehensive epidemiological assessment from India

Incidence of Autism Spectrum Disorder (ASD) is increasing across the globe and no data is available from India regarding the risk factors of ASD. In this regard a questionnaire based epidemiological assessment was carried out on prenatal, perinatal and neonatal risk factors of ASD across 8 cities in India. A retrospective cohort of 942 children was enrolled for the study. 471 children with ASD, under age of 10, were analyzed for pre-, peri-, and neonatal factors and were compared with the observations from equal number of controls. The quality control of the questionnaire and data collection was done thoroughly and the observations were computed statistically. A total of 25 factors were evaluated by unadjusted and adjusted analysis in this study. Among the prenatal factors considered, advanced maternal age, fetal distress and gestational respiratory infections were found to be associated with ASD and had an odds ratio of 1.8. Evaluation of perinatal and neonatal risk factors showed labor complications, pre-term birth, neonatal jaundice, delayed birth cry and birth asphyxia to be associated with ASD with an odds ratio greater than 1.5. This important study, first of its kind in Indian population gives a firsthand account of the relation of pre-, peri- and neonatal risk factors on ASD from an ethnically and socially diverse country like India, the impact of which was unknown earlier. This advocates additional focused investigations on physiological and genetic changes contributed by these risk factor inducing environments.