Introduction: Urinary tract symptoms and infection have been associated with occupational factors that impact hydration habits particularly in women. We compared self-reported urinary symptoms and infection and hydration habits between nurses and other occupations in dialysis units. Methods: Cross-sectional study. Participants worked in five nephrology centers in Brazil and answered an online questionnaire comprising questions regarding urinary tract symptoms and infection episodes in the preceding year; data on usual daily beverage intake, urine frequency, and urine color according to a urine color chart were also collected, as well as perceptions of water access and toilet adequacy at work. Results: We included 133 women (age=36.9±9.5 years). The self-reported usual daily beverage intake was 6.6±2.9 cups/day (~1320 mL), daily urine frequency was 5.4±2.1, and urine color chart score: 3.0±1.2. Nurses (N=66/49.6%) reported higher prevalence of burning sensation (50 versus 27%; P<0.001), urinary urgency (42 versus 21%; P<0.001), and infection (42% versus 25%; P=0.04) as well as lower liquid intake (6.0±2.6 versus 7.3±3.0 cups/day; P=0.01) than controls. Forty four percent of nurses reported being able to drink when thirsty "always" and "most of the time" versus 93% of the control group. Conclusion: Dialysis female nurses reported lower beverage intake and higher prevalence of symptoms and infection than other occupations in the same environment. Interventions to improve hydration can potentially decrease urinary problems in this population.

Background and Aims Hydration and toilet behavior at work are associated with urinary tract symptoms (UTs) and infection (UTI) in women. We aimed to evaluate the association between self-reported hydration habits, water access and toilet adequacy at work with UTs and UTI in female workers from five dialysis clinics in Southern Brazil. Method All women employed were invited (n=258), and 69.4% (n=179) agreed to participate. For this analysis, we included female workers employed for at least 12 months who were not pregnant or breastfeeding in the last year. Weekly work shift varied from 30 to 42 hours, divided into five or six weekdays. Participants answered an online questionnaire comprising questions regarding UTs (burning feeling; frequent or intense urge to urinate; bloody urine; lower abdomen pain) and UTI episodes in the last year; usual daily beverage intake, usual urine frequency and color according to urine color chart; water access and toilet adequacy perception at work. Workers were divided into two groups according to the employee permission in having a water bottle (WB) at the workplace. Administrative and multidisciplinary staff are allowed (WB group) and nurse staff can not have (non-WB group) due to infection control regulation in dialysis rooms. Results We included 133 women (age=36.9±9.5 years old). Self-reported usual daily beverage intake= 6.6±2.9 cups/day (∼1320 ml); daily urine frequency= 5.1±2.1; urine color chart score= 3.0±1.2. At least one UTs was reported by 53% (n=70) and UTI episode by 34% (n=45) in the last year. Participants with UTs had a lower urine frequency (4.7±2.3 versus 5.5±1.7 times/day; P=0.03) and a higher urine color score (3.3±1.2 versus 2.6±1.1;P=0.002). Non-WB workers (N=66/49.6%) reported a lower beverage intake (6.0±2.6 versus 7.3±3.0 cups/day;P=0.01), had a higher prevalence of UTs (65% versus 45%; P=0.02) and UTI (42% versus 25%; P=0.04). Among non-WB participants, 47% considered that the distance to water supply from the workplace spot impairs adequate hydration, and 39% answered that the number of toilets available also as a barrier. A higher prevalence of UTs was reported by these subgroups that perceived environment infrastructure barriers (77% versus 54%; P=0.04 and 92% versus 47%; P&lt;0.001, respectively). Non-WB who responded that toilet hygiene impairs hydration (11%) had a higher prevalence of UTI (86% versus 37%; P=0.03). No significant association between work environment perception and urinary problems was found in the WB group. Conclusion Lower urine frequency and darker urine color were associated with UTs in this population. Workers who do not have a water bottle at the workplace reported a lower beverage intake, higher UTs and UTI prevalence. Non-WB participants that perceived work barriers to adequate hydration had a higher prevalence of urinary problems.