Female nurses have a higher prevalence of urinary tract symptoms and infection than other occupations in dialysis units

Abstract

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.

Occupational risk factors associated with lower urinary tract symptoms among female workers: a systematic review

“…The included studies were all written in English and published between 1999 and 2022. Among the included studies, four were conducted in the USA,14–17 four in China,7 8 18 19 one in Taipei,9 one in India,20 one in Portugal,10 one in Korea,21 one in Turkey,22 one in Chile,23one in Brazil24 and one in Iran 25. All studies had a cross-sectional design.…”

“…Thirteen of the 16 studies only included female participants with or without LUTS, while three studies included mixed-sex participants 8 18 25. The occupations of the participants were as follows: air force active-duty women,14 elementary schoolteachers,9 healthcare workers including nurses,7 16 18 19 22 24 25 secretaries22 and the general working population 7 8 10 15 17 20 21 23. The most frequently studied occupation was healthcare workers.…”

“…The outcome variables investigated were LUTS,7 9 17 20 22 25 UI10 14 23 and OAB 8 16 18 19. The occupational risk factors identified in the studies were physical demand and activity, prolonged sitting,20 occupational stress,9 18 19 shift work,25 limited use of the toilet at work9 17 22 24 and other occupational environments.…”

“…Approximately 11% of the 3062 women in the final analytical sample responded that they used the toilet only sometimes or never at work, and it was associated with urgency (AOR=1.39, 95% CI=1.04 to 1.86), stress incontinence (AOR=1.33, 95% CI=1.01 to 1.76) and UI (AOR=1.52, 95% CI=1.18 to 1.94). In an online survey conducted at five nephrology centres in Brazil, 66 nurses and 67 controls were compared 24. The nurses were assigned in the dialysis rooms, and the toilets and water supplies were available outside of the dialysis rooms.…”