Occupation and lower urinary tract symptoms in women: A rapid review and meta‐analysis from the PLUS research consortium

Abstract

Aims: Chronic, infrequent voiding may be a risk factor for lower urinary tract symptoms (LUTS) in women. To inform this hypothesis, we conducted a rapid literature review and meta-analysis of LUTS by occupation as an indirect measure of infrequent voiding behaviors. Methods: Two independent medical librarians searched Pubmed.gov studies (1990–2017) on adult women for occupations, industries, and workplace environment and LUTS outcomes: overactive bladder (OAB), urinary incontinence (UI), urinary tract infections (UTIs), and individual voiding and storage LUTS. Two authors reviewed full text articles meeting content criteria. Among studies with similar UI definitions, we estimated the prevalence of monthly UI using a random effects meta-analysis model. Results: Of 1078 unique citations identified, 113 underwent full article review and 33 met inclusion criteria. Twenty-six of these studies examined specific occupation groups, including nurses/midwives (n = 6 studies), healthcare workers/support staff (n = 6), military personnel (n = 3), teachers (n = 3), and other groups (n = 7), whereas eight compared findings across broad occupation groups. UI was reported in 30 studies (23% using validated measures), OAB in 6 (50% validated), and UTIs in 2 (non-validated). In pooled models, the degree of heterogeneity was too high (I2 = 96.9–99.2%) among the studies to perform valid prevalence estimates for LUTS. Conclusions: Current literature limits the ability to evaluate LUTS by occupation types. Future studies should characterize voiding frequency and toilet access in a consistent manner by occupation and explore its relation to LUTS development.

Toileting Behaviors and Bladder Symptoms in Women Who Limit Restroom Use at Work: A Cross-Sectional Study

“…A central tenet of current understanding of bladder dysfunction is that certain occupations have higher risks for developing LUTS. 1,2 Conceptually this occurs through adoption of unhealthy bladder habits or toilet behaviors, such as infrequent voiding, urine holding, or suppression of normal sensory driven behaviors, in response to workplace environments or policies that limit restroom accessibility. 2 These habits or behaviors then subsequently contribute to the development of LUTS.…”

Is the juice worth the squeeze? Transdisciplinary team science in bladder health

“…PLUS investigators recognized the need for upfront time to develop a positive transdisciplinary culture, and that this would likely delay short‐term productivity when judged by traditional metrics (eg, publications, presentations, and abstracts at national meetings). These short‐term delays have already been offset by progress with conceptual work and research that promises a significant health impact, including 11 peer‐reviewed papers, 1,9,10,15‐22 26 peer‐reviewed abstracts, 23‐47 and 15 invited presentations to date. PLUS has formalized key strategic initiatives informed by the shared language, critical awareness, and transdisciplinary orientation developed over the past 4 years.…”

“…There is evidence that the PLUS Consortium is maturing as a transdisciplinary team. Products include a strong conceptual framework, 10 a clear working definition of bladder health, 9 insights from the PLUS consortium qualitative study, 15‐17,26 completed literature reviews, 21 development of items to measure bladder health and protocols to validate the instrument (not yet published), submitted and planned manuscripts, completed academic presentations, ongoing foundational studies, and a solidified commitment to community engagement.…”

A Bayesian multivariate meta‐analysis of prevalence data

“…Recently, members of the Prevention of Lower Urinary Tract Symptoms Research Consortium 31 conducted a rapid review of studies reporting lower urinary tract symptoms in women in suspected high risk working environments 32 . Of the studies collected, 26 report the overall number of women in the study as well as the number experiencing any form of urinary incontinence (UI).…”

“…In addition, many studies provide data on two subtypes of UI: stress urinary incontinence (SUI), and urgency urinary incontinence (UUI). We present the data in Table W.1, which was not included in the original article by Markland et al 32 Let y i 0 , y i 1 , and y i 2 denote the number of women experiencing any UI, SUI, and UUI in study i , respectively, and let n i denote the total number of women in each study. While all studies provide counts for the total number of women experiencing any UI, many studies do not report one or both subtype counts.…”