Occupational exposure to whole-body vibrations and pregnancy complications: a nationwide cohort study in Sweden

Abstract

ObjectivesPregnancy complications are common contributors to perinatal mortality and morbidity. Still, the cause(s) of gestational hypertensive disorders and diabetes are largely unknown. Some occupational exposures have been inconsistently associated with pregnancy complications, but exposure to whole-body vibrations (WBV) has been largely overlooked even though it has been associated with adverse birth outcomes. Therefore, the aim was to assess whether occupational WBV exposure during pregnancy is associated with pregnancy complications in a nationwide, prospective cohort study.MethodsThe Fetal Air Pollution Exposure cohort was formed by merging multiple Swedish, national registers containing information on occupation during pregnancy and diagnosis codes, and includes all working women who gave birth between 1994 and 2014 (n=1 091 044). WBV exposure was derived from a job-exposure matrix and was divided into categories (0, 0.1–0.2, 0.3–0.4 and ≥0.5 m/s2). ORs with 95% CIs were calculated using logistic regression adjusted for potential confounders.ResultsAmong women working full time (n=646 490), we found increased risks of all pregnancy complications in the highest exposure group (≥0.5 m/s2), compared with the lowest. The adjusted ORs were 1.76 (95% CI 1.41 to 2.20), 1.55 (95% CI 1.26 to 1.91) and 1.62 (95% CI 1.07 to 2.46) for preeclampsia, gestational hypertension and gestational diabetes, respectively, and were similar in all sensitivity analyses. There were no clear associations for part-time workers.ConclusionsThe results suggest that women should not be exposed to WBV at/above the action limit value of 0.5 m/s2 (European directive) continuously through pregnancy. However, these results need further confirmation.

Occupational Risk Factors and Hypertensive Disorders in Pregnancy: A Systematic Review

“…As noise exposures in occupational settings are very different in their features, further research is necessary to define a possible dose-response relationship, specific molecular mechanisms of action and to deeply investigate the complex interplay between noise characteristics, in terms of i.e., type, intensity and duration of exposure, and individual characteristics of women, i.e., age of the pregnant women, anthropometric parameters and pregnancy periods of exposure, as well as collective and individual protective measures adopted in the workplace in influencing HDP onset [49,51]. No sufficient information is currently available on the role of extreme temperature and vibration exposure in determining HDP, with only one study showing a statistical association between exposure to WBV and the risk of HDP [53].…”

“…Haelterman et al [35] and Irwin et al [47] showed no association between extreme temperatures and HDP. Only two studies analyzed the association between exposure to WBV and HDP risk in women [35,53]. Haelterman et al [35] found that WBV slightly raised, although not significantly, the risk of PE (aOR 1.2).…”

“…Haelterman et al [35] found that WBV slightly raised, although not significantly, the risk of PE (aOR 1.2). More recently, Skröder et al [53], derived WBV exposure from a job-exposure matrix and divided the levels of exposure into four categories (0, 0.1-0.2, 0.3-0.4 and ≥0.5 m/s 2 ). The authors found a significant increased risk for both PE (aOR 1.76; 95% CI 1.41 to 2.20) and GH (aOR 1.55) in full time working women exposed to the highest WBV levels, while low (0.1-0.2 m/s 2 ) or medium (0.3-0.4 m/s 2 ) levels were not associated with a significantly increased risk of any outcome.…”

Applying the exposome concept to working life health

“…12 In addition, although over the last decades female participation in the workforce has risen, work-related risks to women’s health are less studied. 13 For instance, even studies of occupational risks for pregnant women have focused on fetal effects for decades, but recent studies also suggest an increased risk of pregnancy-related health effects in women exposed to physical risk factors like noise and vibration. 14,15 Lastly, insights into informative biological pathways and biomarkers to link exposure to health are mostly lacking.…”

“… 13 For instance, even studies of occupational risks for pregnant women have focused on fetal effects for decades, but recent studies also suggest an increased risk of pregnancy-related health effects in women exposed to physical risk factors like noise and vibration. 14 , 15 Lastly, insights into informative biological pathways and biomarkers to link exposure to health are mostly lacking. These could contribute to the quantitative understanding of exposure-response associations and provide agnostic discovery of biomarkers for exposure monitoring.…”