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Wilkins, David E.; Shemmings, David; Shemmings, Yvonne

doi:10.1057/978-1-137-00827-5_16

Cited by 3 publications

(3 citation statements)

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“…Demographic characteristics were ascertained for physicians and nonphysicians at age 15 years and included residential income quintile, era of cohort entry (1995-2006, 2007-2018), immigration status (immigrant, Canadian-born), comorbidities (0, 1-5, 6-9, ≥10), and previous live births (0, 1, ≥2). Residential income quintile is an area-level measure of socioeconomic status derived from Canadian census data on the median reported income for the neighborhood where individuals live . Comorbidities were categorized into Aggregated Diagnosis Groups on the basis of clinical similarity, chronicity, disability, and likelihood of requiring specialty care, using the Johns Hopkins ACG System, version 10 (Johns Hopkins Healthcare Solutions) (eTable 2 in Supplement 2).…”

Section: Methodsmentioning

confidence: 99%

Delay of Pregnancy Among Physicians vs Nonphysicians

et al. 2021

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IMPORTANCE Women physicians may delay childbearing and experience childlessness more often than nonphysicians, but existing knowledge is based largely on self-reported survey data.OBJECTIVE To compare patterns of childbirth between physicians and nonphysicians. DESIGN, SETTING, AND PARTICIPANTS Population-based retrospective cohort study of reproductive-aged women (15-50 years) in Ontario, Canada, accrued from January 1, 1995, to November 28, 2018, and observed to March 31, 2019. Outcomes of 5238 licensed physicians of the College of Physicians and Surgeons of Ontario were compared with those of 26 640 nonphysicians (sampled in a 1:5 ratio). Physicians and nonphysicians were observed from age 15 years onward. EXPOSURES Physicians vs nonphysicians. MAIN OUTCOMES AND MEASURESThe primary outcome was childbirth at gestational age of 20 weeks or greater. Cox proportional hazards models were used to examine the association between physician status and childbirth, overall and across career stage (postgraduate training vs independent practice) and specialty (family physicians vs specialists).RESULTS All physicians (n = 5238) and nonphysicians (n = 26 640) were aged 15 years at baseline, and 28 486 (89.1%) were Canadian-born. Median follow-up was 15.2 (interquartile range, 12.2-18.2) years after age 15 years. Physicians were less likely to experience childbirth at younger ages (hazard ratio [HR] for childbirth at 15-28 years, 0.15; 95% CI, 0.14-0.18; P < .001) and initiated childbearing significantly later than nonphysicians; the cumulative incidence of childbirth was 5% at 28.6 years in physicians and 19.4 years in nonphysicians. However, physicians were more likely to experience childbirth at older ages (HR for 29-36 years, 1.35; 95% CI, 1.28-1.43; P < .001; HR for Ն37 years, 2.62; 95% CI, 2.00-3.43; P < .001), and ultimately achieved a similar cumulative probability of childbirth as nonphysicians overall. Median age at first childbirth was 32 years in physicians and 27 years in nonphysicians (P < .001). After stratifying by specialty, the cumulative incidence of childbirth was higher in family physicians than in both surgical and nonsurgical specialists at all observed ages. CONCLUSIONS AND RELEVANCEThe findings of this cohort study suggest that women physicians appear to delay childbearing compared with nonphysicians, and this phenomenon is most pronounced among specialists. Physicians ultimately appear to catch up to nonphysicians by initiating reproduction at older ages and may be at increased risk of resulting adverse reproductive outcomes. System-level interventions should be considered to support women physicians who wish to have children at all career stages.

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Section: Methodsmentioning

confidence: 99%

Delay of Pregnancy Among Physicians vs Nonphysicians

et al. 2021

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“…This disparity resulted in the explosion of the reaction mixture causing personnel injuries. Thus, because of this lack of risk assessment, as well as other broader managerial deficiencies, the CSB determined that the physical hazards in the laboratory could have been better managed through effective hazard evaluation guidance, research-specific risk training, and the presence of formal documentation such as standard operating procedures (SOPs). , Furthermore, on revisiting the lessons learned from some of the other recent academic laboratory safety incidents, − we observed that these incidents could have been prevented if a more thorough hazard evaluation process was undertaken. Moreover, the CSB case study mentioned that there seem to exist different levels of hazard evaluation between industry and academic laboratories and have called for a guidance on hazard evaluation methodologies within academic laboratories. , …”

Section: Introductionmentioning

confidence: 94%

Promoting a Safe Laboratory Environment Using the Reactive Hazard Evaluation and Analysis Compilation Tool

Talpade

Ghanekar

Ezenwa

et al. 2021

ACS Chem. Health Saf.

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In the past several years, the U.S. Chemical Safety Board has found an increase in the frequency of laboratory accidents and injuries. An independent survey of industrial and academic laboratories by the authors indicated the shortage of documentation on best practices and lack of free and user-friendly risk assessment tools to be some of the key reasons for the occurrence of safety incidents. Thus, development of a framework to document, assess, and mitigate hazards is a critical starting point for ensuring safe laboratory practices. To address this requirement, Reactive Hazards Evaluation Analysis and Compilation Tool (RHEACT), an online platform to compile and scrutinize hazards-related information, was developed. When planning an experiment, the researchers provide RHEACT: (1) information about the chemicals involved in the reaction, in the form of Safety Data Sheets (SDS), and (2) operating parameters of the reaction. Through the user-supplied SDS, an operational hazard matrix and a chemical compatibility matrix are generated. In addition, adiabatic temperature rise of the reaction is estimated to ensure that the chemistry is within user-controlled bounds. The user is provided with a broad initial evaluation of potential hazards and is notified of safety concerns associated with the reaction before conducting the experiment. We believe that this user-friendly online tool will help engender a safer laboratory working environment.

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“…We included all women aged 20 to 50 years in Ontario, Canada, who had a live birth or stillbirth at 20 or more weeks’ gestation from April 1, 2002, to November 26, 2018. We excluded women who were not eligible for the Ontario Health Insurance Plan or women whose Ontario Health Insurance Plan coverage was interrupted during pregnancy to allow complete ascertainment of obstetric outcomes, and we excluded women residing in rural areas because neighborhood-level income quintile (a socioeconomic index routinely used in Ontario owing to a lack of individual-level data) is inaccurate in rural areas . To create an appropriate comparison group and limit confounding due to socioeconomic status, we only included nonphysicians living in the highest-income quintile level (Figure).…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Adverse Pregnancy Outcomes in Physicians Compared With Nonphysicians

et al. 2022

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Key Points Question Are physicians at an increased risk of adverse pregnancy outcomes compared with nonphysicians? Findings In this cohort study of 10 489 births in 6161 physicians, there was an increased risk of severe maternal morbidity among physicians compared with high-income nonphysicians; however, this association was not found after adjustment for maternal age and other clinical factors. No difference in adverse outcome was observed when comparing physician specialty groups. Meaning The findings of this study suggest that observed associations between physician occupation and pregnancy complications are likely mediated by advanced maternal age rather than the nature of the occupation.

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Cited by 3 publications

References 0 publications

Delay of Pregnancy Among Physicians vs Nonphysicians

Delay of Pregnancy Among Physicians vs Nonphysicians

Promoting a Safe Laboratory Environment Using the Reactive Hazard Evaluation and Analysis Compilation Tool

Evaluation of Adverse Pregnancy Outcomes in Physicians Compared With Nonphysicians

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