Working conditions and absence from work during pregnancy in a cohort of healthcare workers

Abstract

ObjectivesTo assess the relationship between exposure to occupational risk factors during pregnancy and absence from work using two different social benefits.MethodThree working pregnancy trajectories (WPT) were identified in a cohort of 428 pregnant workers from a healthcare institution (period 2010–2014), based on absence days and using cluster analysis. WPT1 included absences mainly covered by sickness absence benefit (32.0% of women), WPT2 included absences covered by pregnancy occupational risk (POR) benefit (28.3%) and WPT3 were pregnant workers with few absences (39.9%). Exposure to occupational risk factors was assessed by experts and association with trajectories was analysed using logistic regression. Relative risks (RR) and their 95% CIs were adjusted for age, type of contract and shift work.ResultsWPT2 was associated with exposure to physical (RR=1.86, 95%CI 1.17 to 2.97), safety (RR=2.10, 95%CI 1.61 to 2.73), ergonomic (RR=2.52, 95%CI 1.89 to 3.36) and psychosocial (RR=1.79, 95%CI 1.31 to 2.46) factors, and with exposure level. For physicians, WPT1 was associated with safety risks (RR=3.13, 95%CI 1.22 to 7.99), WPT2 with chemical and ergonomic for administrative/technical support (RR=12.20, 95%CI 1.69 to 88.09; RR=14.09, 95%CI 1.34 to 148.61, respectively), with safety and ergonomic risks for nursing aides (RR=1.84, 95%CI 1.12 to 3.02; RR=3.94, 95% CI 2.38 to 6.53, respectively), and with physical (RR=1.72, 95%CI 1.04 to 2.86), safety (RR=2.21, 95%CI 1.62 to 3.03), ergonomic (RR=2.02, 95%CI 1.44 to 2.86) and psychosocial factors (RR=1.96, 95%CI 1.32 to 2.90) for nurses.ConclusionsAbsences from work covered by POR benefit show a consistent relationship with exposure to occupational risks. Sickness absence is the most frequent benefit used by pregnant workers. Current social benefits are apparently used adequately for protecting women from occupational exposures. Future studies are needed to clarify this further.

Pregnancy and working conditions in the hospital sector: a scoping review

“… 17 The causes of long-term sick leave (> 20 days, continuous or intermittent) can be multiparity, 37 low back pain before pregnancy, and illness or mental disorder, 27 , 42 not necessarily related to working conditions. 17 , 26 …”

“…From the third trimester onwards, occupational risk-benefits tend to be used by pregnant workers under high exposure to ergonomic, safety, hygiene, and psychosocial occupational risk factors. 26 , 42 …”

“…The most significant barrier to the effectiveness of measures appears to be the delay between their conception and implementation. In many countries, preventive leave or sick leave is preferred at the expense of adaptations in the workplace or reassignment of workers to other sectors, 26 , 24 , 21 showing inefficient implementation of maternity protection legislation or its inexistence. 49 …”

Sickness absence, medical and workplace conditions during pregnancy in a cohort of healthcare workers

“…Risks were classified into trivial, tolerable, moderate, substantial or intolerable, taking into account the probability of exposure and its potential consequences on health (30) . The methodology applied in this study reproduces the one used in a previously published work over the same cohort (31) . These risk categories were grouped into a dichotomous variable (yes/no), being "yes" when the risk assessment report had qualified them as substantial or intolerable, and "no" for moderate, tolerable or trivial.…”

Establishing a health-based recommended occupational exposure limit for nitrous oxide using experimental animal data – A systematic review protocol

“…In a sub-analysis of six high quality studies, the RR increased to 1.90 (95% CI 1.72-2.09). A clear limitation of these studies is that other concurrent potential risk factors for spontaneous abortion were not considered, such as exposure to cytostatic drugs, physical strains, and mental stress (Lee et al, 2010;Ladeira et al, 2014;Villar et al, 2019). After the review by Boivin in 1997, Peelen et al (1999, reported on a study among nurses working in hospitals in The Netherlands.…”