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MacDonald LA, Johnson CY, Lu ML, Santiago-Colón A, Adam GP, Kimmel HJ, Napolitano PG, Saldanha IJ. Physical job demands in pregnancy and associated musculoskeletal health and employment outcomes: a systematic review. Am J Obstet Gynecol 2024; 230:583-599.e16. [PMID: 38109950 PMCID: PMC11139607 DOI: 10.1016/j.ajog.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/12/2023] [Accepted: 12/12/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVE A decline in musculoskeletal health during pregnancy is an underappreciated adverse outcome of pregnancy that can have immediate and long-term health consequences. High physical job demands are known risk factors for nontraumatic musculoskeletal disorders in the general working population. Evidence from meta-analyses suggest that occupational lifting and prolonged standing during pregnancy may increase risk of adverse pregnancy outcomes. This systematic review examined associations between occupational lifting or postural load in pregnancy and associated musculoskeletal disorders and related sequalae. DATA SOURCES Five electronic databases (Medline, Embase, CINAHL, NIOSHTIC-2, and Ergonomic Abstracts) were searched from 1990 to July 2022 for studies in any language. A Web of Science snowball search was performed in December 2022. Reference lists were manually reviewed. STUDY ELIGIBILITY CRITERIA Eligible studies reported associations between occupational lifting or postural load and musculoskeletal health or sequelae (eg, employment outcomes) among pregnant and postpartum workers. METHODS Data were extracted using a customized form to document study and sample characteristics; and details of exposures, outcomes, covariates, and analyses. Investigators independently assessed study quality for 7 risk-of-bias domains and overall utility, with discrepant ratings resolved through discussion. A narrative synthesis was conducted due to heterogeneity. RESULTS Sixteen studies (11 cohort studies, 2 nested case-control studies, and 3 cross-sectional studies) from 8 countries were included (N=142,320 pregnant and N=1744 postpartum workers). Limited but consistent evidence with variable quality ratings, ranging from critical concern to high, suggests that pregnant workers exposed to heavy lifting (usually defined as ≥22 lbs or ≥10 kg) may be at increased risk of functionally limiting pelvic girdle pain and antenatal leave. Moreover, reports of dose-response relationships suggest graded risk levels according to lifting frequency, ranging from 21% to 45% for pelvic girdle pain and 58% to 202% for antenatal leave. Limited but consistent evidence also suggests that postural load increases the risk of employment cessation. CONCLUSION Limited but consistent evidence suggests that pregnant workers exposed to heavy lifting and postural load are at increased risk of pelvic girdle pain and employment cessation. Job accommodations to reduce exposure levels may promote safe sustainable employment for pregnant workers.
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Affiliation(s)
- Leslie A MacDonald
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Cincinnati, OH.
| | - Candice Y Johnson
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Cincinnati, OH; Division of Occupational and Environmental Medicine, Department of Family Medicine and Community Health, Duke University, Durham, NC
| | - Ming-Lun Lu
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Cincinnati, OH
| | - Albeliz Santiago-Colón
- World Trade Center Health Program, National Institute for Occupational Safety and Health, Cincinnati, OH
| | - Gaelen P Adam
- Center for Evidence Synthesis in Health, Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI
| | | | - Peter G Napolitano
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA
| | - Ian J Saldanha
- Center for Evidence Synthesis in Health, Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI; Center for Clinical Trials and Evidence Synthesis, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Lauridsen J, Hansen ML, Begtrup LM, Momsen AMH, Pedersen P, Thulstrup AM, Maimburg RD. Hospital managers' perspectives on pregnancy policy and work adjustments: A cross-sectional study. Work 2024:WOR230458. [PMID: 38669504 DOI: 10.3233/wor-230458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Risk assessment and work adjustment according to EU legislation may safeguard pregnant employees and their offspring. Knowledge on management perspectives in relation to implementation of protective measures is limited. OBJECTIVES The primary aim was to describe Danish hospital managers' engagement in pregnancy policy and work adjustment for pregnant employees. The secondary aim was to investigate how managers' characteristics and the setting affect engagement and behaviour. METHODS This was a cross-sectional study of survey data from 212 managers. Outcomes were within dimensions of health promotion, pregnancy policy, work adjustment, collaboration, manager support, and sick leave. Logistic and ordinal logistic regression models were applied to identify associations between background information and outcomes. RESULTS Of the managers included, 84% arranged meetings and 76% conducted occupational risk assessment. Most managers (96%) engaged in dialogue with the employees before sick leave. Most managers felt competent in providing guidance for pregnant employees and 99% considered work adjustment important, mainly to safeguard mothers and children. The self-reported data showed positive associations between female managers and feeling competent to guide the employee. Further, management training was associated with meetings with pregnant employees. Seniority was associated with feeling competent to guide and dialogue. Midwifery support was associated with competence in guiding employees about risk factors. CONCLUSION Work adjustment and risk assessment for pregnant employees are considered a priority by Danish hospital managers. Overall, managers feel competent guiding pregnant employees. However, managers experience midwifery support beneficial for the guidance of pregnant employees.
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Affiliation(s)
- Jane Lauridsen
- Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Mette Lausten Hansen
- Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Pernille Pedersen
- DEFACTUM, Social & Health Services and Labour Market, Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Ane Marie Thulstrup
- Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Rikke Damkjær Maimburg
- Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- University College of Northern Denmark, Denmark
- School of Nursing and Midwifery, Western Sydney University, Sydney, NSW, Australia
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Moschetti K, Brunner L, Abderhalden-Zellweger A, Probst I, Renteria SC, Vonlanthen J, Krief P. Predictors of the return to work for pregnant employees on preventive leave: Patients from an occupational medicine consultation in Switzerland. PLoS One 2024; 19:e0300686. [PMID: 38517845 PMCID: PMC10959330 DOI: 10.1371/journal.pone.0300686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 03/02/2024] [Indexed: 03/24/2024] Open
Abstract
According to the Swiss legislation on maternity protection in the workplace (OProMa), if pregnant workers are exposed to occupational hazards and no protective measures are taken, a gynecologist will prescribe a certificate of preventive leave and the women must stop working. Returning to work is only possible if job adjustments are made. This study aims to evaluate the burden of absences on companies and to examine the predictors of the return to work for pregnant workers on preventive leave, by examining both the probability of return to work and the time required to return to work. The study sample includes data on 258 workplaces of pregnant workers on preventive leave, collected during an occupational medicine consultation aimed at supporting the implementation of the OProMa. Information is available on the worker (age, date of consultation), the hazards to which she is exposed, the company's knowledge of the OProMa and whether a risk analysis exists. Descriptive statistics and multivariate regression analysis are carried out. In 58% of the workplaces, it was not possible to return to work before the end of the pregnancy. This corresponds to an average absence of 4.5 months. In 42% of the workplaces, a return to work was possible thanks to workplace adaptations. A conforming risk analysis and a full knowledge of the OProMa for companies, and an early visit to the occupational medicine consultation for workers are good predictors of the likelihood of returning to work. Younger age and exposure to certain types of risks are factors that influence the duration of preventive leave. The implementation of OProMa in Switzerland poses serious challenges, but early identification of occupational hazards and practices that anticipate compliance with the law in the company increase the return to work in safety for pregnant workers.
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Affiliation(s)
- Karine Moschetti
- Center for Primary Care and Public Health (Unisanté), Department of Epidemiology and Health Systems (DESS), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Loïc Brunner
- Center for Primary Care and Public Health (Unisanté), Department of Epidemiology and Health Systems (DESS), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Alessia Abderhalden-Zellweger
- Center for Primary Care and Public Health (Unisanté), Department of Health, Work and Environment (DSTE), University of Lausanne (UNIL), Lausanne, Switzerland
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Isabelle Probst
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Saira-Christine Renteria
- Centre Hospitalier Universitaire Vaudois, (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Julien Vonlanthen
- Center for Primary Care and Public Health (Unisanté), Department of Health, Work and Environment (DSTE), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Peggy Krief
- Center for Primary Care and Public Health (Unisanté), Department of Health, Work and Environment (DSTE), University of Lausanne (UNIL), Lausanne, Switzerland
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Wada A, Nakamura Y, Kawajiri M, Takeishi Y, Yoshida M, Yoshizawa T. Feasibility and Usability of the Job Adjustment Mobile App for Pregnant Women: Longitudinal Observational Study. JMIR Form Res 2023; 7:e48637. [PMID: 37962945 PMCID: PMC10685280 DOI: 10.2196/48637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Working pregnant women often need to adjust their physically demanding jobs for a healthy pregnancy. However, uncertainty about the extent of these adjustments can hinder their effectiveness. To address this, we developed the Job Adjustment mobile app, which allows users to input job and health details to generate a variety of personalized action plans. As this is the first version of the app, assessing its feasibility and usability is crucial. OBJECTIVE This study aims to verify the feasibility and usability of the Job Adjustment mobile app. METHODS A longitudinal observational study was conducted on pregnant Japanese women who were allowed to use the app anytime from 12 to 34 weeks of gestation; they received reminder emails every 2 weeks encouraging app use. A questionnaire was administered before app use and at 20 and 32 weeks of gestation. Feasibility was evaluated across 4 domains: implementation, demand, acceptability, and adverse events. Implementation was evaluated based on 3 parameters: dropout rate, initial reminder email receipt rate, and adherence rate (measured as pregnant women who used the app at intervals of 2.5 weeks or less). Demand was measured by intervals between use and intervals between log-in, and participants answered 15 questions to assess acceptability. Adverse events were assessed by analyzing the degree of anxiety related to work. Demographic data were analyzed to determine any statistically significant differences in intervals between uses. Usability was evaluated using the System Usability Scale. RESULTS The analysis included 66 pregnant women, and 61% (n=40) of them were multipara. The dropout rate, adherence rate, and initial reminder email receipt rate were 18% (13/71), 44% (29/66), and 79% (52/66) respectively. The median intervals between use and intervals between log-in were 2.94 (IQR 2.00-5.13) weeks and 2.28 (IQR 1.81-4.00) weeks, respectively. Overall, 60% (35/58) to 90% (52/58) of the participants responded positively to all 15 questions assessing acceptability, and no anxiety regarding work was recorded. The mean System Usability Scale score was 66.1 points. Multipara women had significantly longer intervals between app use compared to primipara women (P=.01). CONCLUSIONS The results demonstrated acceptable levels of feasibility and usability of the app. However, the low adherence rates, especially among multipara women, suggest the need for modifications to reduce the time burden of the app. Further research should explore more effective and acceptable intervals between use and timing, involving a larger sample and accounting for diverse characteristics of pregnant women. TRIAL REGISTRATION UMIN Clinical Trials Registry UMIN000042943; https://tinyurl.com/ydrchfas.
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Affiliation(s)
- Aya Wada
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Hachioji, Tokyo, Japan
| | - Yasuka Nakamura
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Maiko Kawajiri
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Yoko Takeishi
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Mikako Yoshida
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Toyoko Yoshizawa
- Health Sciences Department of Nursing, Kansai University of International Studies, Miki, Hyogo, Japan
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Henrotin JB, Gulisano F. Sick leave during pregnancy and occupational factors: a systematic review. Occup Med (Lond) 2022; 72:550-558. [PMID: 36250790 DOI: 10.1093/occmed/kqac090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The reported prevalence of sick leave (SL) during pregnancy is high among European pregnant workers (PW). The causes of SL during pregnancy are complex, and further research is necessary to explain their occurrence. AIMS Summarize the evidence for an association between occupational risks for pregnancy and SL. METHODS A systematic review was conducted by two independent reviewers using PRISMA guidelines. Two databases (Pubmed, Embase) were interrogated between January 1990 and November 2021. The search question integrated key terms according to the PICOS acronym (free terms, MeSH, EMTREE). The quality of the selected studies was assessed according to the Methodological Index for Non-randomized Studies score. RESULTS This review assessed 11 epidemiological studies. Overall, the mean Methodological Index for Non-Randomized Studies score was 11, indicating moderate study quality. The results of the limited number of studies showed limited evidence for associations between psychosocial and physical work-related risk factors and the occurrence of SL among PW. However, this assessment was strengthened by the observation in several studies of a dose-response relationship between the number of occupational risks during pregnancy and SL. CONCLUSIONS The analysis of this review implicates PW'S exposure to occupational risks in the occurrence of SL. However, the few studies that support this conclusion have provided weak evidence; thus, further research is necessary.
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Affiliation(s)
- J B Henrotin
- Medical inspection service, Regional Management of Labor, 21 Boulevard Voltaire, Dijon, 21011, France
| | - F Gulisano
- University Faculty of Medicine, 7 Boulevard Jeanne d'Arc, Dijon, 21079, France
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van Beukering MDM, Schuster HJ, Peelen MJCS, Schonewille MEA, Hajenius PJ, Duijnhoven RG, Brand T, Painter RC, Kok M. Working conditions in low risk nulliparous women in The Netherlands: are legislation and guidelines a guarantee for a healthy working environment? A cohort study. Int Arch Occup Environ Health 2022; 95:1305-1315. [PMID: 35708771 PMCID: PMC9273547 DOI: 10.1007/s00420-022-01888-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 05/16/2022] [Indexed: 12/04/2022]
Abstract
Objective Hazardous working conditions increase the risk of adverse pregnancy outcomes. In this study, we examine adherence to legislation and guidelines aimed at improving working conditions in pregnancy. Methods Between 2014 and 2016, we recruited a prospective cohort of low-risk nulliparous pregnant women in paid employment or self-employed in 16 community midwifery practices in The Netherlands. Participants completed two questionnaires concerning demographics, education, general health and working conditions between 10–16 and 20–24 weeks of pregnancy. We calculated the proportion of participants with work-related risk factors not in accordance with legislation and/or guidelines. Results Of 269 participants included, 214 (80%) completed both questionnaires. At 10–16 weeks 110 (41%) participants and at 20–24 weeks 129 (63%) participants continued to work under circumstances that did not meet recommendations. Employers provided mandated information on work adjustment to 37 (15%) participants and 96 (38%) participants received no information about the potential hazards while working with biological and chemical hazards. Participants with lower educational attainment (aOR 2.2 95%CI 1.3–3.9), or employment in healthcare (aOR 4.5, 95%CI 2.2–9.0), education/childcare and social service (aOR 2.6, 95%CI 1.1–6.0 2),, catering (aOR 3.6, 95%CI 1.1–12) and industry, construction and cleaning (aOR 3.3, 95%CI 1.1–10.3) more often continued work which did not meet recommendations. Conclusion There is poor adherence to national legislation and guidelines for safe working in pregnancy in The Netherlands: 50% of the pregnant women worked under hazardous conditions. Given the impact on adverse pregnancy outcomes as well as on the public purse, action to improve compliance must be taken by all stakeholders.
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Affiliation(s)
- Monique D M van Beukering
- Department of Obstetrics and Gynaecology, Location Amsterdam Medical Center, Amsterdam University Medical Centres, P.O. Box 22660, Amsterdam, 1100 DD, The Netherlands.
| | - Heleen J Schuster
- Department of Obstetrics and Gynaecology, Location Amsterdam Medical Center, Amsterdam University Medical Centres, P.O. Box 22660, Amsterdam, 1100 DD, The Netherlands
- Department of Medical Microbiology and Infection Control, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Myrthe J C S Peelen
- Department of Obstetrics and Gynaecology, Location Amsterdam Medical Center, Amsterdam University Medical Centres, P.O. Box 22660, Amsterdam, 1100 DD, The Netherlands
| | - Marit E A Schonewille
- Department of Obstetrics and Gynaecology, Location Amsterdam Medical Center, Amsterdam University Medical Centres, P.O. Box 22660, Amsterdam, 1100 DD, The Netherlands
| | - Petra J Hajenius
- Department of Obstetrics and Gynaecology, Location Amsterdam Medical Center, Amsterdam University Medical Centres, P.O. Box 22660, Amsterdam, 1100 DD, The Netherlands
| | - Ruben G Duijnhoven
- Department of Obstetrics and Gynaecology, Location Amsterdam Medical Center, Amsterdam University Medical Centres, P.O. Box 22660, Amsterdam, 1100 DD, The Netherlands
| | - Teus Brand
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Rebecca C Painter
- Department of Obstetrics and Gynaecology, Location Amsterdam Medical Center, Amsterdam University Medical Centres, P.O. Box 22660, Amsterdam, 1100 DD, The Netherlands
| | - Marjolein Kok
- Department of Obstetrics and Gynaecology, Location Amsterdam Medical Center, Amsterdam University Medical Centres, P.O. Box 22660, Amsterdam, 1100 DD, The Netherlands
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Krief P, Mediouni Z, Abderhalden-Zellweger A, Kerr D, Nesi S, Renteria SC, Vonlanthen J, Danuser B. Evaluation of a pilot consultation for maternity protection at work in Switzerland. Swiss Med Wkly 2022; 152:w30160. [PMID: 35704946 DOI: 10.4414/smw.2022.w30160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
STUDY AIMS Switzerland's Labour Law and its Ordonnance on Maternity Protection aim to protect the health of pregnant employees and their unborn children while enabling them to continue to pursue their professional activities. Some companies encounter difficulties implementing the law's provisions. The Department of Occupational and Environmental Health, part of the Center for Primary Care and Public Health (Unisanté), has provided specialist occupational medicine consultations for pregnant employees since 2015. This study aimed to evaluate how well Swiss' maternity protection legislation is implemented by examining a list of relevant indicators measured during the occupational health consultation. The study also sought to investigate the consultation support provided to the relevant stakeholders and the adjustments made to pregnant employees' working conditions. METHODS Descriptive variables and indicators relative to the application of the Swiss maternity protection legislation for 83 pregnant employees were collected during the consultation's pilot phase (between 2015 and 2016). Descriptive statistics and cross-analyses of these indicators were made. RESULTS Most pregnant employees faced multiple exposures to occupational risks. Preventive risk analyses were rare. Few adjustments to workstations were proposed. We found a tendency for employees to leave their workstations early on in their pregnancies due to sick leave certificate prescriptions. Specialist consultation and collaboration with occupational health physicians to recommend interventions for pregnant employees can provide significant benefits and help some pregnant women to continue at their workstations with appropriate adjustments. DISCUSSION A specialised occupational health consultation is a useful instrument for identifying occupational hazards for both the pregnant woman and her unborn child. It is also an opportunity to explain employers' legal responsibilities and obligations to safeguard the health of their pregnant employees and to give specific advice for their company's situation. This consultation also enables employers to maintain their employees' valuable professional competencies in the workplace for as long as possible. Finally, occupational health consultation helps and supports healthcare providers who must, according to the law, make decisions about whether pregnant employees can continue working safely or not.
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Affiliation(s)
- Peggy Krief
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne (Unil), Epalinges-Lausanne, Switzerland
| | - Zakia Mediouni
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne (Unil), Epalinges-Lausanne, Switzerland
| | - Alessia Abderhalden-Zellweger
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne (Unil), Epalinges-Lausanne, Switzerland.,School of Health Sciences (HESAV,) University of Applied Sciences and Arts of Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Dominique Kerr
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne (Unil), Epalinges-Lausanne, Switzerland
| | | | - Saira-Christine Renteria
- Psychosocial Unit, Department of Women's, Mothers' and Children's Health, Lausanne University Hospital, Lausanne, Switzerland
| | - Julien Vonlanthen
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne (Unil), Epalinges-Lausanne, Switzerland
| | - Brigitta Danuser
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne (Unil), Epalinges-Lausanne, Switzerland
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Andersen DR, Momsen AMH, Pedersen P, Damkjær Maimburg R. Reflections on workplace adjustments for pregnant employees: a qualitative study of the experiences of pregnant employees and their managers. BMC Pregnancy Childbirth 2022; 22:456. [PMID: 35650542 PMCID: PMC9158161 DOI: 10.1186/s12884-022-04749-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 05/10/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The European Union directive requires employers to assess and ensure safety measures for pregnant women in the workplace. Despite this, the rate of sick leave among pregnant Scandinavian women is relatively high. This study aims to provide insight into how pregnant employees and their managers experience and address pregnancy at the workplace, to identify preconditions for successful workplace adjustments for pregnant women. METHODS We carried out a qualitative study that involved semi-structured interviews with seventeen participants: eight pregnant women and nine managers from occupations whose employees demonstrate an increased likelihood of taking sick leave during pregnancy. The interviews were thematically coded and organized into main themes and subthemes. RESULTS Based on semi-structured interviews with the seventeen participants (eight pregnant employees and nine managers), we identified preconditions for successful workplace adjustments. According to the pregnant employees, these included, "The managers' concern, understanding, and acknowledgment," "support and acceptance from colleagues," and "pregnant employees' acceptance of their need for adjustments." According to the managers, the preconditions for successful workplace adjustments included "an open and honest dialogue" and "a systematic approach." CONCLUSION Implementing workplace adjustments for pregnant employees is a complex process that comprises various initiatives, and their success may depend on several factors. This study's findings suggest that the success of workplace interventions depends on 1) management, colleagues, and the pregnant employee recognizing and accepting pregnant women's needs, 2) an organizational culture that supports women and pregnancy without compromising the occupational health of other employees, and 3) professional guidance that supports both women and managers when dealing with pregnancy-related concerns. We suggest that this study's findings may be used to improve the implementation of workplace adjustments for pregnant women.
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Affiliation(s)
- Dorte Raaby Andersen
- grid.452352.70000 0004 8519 1132Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark
| | | | - Pernille Pedersen
- DEFACTUM, Central Denmark Region, Marselisborg Center, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Rikke Damkjær Maimburg
- grid.7048.b0000 0001 1956 2722Department of Clinical Medicine, Aarhus University, Aarhus, Denmark ,grid.154185.c0000 0004 0512 597XDepartment of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark ,grid.1029.a0000 0000 9939 5719School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
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Clayborne ZM, Colman I, Kingsbury M, Torvik FA, Gustavson K, Nilsen W. Prenatal work stress is associated with prenatal and postnatal depression and anxiety: Findings from the Norwegian Mother, Father and Child Cohort Study (MoBa). J Affect Disord 2022; 298:548-554. [PMID: 34774976 DOI: 10.1016/j.jad.2021.11.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/06/2021] [Accepted: 11/09/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND An emerging body of research suggests that stress experienced in the workplace can have detrimental impacts on maternal mental health, including greater risk of postnatal depression. However, few longitudinal studies have examined these associations during the perinatal period. The objective of this study was to examine the associations between prenatal work stress and subsequent depression and anxiety. METHODS This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa), and included 77,999 employed women recruited between 1999 and 2008. The exposure variable was prenatal work stress measured at 17 weeks' gestation, using an 8-item scale examining factors including autonomy, working relationships, and work enjoyment. Outcomes included depression and anxiety at 30 weeks' gestation and 6 months postpartum, measured using the Symptom Checklist-8. Analyses comprised of unadjusted and adjusted logistic regressions. RESULTS After covariate adjustment, prenatal work stress was associated with depression and anxiety at 30 weeks' gestation (OR = 1.33, 95% CI: 1.19-1.49), and 6 months postpartum (OR = 1.44, 95% CI: 1.28-1.61). Most associations remained after adjustment for additional work-related variables and maternity leave. LIMITATIONS Work stress was measured once during pregnancy, thus variation of associations by trimester could not be investigated. Findings are reported for a sample with high socioeconomic status, and may not generalize to other populations. CONCLUSIONS Women dealing with work stress during pregnancy are more likely to experience subsequent depression and anxiety. Findings can inform the development of workplace strategies to support the mental health of expecting and new mothers.
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Affiliation(s)
- Zahra M Clayborne
- School of Epidemiology and Public Health, University of Ottawa, Room 308D, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada; Centre for Fertility and Health, Norwegian Institute of Public Health, Norway.
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, Room 308D, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada; Centre for Fertility and Health, Norwegian Institute of Public Health, Norway
| | - Mila Kingsbury
- School of Epidemiology and Public Health, University of Ottawa, Room 308D, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada
| | - Fartein Ask Torvik
- Centre for Fertility and Health, Norwegian Institute of Public Health, Norway; Department of Psychology, University of Oslo, Norway
| | - Kristin Gustavson
- Department of Psychology, PROMENTA Research Center, University of Oslo, Norway; Department of Mental Disorders, Norwegian Institute of Public Health, Norway
| | - Wendy Nilsen
- Work Research Institute, OsloMet-Oslo Metropolitan University, Norway
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Schmauder S, Kämpf D, Hegewald J, Catrein B, Nienhaus A, Seidler A. [Pregnant Physicians in Surgical Specialties - Implementation of the Maternity Protection Act Among Female Physicians in Saxony]. DAS GESUNDHEITSWESEN 2021; 83:998-1005. [PMID: 34891187 PMCID: PMC11248286 DOI: 10.1055/a-1633-4049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM The aim of the study was to investigate compliance with occupational health and safety (OHS) among pregnant surgeons. METHODS All female surgeons in Saxony up to 45 years of age received a written questionnaire about their work environment during pregnancy. Predefined and expert-based criteria of OHS were analyzed descriptively. Poor compliance with OSH was defined as meeting a maximum of half of the criteria. Using logistic regression, professional factors (i. e. "operating due to lack of staff") and personal factors (i. e. "operating due to residency") were investigated for poor compliance with OSH. RESULTS Of the participating female specialists, 55% (response=39%) had performed surgery during pregnancy. On average, 7.4 of the 16 occupational health and safety measures were fulfilled (median=8; range 1-13). In none of the cases were all predefined OSH criteria fulfilled. Two-thirds of the women who worked in non-operative areas took on invasive activities. When the women were working outside the operating theatre, an average of 4.1 of 13 predefined OSH criteria was fulfilled (median=4; range 0-8). "Lack of staff" was related to poor OSH compliance in the multivariate analysis (OR=5.9 (95% CI 1.7-20.0)). CONCLUSION The results of the study show a great need for improvement in the occupational safety of pregnant surgeons.
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Affiliation(s)
- Stefanie Schmauder
- Institut und Poliklinik für Arbeits- und Sozialmedizin, Medizinische Fakultät Carl Gustav Carus, Dresden, Deutschland
| | - Daniel Kämpf
- Institut und Poliklinik für Arbeits- und Sozialmedizin, Medizinische Fakultät Carl Gustav Carus, Dresden, Deutschland
| | - Janice Hegewald
- Institut und Poliklinik für Arbeits- und Sozialmedizin, Medizinische Fakultät Carl Gustav Carus, Dresden, Deutschland
| | - Beate Catrein
- Regierungspräsidium Darmstadt, Abteilung Arbeitsschutz und Umwelt Wiesbaden, Wiesbaden, Deutschland
| | - Albert Nienhaus
- Competenzzentrum für Epidemiologie und Versorgungsforschung bei Pflegeberufen (CVcare), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
- Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege, Abteilung Arbeitsmedizin, Gefahrstoffe und Gesundheitswissenschaften (AGG), Hamburg, Deutschland
| | - Andreas Seidler
- Institut und Poliklinik für Arbeits- und Sozialmedizin, Medizinische Fakultät Carl Gustav Carus, Dresden, Deutschland
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Wada A, Nakamura Y, Tsuno YS, Nagasaka K, Kawajiri M, Takeishi Y, Yoshida M, Yoshizawa T. Factors Associated With the Work Productivity of Japanese Working Pregnant Women: A Cross-Sectional Study. J Occup Environ Med 2021; 63:e759-e764. [PMID: 34412092 DOI: 10.1097/jom.0000000000002359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Working pregnant women experience physical and psychosocial changes, which are associated with two aspects of work productivity: presenteeism and absenteeism. We examined the factors that affect these two aspects. METHODS This cross-sectional study was conducted in April to May 2019 through an online survey. Participants were 450 working women who were pregnant for the first time. RESULTS Occupational stress (job overload sβ: 0.14, suitable jobs sβ: 0.16); physical conditions, such as pregnancy complications (sβ: 0.32) and gestational period (sβ: 0.18); and adjustment status in the workplace due to pregnancy, such as pregnancy disclosure (sβ: 0.11) and pregnancy discrimination (sβ: 0.18), were related to presenteeism. Meanwhile, pregnancy complications were the only factor associated with absenteeism (sβ: 0.32; all P < 0.05). CONCLUSIONS In addition to physical condition support, support for psychosocial conditions in the workplace is required.
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Affiliation(s)
- Aya Wada
- Department of Women's Health Nursing & Midwifery (Ms Wada, Dr Nakamura, Dr Kawajiri, Dr Takeishi, Dr Yoshida, Dr Yoshizawa); Department of Public Health Nursing (Dr Tsuno), Tohoku University Graduate School of Medicine, Sendai, Miyagi; Department of Health Sciences, Saitama Prefectural University, Koshigaya, Saitama (Dr Tsuno); NTT Medical Center Tokyo (Dr Nagasaka); NPO Improving the Lives of Pregnancy, Shinagawa (Dr Nagasaka), Tokyo, Japan
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Abderhalden-Zellweger A, Probst I, Politis Mercier MP, Zenoni M, Wild P, Danuser B, Krief P. Implementation of the Swiss ordinance on maternity protection at work in companies in French-speaking Switzerland. Work 2021; 69:157-172. [PMID: 33998579 DOI: 10.3233/wor-213465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Switzerland's Ordinance on Maternity Protection at Work (OProMa) requires that companies take the necessary measures to ensure that pregnant employees can continue working without danger. OBJECTIVE To investigate the extent of compliance with OProMa within companies in French-speaking Switzerland as well as factors which facilitate and obstruct the ordinance's implementation. METHODS A stratified random telephone survey of 202 companies from the healthcare and food industry was conducted. Descriptive and correlational statistics were calculated. Responses to open questions were analysed thematically. RESULTS Only a minority of companies performed risk analyses or adapted employees' workstations, as per the legislation. OProMa was implemented more effectively in larger companies than smaller ones, in public rather than private ones, in the healthcare sector rather than the food industry, and when the person responsible for the wellbeing of pregnant employees within the company had undergone specific training on the subject. Data extrapolation suggested that only 2% of pregnant employees in French-speaking Switzerland's food industry and 12% in its healthcare sector are properly protected according to OProMa's provisions. CONCLUSIONS Maternity protection in French-speaking Switzerland's companies urgently requires improvement. In addition to the apparent need for stronger incentives and for monitoring of companies, our findings indicate a need to provide them with resources to meet OProMa's provisions.
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Affiliation(s)
- Alessia Abderhalden-Zellweger
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland.,Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Isabelle Probst
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Maria-Pia Politis Mercier
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Michela Zenoni
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Pascal Wild
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland.,Research and Study Management Unit, INRS, Vandoeuvre les Nancy, France
| | - Brigitta Danuser
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Peggy Krief
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
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Experiences managing pregnant hospital staff members using an active management policy-A qualitative study. PLoS One 2021; 16:e0247547. [PMID: 33635871 PMCID: PMC7909656 DOI: 10.1371/journal.pone.0247547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 02/09/2021] [Indexed: 12/02/2022] Open
Abstract
Background and objective During pregnancy, absence from work increases significantly. Job adjustments have been shown to decrease absences; however, studies show only half of pregnant women who need job adjustments receive them. Little is known about the viewpoints of managers and possible challenges in the management of pregnant employees. The aim of this study was to investigate the experiences and considerations of managers in relation to managing pregnant hospital staff members and to describe the experiences of an active management policy for pregnant individuals. Methods A qualitative study based on five focus group interviews was conducted at five public hospitals in Zealand, Denmark with participation of 19 hospital managers, from 17 different wards, representing six different medical specialties. The interviews took place from February to May 2019. Thematic analysis was used to analyze the data. Results Four themes were identified: (1) The everyday management, (2) Managerial dilemmas, (3) Acknowledging the workplace culture, and (4) Dialogue as a means for the working relationship. The managers’ experiences revolved around investing a lot of effort into the working relationship with pregnant staff members by adjusting job tasks and work schedules while balancing work tasks between all staff members. The dialogue was considered central in order to identify the needs of the individual staff member. Conclusions Overall, management dialogue constituted a central tool in order to identify the needs of the individual staff member. A proactive and open approach increased the chances of a fruitful dialogue. The individual staff member, the influence of the workplace culture, and the everyday management of the workplace all shaped the experiences of the managers. The concept of an active management policy for pregnant individuals was perceived to entail useful elements, but also as replicating what managers already did.
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Carlsen OC, Gudmundsdóttir HK, Bains KES, Bertelsen R, Carlsen KC, Carlsen KH, Endre KM, Granum B, Haugen G, Hedlin G, Jonassen CM, Kreyberg I, Landrø L, Mägi CAO, Nordlund B, Nordhagen LS, Pehrson K, Saunders CM, Sjøborg K, Skjerven HO, Staff AC, Svanes C, Söderhäll C, Vettukattil R, Værnesbranden M, Wiik J, Rehbinder EM. Physical activity in pregnancy: a Norwegian-Swedish mother-child birth cohort study. AJOG GLOBAL REPORTS 2021; 1:100002. [PMID: 36378878 PMCID: PMC9563683 DOI: 10.1016/j.xagr.2020.100002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Physical activity during pregnancy is important for maternal and offspring health. Optimal conditions during pregnancy may help reduce the burden of noncommunicable diseases. National and international guidelines recommend at least 150 minutes of physical activity of at least moderate intensity per week. To optimize physical activity in pregnant women, it is important to identify factors associated with higher levels of physical activity. OBJECTIVE This study aimed to explore types and levels of physical activity in midpregnancy in Norway and Sweden and to identify factors associated with higher levels of physical activity. MATERIALS AND METHODS From the population-based mother-child cohort Preventing Atopic Dermatitis and Allergies in Children study recruiting 2697 women in Norway and Sweden from 2014 to 2016, we included 2349 women who answered an electronic questionnaire at enrollment in midpregnancy. Women were asked about regular physical activity in the last 2 weeks of pregnancy and afterward for types and levels of physical activity in pregnancy and before pregnancy and socioeconomic status, lifestyle, and maternal health. Logistic regression analyses were used to identify factors associated with higher levels of physical activity in pregnancy, defined as >30 minutes per session of ≥2 times per week of moderate- or high-intensity brisk walking, strength training, jogging, and bicycling. RESULTS No regular physical activity during the last 2 weeks before answering the questionnaire at midpregnancy was reported by 689 women (29%). In this study, 1787 women (76%) reported weekly strolling during pregnancy. Regular physical activity at least twice weekly in the first half of pregnancy was reported as brisk walking by 839 women (36%), bicycling by 361 women (15%), strength training by 322 women (14%), and other activities by <10% of women. Among the 1430 women with regular moderate- or high-intensity physical activity, the estimated median duration per week was 120 minutes. Higher physical activity levels were achieved in 553 women (23.5%) by brisk walking, 287 women (12.2%) by strength training, 263 women (11.2%) by bicycling, and 114 women (4.9%) by jogging. Higher physical activity levels were positively associated with regular physical activity before pregnancy, dog ownership, and atopic dermatitis and negatively associated with higher body mass index, study location in Østfold, previous pregnancy or pregnancies, non-Nordic origin, suburban living, and sick leave. CONCLUSION At midpregnancy, 29% of women were inactive, and less than 50% of women had at least 2 hours of moderate-intensity physical activity weekly. Awareness of physical activity in pregnancy should be discussed at pregnancy follow-up visits, particularly among women with higher body mass index, sick leave, previous pregnancy or pregnancies, and non-Nordic origin.
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15
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Begtrup LM, Malmros P, Brauer C, Soegaard Toettenborg S, Flachs EM, Hammer PEC, Bonde JP. Manager-oriented intervention to reduce absence among pregnant employees in the healthcare and daycare sector: a cluster randomised trial. Occup Environ Med 2021; 78:oemed-2020-106794. [PMID: 33436380 DOI: 10.1136/oemed-2020-106794] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 11/23/2020] [Accepted: 12/03/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim was to test if targeting managers with an educational intervention reduces absence among pregnant employees. METHODS The study was a non-blinded cluster randomised trial conducted in hospitals and daycare institutions from two administrative Danish Regions and two Danish municipalities. Clusters (work units) were assigned randomly and non-blinded to either (1) intervention, where all managers were invited to participate in a 3-hour seminar addressing needs and options for adjustment of work in pregnancy, or (2) control, with practice as usual. The primary outcome based on payroll data was long-term pregnancy-related absence, defined as ≥12.5% cumulated absence during pregnancy weeks 1-32. Intention-to-treat analysis was applied using mixed logistic regression. RESULTS Ninety work units were included (56 hospital departments and 34 daycare units) with 451 pregnant employees in the intervention group and 464 in the control group. Work units had on average 11 pregnant employees with no difference between the groups. 103 of the 216 invited managers (48%) participated in a the 3-hour seminar. In the intervention group, 154 (34%) had long-term pregnancy-related absence during pregnancy weeks 1-32 vs 166 (36%) in the control group. Relative odds of having long-term pregnancy-related absence, when being in the intervention group, was 1.06 (95% CI 0.71 to 1.58), with an interclass correlation coefficient of 0.07. CONCLUSION An educational intervention targeting managers did not reduce pregnancy-related absence among pregnant employees. TRIAL REGISTRATION NUMBER NCT03002987.
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Affiliation(s)
- Luise Moelenberg Begtrup
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Per Malmros
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Charlotte Brauer
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Sandra Soegaard Toettenborg
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Paula Edeusa Cristina Hammer
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
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March AN, Villar R, Ubalde-Lopez M, G. Benavides F, Serra L. Do birthrates contribute to sickness absence differences in women? A cohort study in Catalonia, Spain, 2012-2014. PLoS One 2020; 15:e0237794. [PMID: 32845930 PMCID: PMC7449461 DOI: 10.1371/journal.pone.0237794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 08/03/2020] [Indexed: 11/19/2022] Open
Abstract
AIMS This study explores the differences in sickness absence trends in women according to reproductive age group and medical diagnoses. METHODS Data were obtained from two administrative registries: the Continuous Working Life Sample and the Catalonian Institute of Medical Evaluations from 2012 to 2014, containing 47,879 female employees. Incidence rates and incidence risk ratios derived from Poisson and negative binomial models were calculated to compare sickness absence trends among reproductive age groups based on Catalonian birthrates: early-reproductive (25-34 years old), middle-reproductive (35-44) and late-reproductive (45-54), according to diagnostic groups, selected diseases, type of contract, occupational category, and country of origin. RESULTS Younger women show a higher incidence of overall sickness absence compared to late-reproductive-aged women. Incidence risk ratios of sickness absence decreased significantly from early-reproductive to late-reproductive age for low back pain, hemorrhage in early pregnancy, nausea and vomiting, and abdominal and pelvic pain. DISCUSSION The higher incidence of sickness absence due to pregnancy-related health conditions in early-reproductive women compared to other reproductive age groups, may explain the sickness absence differences by age in women. Proper management of sickness absence related to pregnancy should be a goal to reduce the sickness absence gap between younger and older women.
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Affiliation(s)
- Andrew N. March
- Center for Research in Occupational Health, Universitat Pompeu Fabra, Barcelona, Spain
| | - Rocío Villar
- Center for Research in Occupational Health, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- IMIM Parc de Salut Mar, Barcelona, Spain
| | | | - Fernando G. Benavides
- Center for Research in Occupational Health, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- IMIM Parc de Salut Mar, Barcelona, Spain
| | - Laura Serra
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
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Pedersen P, Momsen AMH, Andersen DR, Nielsen CV, Nohr EA, Maimburg RD. Associations between work environment, health status and sick leave among pregnant employees. Scand J Public Health 2020; 49:149-158. [PMID: 32466722 DOI: 10.1177/1403494820919564] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Aims: To study the associations between and timing of psychosocial and physical work factors and health status on sick leave among Danish pregnant employees. Methods: A total of 910 pregnant women completed a questionnaire in gestational weeks 12 (baseline) and 27 (follow-up). Information about psychosocial and physical work factors and health status was obtained at baseline. Associations with sick leave ⩾14 days were estimated using logistic regression. Further, the impact of timing and duration of exposure on sick leave were examined. Results: A total of 133 women (14.6%) reported ⩾14 days of sick leave at follow-up (27 weeks of gestation). Work-related risk factors for sick leave were high work pace, low influence, low recognition, low job satisfaction, conflict in work−family balance, standing/walking, heavy lifting, and shift work/night shift. Health-related risk factors were burnout, stress, possibility of depression, low work ability, previous sick leave, and poor self-rated health. Being exposed to work-related risk factors during the first 27 weeks of pregnancy or at follow-up increased the risk of sick leave compared with those not exposed at any time or only exposed at baseline. Poor health status increased the risk if women were exposed in the first 27 weeks of pregnancy; however, high possibility of depression was also a risk factor when experienced in early pregnancy. Conclusions: Psychosocial and physical work-related risk factors and poor health status were associated with more sick leave in pregnant employees. Early adjustment of work-related risk factors at the workplace is needed to reduce sick leave.
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Affiliation(s)
- Pernille Pedersen
- Department of Public Health, Aarhus University, Aarhus C, Denmark
- DEFACTUM, Social & Health Services and Labour Market, Central Denmark Region, Aarhus C, Denmark
| | - Anne-Mette H. Momsen
- DEFACTUM, Social & Health Services and Labour Market, Central Denmark Region, Aarhus C, Denmark
| | - Dorte R. Andersen
- Occupational Medicine, Regional Hospital West Jutland, University Research Clinic, Aarhus University, Herning, Denmark
| | - Claus V. Nielsen
- Department of Public Health, Aarhus University, Aarhus C, Denmark
- DEFACTUM, Social & Health Services and Labour Market, Central Denmark Region, Aarhus C, Denmark
- Regional Hospital West Jutland, Herning, Denmark
| | - Ellen A. Nohr
- Research Unit for Gynaecology and Obstetrics, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Centre of Women’s, Family and Child Health, University of South-Eastern Norway, Kongsberg, Norway
| | - Rikke D. Maimburg
- Department of Clinical Medicine, Aarhus University and Department of Gynaecology Obstetrics, Aarhus University Hospital, Aarhus, Denmark
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Abderhalden-Zellweger A, Probst I, Politis Mercier MP, Danuser B, Wild P, Krief P. Implementation of maternity protection legislation: Gynecologists' perceptions and practices in French-speaking Switzerland. PLoS One 2020; 15:e0231858. [PMID: 32353865 PMCID: PMC7192633 DOI: 10.1371/journal.pone.0231858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 04/02/2020] [Indexed: 01/01/2023] Open
Abstract
Background In several countries, maternity protection legislations (MPL) confer an essential role to gynecologist-obstetricians (OBGYNs) for the protection of pregnant workers and their future children from occupational exposures. This study explores OBGYNs’ practices and difficulties in implementing MPL in the French-speaking part of Switzerland. Methods An online survey was sent to 333 OBGYNs. Data analysis included: 1) descriptive and correlational statistics and 2) hierarchical cluster analysis to identify patterns of practices. Results OBGYNs evoked several problems in MPL implementation: absence of risk analysis in the companies, difficult collaboration with employers, lack of competencies in the field of occupational health. Preventive leave was underused, with sick leave being prescribed instead. Training had a positive effect on OBGYNs’ knowledge and implementation of MPL. Hierarchical cluster analysis highlighted three main types of practices: 1) practice in line with legislation; 2) practice on a case-by-case basis; 3) limited practice. OBGYNs with good knowledge of MPL more consistently applied its provisions. Conclusion The implementation of MPL appears challenging for OBGYNs. Collaboration with occupational physicians and training might help OBGYNs to better take on their role in maternity protection. MPL in itself could be improved.
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Affiliation(s)
- Alessia Abderhalden-Zellweger
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Epalinges, Switzerland
- * E-mail:
| | - Isabelle Probst
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Maria-Pia Politis Mercier
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Brigitta Danuser
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Epalinges, Switzerland
| | - Pascal Wild
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Epalinges, Switzerland
- INRS Research and Studies Management, Vandoeuvre les Nancy, France
| | - Peggy Krief
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Epalinges, Switzerland
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Sickness absence and disability pension before and after first childbirth and in nulliparous women by numerical gender segregation of occupations: A Swedish population-based longitudinal cohort study. PLoS One 2019; 14:e0226198. [PMID: 31834901 PMCID: PMC6910695 DOI: 10.1371/journal.pone.0226198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 11/21/2019] [Indexed: 11/19/2022] Open
Abstract
Background Pregnancy is associated with a temporarily increased sickness absence (SA) risk. This association may vary by the level of occupational gender segregation; however, knowledge in this area is limited. We studied whether trends in SA and disability pension (DP) in the years before and after first childbirth among women with one or more childbirths and with no childbirth during the study period varied by occupational gender segregation. Methods We conducted a population-based register study involving nulliparous women aged 18–39 years, living in Sweden in 2002–2004 (n = 364,411). We classified participants in three childbirth groups as: (1) no childbirth in 2005 or in the next 3.75 years, (2) first childbirth in 2005 and no births in the subsequent 3.75 years, and (3) first childbirth in 2005 and at least one additional birth in the subsequent 3.75 years, and into five categories based on the rate of women in their occupations. We compared crude and standardized mean annual net SA and DP days during the three years before and the three years after 2005 across the childbirth and occupational gender segregation categories. Results Women in extremely male-dominated occupations had or tended to have somewhat higher mean combined SA and DP days than women in gender-integrated occupations; women in female-dominated occupations had comparable or tended to have slightly higher mean SA and DP days than women in gender-integrated occupations. Except for the year before the first childbirth, women who gave birth, especially those who gave several births, had generally a lower mean combined standardized SA and DP days than nulliparous women. We found no substantial differences in trends in SA and DP around the time of first childbirth according to occupational gender segregation. Conclusions Trends in SA and DP around the time of first childbirth did not vary by occupational gender segregation.
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Severinsen A, Midtgaard J, Backhausen MG, Broberg L, Hegaard HK. Pregnant women’s experiences with sick leave caused by low back pain. A qualitative study. Work 2019; 64:271-281. [DOI: 10.3233/wor-192991] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Anette Severinsen
- The Research Unit Women’s and Children’s Health, The Juliane Marie Centre, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
- Department of Gynecology and Obstetrics, Zealand University Hospital, Roskilde, Denmark
| | - Julie Midtgaard
- The University Hospitals’ Centre for Health Research (UCSF), Copenhagen University Hospital (Rigshospitalet), Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Lotte Broberg
- The Research Unit Women’s and Children’s Health, The Juliane Marie Centre, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
- Department of Obstetrics, Copenhagen University Hospital (Rigshospitalet), Denmark
| | - Hanne Kristine Hegaard
- The Research Unit Women’s and Children’s Health, The Juliane Marie Centre, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
- The Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Obstetrics, Copenhagen University Hospital (Rigshospitalet), Denmark
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Stafne SN, Vøllestad NK, Mørkved S, Salvesen KÅ, Stendal Robinson H. Impact of job adjustment, pain location and exercise on sick leave due to lumbopelvic pain in pregnancy: a longitudinal study. Scand J Prim Health Care 2019; 37:218-226. [PMID: 31057021 PMCID: PMC6566798 DOI: 10.1080/02813432.2019.1608058] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective: To identify factors associated with sick leave due to lumbopelvic pain (LPP) in pregnancy. Design: Prospective cohort study using participants from a randomized controlled trial (RCT) designed to study the effect of exercise during pregnancy on pregnancy related diseases. Setting: St. Olavs Hospital, Trondheim University Hospital and Stavanger University Hospital, April 2007 to December 2009. Subjects: Healthy pregnant women. Main outcome measures: Self-reported sick leave due to LPP in late pregnancy (gestation week 32-36). Results: In total, 532/716 (74%) women reported LPP at 32-36 weeks of pregnancy, and 197/716 (28%) reported sick leave due to LPP. Not receiving job adjustments when needed (Odds ratio, OR with 95% confidence interval, CI, was 3.0 (1.7-5.4)) and having any pain in the pelvic girdle versus no pain (OR 2.7 (1.3-5.6), OR 2.7 (1.4-5.2) and OR 2.2 (1.04-4.8)) for anterior, posterior and combined anterior and posterior pain in the pelvis respectively, were associated with sick leave due to LPP in late pregnancy. Also higher disability, sick listed due to LPP at inclusion and lower education, were significant explanatory variables. There was a trend of reduced risk for sick leave due to LPP when allocated to the exercise group in the original RCT (OR 0.7 (0.4-1.0)). Conclusion: Facilitating job adjustments when required might keep more pregnant women in employment. Furthermore, pain locations in pelvic area, disability, lower education and being sick listed due to LPP in mid pregnancy are important risk factors for sick leave in late pregnancy. Key points Current awareness: More than half of pregnant women are on sick leave during pregnancy and the most frequently reported cause is lumbopelvic pain. This paper adds: Inability to make job adjustments, pain locations in pelvic area, disability and lower education level were the most important risk factors for sick leave in late pregnancy. Facilitating early job adjustment might be a precaution to keep more pregnant women in work. Allocation to an exercise group tended to reduce the risk of sick leave in late pregnancy.Registration number: Clinical trial gov (NCT00476567).
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Affiliation(s)
- Signe N. Stafne
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway;
- Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway;
- CONTACT Signe N. Stafne Department of Public Health and Nursing, Faculty of Medicine, Norwegian University of Science and Technology, P.O. Box 8905, 7491Trondheim, Norway
| | - Nina K. Vøllestad
- Department of Health Sciences, Institute of Health and Society, University of Oslo, Norway;
| | - Siv Mørkved
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway;
- Research Department, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway;
| | - Kjell Å. Salvesen
- Department of Obstetrics and Gynecology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway;
- Institute of clinical and molecular medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Hilde Stendal Robinson
- Department of Health Sciences, Institute of Health and Society, University of Oslo, Norway;
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Brekke I, Richardsen KR, Jenum AK. Sickness absence in pregnancy and sedentary behavior: a population-based cohort study from Norway. BMC Public Health 2019; 19:71. [PMID: 30651106 PMCID: PMC6334424 DOI: 10.1186/s12889-018-6379-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 12/27/2018] [Indexed: 11/21/2022] Open
Abstract
Background Sickness absence in pregnancy accounts for a large part of sickness-related absenteeism among women. Exercise in pregnancy is associated with a lower level of sickness absence, however little is known about how sedentary behaviour is related to sickness absence in pregnancy. In the current study, we hypothesize a positive association between sedentary hours/day and the risk of long-term sickness absence. Methods Population-based cohort study of pregnant women attending three Child Health Clinics in Groruddalen, Oslo, 823 Women (74% of those eligible) were included between 2008 and 2010. Questionnaire data were collected at gestational weeks 10–20 (visit 1) and 28 (visit 2). Sedentary time and physical activity were objectively recorded at visit 1 with the multi-sensor SenseWear™ Pro3 Armband (SWA). Long-term sickness absence was self-reported at visit 2. We explored the association between sedentary time and long-term sickness absence in pregnancy using multiple logistic regression analysis. Results The odds of long-term sickness absence was significantly increased per one-hour increase in daily sedentary time (odds ratio 1.45 [95% confidence interval 1.13–1.84]), providing support for our hypothesis that sedentary time is positively associated with long-term sickness absence. Conclusions Pregnant women with a sedentary lifestyle have a higher risk of long-term sickness absence from work. Reducing sedentary time in pregnancy may improve health, and may, in turn reduce sickness absence in pregnancy.
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Affiliation(s)
- Idunn Brekke
- Centre for Welfare and Labour Research - Norwegian Social Research, OsloMet - Oslo Metropolitan University, Post box 4 St. Olavs plass, N-0130, Oslo, Norway. .,Faculty of Health Sciences - Department of Nursing and Health promotion, OsloMet - Oslo Metropolitan University, Post box 4 St. Olavs plass, N-0130, Oslo, Norway.
| | - Kåre Rønn Richardsen
- Faculty of Health Sciences - Department of Physiotherapy, OsloMet - Oslo Metropolitan University, Post box 4 St. Olavs plass, N-0130, Oslo, Norway
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, University of Oslo, Institute of Health and Society, Post Box 1130 Blindern, 0318, Oslo, Norway
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Kristensen P, Corbett K, Mohn FA, Hanvold TN, Mehlum IS. Information bias of social gradients in sickness absence: a comparison of self-report data in the Norwegian Mother and Child Cohort Study (MoBa) and data in national registries. BMC Public Health 2018; 18:1275. [PMID: 30453919 PMCID: PMC6245919 DOI: 10.1186/s12889-018-6208-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 11/08/2018] [Indexed: 11/13/2022] Open
Abstract
Background Measurement error in self-report questionnaires is a common source of bias in epidemiologic studies. The study aim was to assess information bias of the educational gradient in sickness absence among participants in the Norwegian Mother and Child Cohort Study (MoBa), comparing self-report data with national register data. Methods MoBa is a national prospective cohort study. The present study included 49,637 participants, born 1967–1976, who gave birth 2000–2009. The highest completed education level was recorded in categories and as educational years. Sickness absence was defined as one or more spell lasting more than 16 days between pregnancy weeks 13 and 30. We computed sickness absence risk in mid-pregnancy in strata of education level. Associations between completed educational years and sickness absence were estimated as risk differences in binomial regression and compared between self-report and register data. In additional analyses, we aimed to explain discrepancies between estimates from the two data sources. Results The overall registry-based sickness absence risk was 0.478 and decreased for increasingly higher education in a consistent fashion, yielding an additive risk difference in association with one additional education year of − 0.032 (95% confidence interval − 0.035 to − 0.030). The self-report risk was lower (0.307) with a corresponding risk difference of only − 0.013 (95% confidence interval − 0.015 to − 0.011). The main explanation of the lower risk difference in the self-report data was a tendency for mothers in low education categories to omit reporting sickness absence in the questionnaire. Conclusions A plausible explanation for the biased self-report association is complexity of the sickness absence question and a resulting educational gradient in non-response. As shown for sickness absence in mid-pregnancy in the present study, national registries could be a preferred alternative to self-report questionnaires. Electronic supplementary material The online version of this article (10.1186/s12889-018-6208-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Petter Kristensen
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway.
| | - Karina Corbett
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
| | - Ferdinand A Mohn
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway.,Institute for Social Research, Oslo, Norway
| | - Therese N Hanvold
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
| | - Ingrid S Mehlum
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
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Pedersen P, Labriola M, Nielsen CV, Maimburg RD, Nohr EA, Momsen AM. Systematic review of interventions targeting sickness absence among pregnant women in healthcare settings and workplaces. BMJ Open 2018; 8:e024032. [PMID: 30366917 PMCID: PMC6224771 DOI: 10.1136/bmjopen-2018-024032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 09/14/2018] [Accepted: 09/18/2018] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The high rate of sickness absence from work during pregnancy is recognised as a problem, and may be higher than necessary from a health perspective. The aim was to evaluate the effectiveness of interventions in healthcare settings and workplaces targeting sickness absence among pregnant women. METHODS Studies were eligible if they included pregnant women participating in any intervention in healthcare settings or workplaces. The outcome was length of sickness absence in days or number of episodes. Study design had to be either randomised controlled trials (RCTs) or quasi-experimental studies.The search for studies was conducted in PubMed, Scopus, CINAHL, PsycINFO, ClinicalTrials.gov and WHO trial registry. Risk of bias was assessed by the Joanna Briggs Institute standardised quality assessment instrument. RESULTS A total of nine studies were quality assessed and of these, four were excluded due to insufficient methodological quality. Five RCTs conducted in healthcare settings in Sweden and Norway were included. Due to heterogeneity, meta-analysis was not performed.Two RCTs examined complementary and alternative medicine and three RCTs the effect of physical exercise. In general, the frequency of women on sickness absence was lower in the intervention groups than the control groups, however, only among pregnant women who participated in a 12-week exercise programme, the frequency was significantly lower (22% vs 30%, p=0.04). CONCLUSION The evidence of interventions targeting sickness absence among pregnant women in healthcare settings is sparse, and no studies were conducted at workplaces.Future interventions including physical activity provided in collaboration with healthcare settings and workplaces are requested. Studies should measure sickness absence based on valid methods, measure compliance to the intervention and provide transparency of statistical methods. PROSPERO REGISTRATION NUMBER CRD42018084802.
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Affiliation(s)
- Pernille Pedersen
- Central Denmark Region, DEFACTUM - Social and Health Services & Labour Market, Aarhus, Denmark
| | - Merete Labriola
- Department of Public Health, Section of Clinical Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark
| | - Claus Vinther Nielsen
- Department of Public Health, Section of Clinical Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark
| | - Rikke Damkjær Maimburg
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Gynaecology Obstetrics, Aarhus Universitetshospital, Aarhus, Denmark
| | - Ellen Aagaard Nohr
- Research Unit for Gynaecology and Obstetrics, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Anne-Mette Momsen
- Central Denmark Region, DEFACTUM - Social and Health Services & Labour Market, Aarhus, Denmark
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Probst I, Zellweger A, Politis Mercier MP, Danuser B, Krief P. Implementation, mechanisms and effects of maternity protection legislation: a realist narrative review of the literature. Int Arch Occup Environ Health 2018; 91:901-922. [DOI: 10.1007/s00420-018-1339-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 07/09/2018] [Indexed: 10/28/2022]
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Villar R, Benavides FG, Serra L, Serra C. [Occupational risk during pregnancy and sick leave in a cohort of workers from Parc de Salut Mar (Barcelona, Spain)]. GACETA SANITARIA 2018; 33:455-461. [PMID: 29914699 DOI: 10.1016/j.gaceta.2018.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 03/08/2018] [Accepted: 03/09/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To study the use of the Pregnancy occupational risk benefit (PORB) and non-work related sickness absence (NWSA) in a cohort of pregnant workers of Parc de Salut Mar, Barcelona (Spain). METHOD Retrospective cohort study of 428 pregnant workers between 2010 and 2014, who were followed-up until delivery. Absences from work, both PORB and NWSA were recorded until the beginning of their maternity leave. The sequence analysis identifies four trajectories, which are described according to workers demographic and job characteristics. RESULTS Of the total cohort, 56 (13.1%) accessed only the PORB, representing 6.126 days of absence; 68 (15.9%) also accessed PORB, with 7.127 days of absence, but had previously accumulated 102 episodes of NWSA with 1.820 days of absence. The majority of pregnant workers in the sample (69.9%) took only one or several episodes of NWSA without using PORB, with 545 episodes and 26,337 days of absence. Most were active during the first quarter and it is from the second quarter that episodes of long-term NWSA appeared. During the last month of pregnancy more than 80% of the workers were absent from work. CONCLUSIONS Pregnant workers remained at work for two thirds of their pregnancy. Absences were mainly due to episodes of NWSA. PORB represented one third of them. As in other similar countries, our results suggest a change in the management of social protection benefits for pregnant workers.
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Affiliation(s)
- Rocío Villar
- Servicio de Salud Laboral, Parc de Salut Mar, IMIM PSMar, Barcelona, España; Centro de Investigación en Salud Laboral, Universitat Pompeu Fabra, Barcelona, España
| | - Fernando G Benavides
- Centro de Investigación en Salud Laboral, Universitat Pompeu Fabra, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Laura Serra
- Centro de Investigación en Salud Laboral, Universitat Pompeu Fabra, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Consol Serra
- Servicio de Salud Laboral, Parc de Salut Mar, IMIM PSMar, Barcelona, España; Centro de Investigación en Salud Laboral, Universitat Pompeu Fabra, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España.
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Henrotin JB, Vaissière M, Etaix M, Dziurla M, Malard S, Lafon D. [Occupational risks during pregnancy: Feedback from occupational medical services]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2018; 46:20-27. [PMID: 29217338 DOI: 10.1016/j.gofs.2017.10.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 10/13/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To describe the follow-up of pregnancies at work and exposures to pregnancy occupational hazards. METHODS A cross-sectional study was performed between January and December 2014 in occupational health services of Languedoc-Roussillon region. Eligible workers were interviewed by occupational health physicians (OHPs) after delivery and at the time of returning to work (exposure, anticipation, prevention, communication, sick leave). Occupational skill levels were classified according to the French standard classification of occupations (version 2003) from the French National Institute of Statistics. Socioeconomic deprivation was assessed using the Evaluation of Deprivation and Inequalities in Health Examination (EPICES) individual scale. RESULTS A total of 1347 workers were recruited. The mean age was at 30.7±4.5 years. Among pregnant workers, there were 54.2% of employees, 30.7% of intermediate occupations, 10.4% of managers and, 4.7% of manual workers. Twenty-two percent of workers were classed as deprived. Also, 43.2% of workers were exposed to three or more occupational hazards during pregnancy. Only 17.7% of workers had medical visits with OHP during pregnancy and 14.7% benefited from workstation adjustments. In contrast, the level of sick leaves was high (74.2%). CONCLUSION Our results argue for the need to follow pregnancies at work. However, the low level of prevention activities and the high level of sick leaves raise the question of the management of pregnant women at work.
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Affiliation(s)
- J-B Henrotin
- Département d'épidémiologie en entreprise, Institut national de recherche et sécurité, 1, rue du Morvan, CS 60027, 54519 Vandœuvre-Lès-Nancy, France.
| | - M Vaissière
- Service de santé au travail, Santé Travail Béziers Cœur d'Hérault, 34502 Béziers, France
| | - M Etaix
- Service de santé au travail, Santé Travail Loire Nord, 42300 Roanne, France
| | - M Dziurla
- Département d'épidémiologie en entreprise, Institut national de recherche et sécurité, 1, rue du Morvan, CS 60027, 54519 Vandœuvre-Lès-Nancy, France
| | - S Malard
- Département d'études et d'assistances médicales, Institut national de recherche et sécurité, 75011 Paris, France
| | - D Lafon
- Unité de santé au travail, professionnelle, AP-HP UVSQ, CHU Poincaré, 92380 Garches, France
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Backhausen M, Damm P, Bendix J, Tabor A, Hegaard H. The prevalence of sick leave: Reasons and associated predictors - A survey among employed pregnant women. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 15:54-61. [PMID: 29389502 DOI: 10.1016/j.srhc.2017.11.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 10/12/2017] [Accepted: 11/20/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We aimed to investigate the prevalence of sick leave and self-reported reasons given for sick leave during pregnancy. Furthermore, we aimed to estimate the frequency of long-term sick leave during pregnancy in relation to pre-baseline maternal characteristics and to identify predictors of long-term sick leave. METHOD Data from 508 employed pregnant women seeking antenatal care was collected by questionnaires from August 2015 to March 2016. The questionnaires, which were filled in at 20 and 32 weeks of gestation, provided information on maternal characteristics, the number of days spent on sick leave and the associated reasons. Descriptive statistics and logistic regression analysis were applied. RESULTS The prevalence of sick leave was 56% of employed pregnant women in the first 32 weeks of gestation and more than one in four reported long-term sick leave (>20 days, continuous or intermittent). Low back pain was the reason most frequently stated. Fewer than one in ten stated that their sick leave was due to work-related conditions. Positive predictors of long-term sick leave were multiparity, pre-pregnancy low back pain and mental disease, while an advanced degree education was a negative predictor. CONCLUSIONS The prevalence of sick leave was 56% in the first 32 weeks of gestation and more than one in four women reported long-term sick leave. The majority of reasons for sick leave were pregnancy-related and low back pain was the most frequently given reason.
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Affiliation(s)
- Mette Backhausen
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark; The Research Unit Women's and Children's Health, Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark; Department of Gynecology and Obstetrics, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark; The Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
| | - Peter Damm
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Jane Bendix
- Department of Gynecology and Obstetrics, Nordsjællands Hospital, University of Copenhagen, Dyrehavevej 29, 3400 Hillerød, Denmark
| | - Ann Tabor
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Hanne Hegaard
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark; The Research Unit Women's and Children's Health, Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark; The Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
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Abstract
BACKGROUND AND OBJECTIVE A comparison of sick leave in pregnancy between countries is difficult as most studies have been conducted in single countries in Scandinavia. The objective of this study was to explore patterns of and reasons for sick leave during pregnancy on a multinational level, focusing on medication use but also differences in sick leave policies. DESIGN AND SETTING Cross-sectional, web-based study in 12 European countries from October 2011 to February 2012. Data were collected via an electronic questionnaire. PARTICIPANTS Pregnant women and mothers of children under the age of 1 year. PRIMARY OUTCOME MEASURE Sick leave prevalence in pregnancy. RESULTS Of 6686 women included, 3385 (50.6%) had been on sick leave during pregnancy. The rates of sick leave varied across countries, ranging from 31.7%-34.8% in Sweden and the UK to 62.4%-71.3% in Norway, Serbia, Croatia and Poland. The most common reasons for being on sick leave were pregnancy complications (26.5%); pain in the neck, back or pelvic girdle (16.2%); and nausea and vomiting (NVP, 16.0%). Women using medications for acute illnesses were more likely to be on sick leave than their non-medicated counterparts, while an opposite trend was observed for women with chronic disorders, where non-medicated women were more likely to be on sick leave. Women from countries with 'low' sick leave policies were less likely to have extensions of sick leaves compared with women from countries with 'medium' policies (adjusted OR 0.63, 95% CI 0.49 to 0.82). CONCLUSION The rates of sick leave in pregnancy vary greatly across European countries. Women using medications were more likely to be on sick leave, especially for acute illnesses. The differences in sick leave patterns across countries only partially reflected differences in sick leave policies, which implies that sick leave in pregnancy is also affected by other national differences.
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Affiliation(s)
- Bich Thuy Truong
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Petter Kristensen
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
- Preventive Medicine and Epidemiology Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Hedvig Nordeng
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway
- Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway
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Henrotin JB, Vaissière M, Etaix M, Dziurla M, Malard S, Lafon D. Exposure to occupational hazards for pregnancy and sick leave in pregnant workers: a cross-sectional study. Ann Occup Environ Med 2017; 29:12. [PMID: 28515945 PMCID: PMC5430597 DOI: 10.1186/s40557-017-0170-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 05/10/2017] [Indexed: 11/13/2022] Open
Abstract
Background This study aimed to investigate the association between exposure to occupational hazards for pregnancy and sick leave (SL) in pregnant workers. Methods A cross-sectional study was performed in French occupational health services in 2014. Occupational hazards for pregnancy were assessed by occupational health physicians (OHPs). After delivery and at the time of returning to work, 1,495 eligible workers were interviewed by OHPs. Information on SL was self-reported. Risk ratios (RRs) were calculated from multivariable analyses based on a generalized linear model with a Bernoulli distribution and a log link adjusted for selected confounders for binary outcomes or zero-inflated negative binomial regression for count outcomes. Results Among recruited workers, 74.9% presented “at least one SL” during pregnancy. After adjustment, the cumulative index of occupational hazards (0, 1–2, 3–4, ≥ 5 risks) for pregnancy was significantly associated with “at least one SL” during pregnancy in a dose–response relationship. This gradient was also observed with “early SL” (<15 week gestation): from 1 to 2 risks, RR = 1.48 (95% confidence intervals (CIs): 0.92-2.38); from 3 to 4 risks, RR = 2.03 (95% CI: 1.25-3.30); equal to or higher than five risks, RR = 2.90 (95% CI: 1.89-4.44); with “duration of absence” (adjusted mean): from 1 to 2 risks, m = 38.6 days; from 3 to 4 risks, m = 46.8 days; equal to or higher than five risks, m = 53.8 days. We also found that deprivation, pregnancy at risk, assisted reproductive therapy, work-family conflicts, home-work commuting felt as difficult and young age are associated with a higher risk of SL. Conclusions Our results support the assertion that pregnant workers exposed to occupational hazards for pregnancy without medical complications are also at risk of taking SL during pregnancy. More prevention in the workplace for pregnant workers exposed to occupational hazards could reduce SL.
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Affiliation(s)
- Jean-Bernard Henrotin
- Department of Occupational Epidemiology, National Research and Safety Institute, 1 rue du Morvan, CS 60027, Vandoeuvre-les-Nancy, 54519 Cedex France
| | - Monique Vaissière
- Occupational Health Service, Santé Travail Béziers Coeur d'Hérault, Béziers, France
| | - Maryline Etaix
- Occupational Health Service, Santé Travail Loire Nord, Roanne, France
| | - Mathieu Dziurla
- Department of Occupational Epidemiology, National Research and Safety Institute, 1 rue du Morvan, CS 60027, Vandoeuvre-les-Nancy, 54519 Cedex France
| | - Stéphane Malard
- Department of Medical Studies and Assistance, National Research and Safety Institute, Paris, France
| | - Dominique Lafon
- Occupational Disease Consultation Centre, Raymond Poincaré Hospital, Garches, France
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Working fulltime throughout pregnancy - The Norwegian women's perspectives. A qualitative approach. Midwifery 2017; 50:193-200. [PMID: 28472741 DOI: 10.1016/j.midw.2017.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 04/21/2017] [Accepted: 04/25/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVE the purpose of this study was to gain a deeper understanding of aspects that influence healthy women's ability to work fulltime throughout the pregnancy, considering women's experiences and individual perspectives, as well as understanding health resources available to them. DESIGN/SETTING a qualitative approach was selected for the data collection, and the data presented is derived from in-depth interviews. Ten pregnant Norwegian women with uncomplicated pregnancies, aged 24-40, working fulltime throughout their pregnancies with no sick leave, were interviewed during pregnancy week 37-39. All participants had their regular check-ups at six local public health clinics. The transcribed interviews were analysed through systematic text condensation. FINDINGS the findings included two main themes: Supporting environment and having a positive mindset. Feeling good about oneself and feeling appreciated at work provided these women with the supporting environment they needed. All the respondents had coped with different challenges that they found important when working throughout their pregnancies while facing the difficulties of a pregnancy. They emphasised that their positive attitude and coping skills contributed to normalising the pregnancy and motivated them to go to work. CONCLUSIONS having a positive mindset and a balanced perspective on the pregnancy and bodily changes are important factors in being able to work throughout pregnancy. Support, in various arenas, might positively influence pregnant women´s positive mindset, having a favourable effect on their health resources and ability to continue working when bearing children.
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Vigoureux S, Blondel B, Ringa V, Saurel-Cubizolles MJ. Occupational, social and medical characteristics of early prenatal leave in France. Eur J Public Health 2016; 26:1022-1027. [PMID: 27259720 DOI: 10.1093/eurpub/ckw072] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In France, most women of childbearing age work. The prenatal leave law in France protects women during pregnancy and their employment. We aimed to describe how long before delivery women stopped working and analyse the association between occupational, social and medical factors and early prenatal leave (before 24 weeks' gestation). METHODS The sample was extracted from the 2010 French National Perinatal Survey. Women were interviewed in French maternity units during a 1-week period. We focused on all women with a singleton live birth who were working during pregnancy (n = 10 149). Women were interviewed between delivery and discharge to collect information on employment, date of leave, sociodemographic and medical characteristics. RESULTS Among women who worked during pregnancy, 27.5% reported early occupational leave (before 24 weeks' gestation). Early occupational leave was more frequent among women with unstable jobs (fixed-term vs. non-fixed-term contract: adjusted odds ratio aOR = 1.60 [95% confidence interval 1.40-1.84]) and with less-qualified occupational categories (manual workers vs. managers and upper-intellectual positions: aOR = 2.96 [2.30-3.82]), even after adjusting for sociodemographic and other employment characteristics. Women with a pathological or at risk pregnancy left work earlier than other women. After stratification on type of pregnancy there was still a higher rate of early leave for women with less qualified occupational group. CONCLUSION In France, social vulnerability of pregnant women, linked to low sociodemographic situation or low occupational categories, is associated with early leave during pregnancy, even after stratification on type of pregnancy.
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Affiliation(s)
- Solène Vigoureux
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, 75014 Paris, France
| | - Béatrice Blondel
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, 75014 Paris, France
| | - Virginie Ringa
- INSERM UMR 1018, CESP Centre for Research in Epidemiology and Population Health, Gender, Sexuality and Health Team, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, Kremlin-Bicêtre F-94276, France.,Institut National d'Etudes Démographiques (INED), F-75020 Paris, France
| | - Marie-Josèphe Saurel-Cubizolles
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, 75014 Paris, France
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Influence des facteurs professionnels sur l’absentéisme de la femme enceinte dans la région du centre tunisien. ARCH MAL PROF ENVIRO 2015. [DOI: 10.1016/j.admp.2015.04.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Alstveit M, Severinsson E, Karlsen B. Health Resources and Strategies among Employed Women in Norway during Pregnancy and Early Motherhood. Nurs Res Pract 2015; 2015:705892. [PMID: 25945258 PMCID: PMC4402169 DOI: 10.1155/2015/705892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 03/26/2015] [Indexed: 11/17/2022] Open
Abstract
The number of women in paid employment is increasing. However, when becoming a mother for the first time, many seem unprepared for the challenge of balancing motherhood and work as well as for the impact on their health. The aim of this study was to investigate the health resources and strategies of employed women in Norway during pregnancy and early motherhood by means of salutogenic theory. A hypothetical-deductive interpretive approach based on Antonovsky's salutogenic theory was applied in a secondary analysis. A total of six themes were identified; three were classified as health resources when experiencing tension and three as health strategies. Salutogenic theory seems to be a useful framework for illuminating the health resources and strategies adopted by employed women who become mothers. The identified health resources when experiencing tension and the health strategies applied may have implications for maternity care professionals and employers in promoting the health of such women and supporting them to combine work and family life.
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Affiliation(s)
- Marit Alstveit
- Department of Health Studies, Faculty of Social Sciences, University of Stavanger, 4036 Stavanger, Norway
| | - Elisabeth Severinsson
- Centre for Women's, Family and Child Health, Faculty of Health Sciences, Buskerud & Vestfold University College, P.O. Box 235, 3603 Kongsberg, Norway
| | - Bjørg Karlsen
- Department of Health Studies, Faculty of Social Sciences, University of Stavanger, 4036 Stavanger, Norway
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Oenning NSX, Carvalho FM, Lima VMC. [Risk factors for absenteeism due to sick leave in the petroleum industry]. Rev Saude Publica 2014; 48:103-22. [PMID: 24789643 PMCID: PMC4206122 DOI: 10.1590/s0034-8910.2014048004609] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Accepted: 09/04/2013] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To identify risk factors for absenteeism among workers with sick leave in an oil company. METHODS A case-control study (120 cases and 656 controls) nested in a retrospective cohort study following up all employees of an oil company in the North-Northeast of Brazil from 2007 to 2009. The response variable used to represent absenteeism with sick leave was the average incidence of sick leave, defined as the ratio between total sick days and potential working days in the period. Logistic regression techniques were used to investigate the association between average incidence of sick leave > 5.0% over the period and the variables sex, position, age, time at work, shift work, smoking, arterial hypertension, body mass index, physical activity, coronary risk, sleep, glycemia, non-managed diabetes, cardiovascular, digestive, musculoskeletal, neurological and neoplastic diseases, straining body positioning during work, satisfaction at work, relationship with management, and concentrated attention at work. RESULTS Average incidence of sick leave higher than 5.0% in the cohort period was 15.5%. The logistic model revealed that workers with average incidence of sick leave higher than 5.0% were 2.6 times more likely to be female; 2.0 time more likely to be smokers; 1.8 time more likely to be former smokers; 2.2 times more likely to report abnormal sleep and 10.5 times more likely to report dissatisfaction with their than workers with average incidence of sick leave ≤ 5.0% in the period. CONCLUSIONS In this population, female gender, being a smoker or a former smoker, reporting dissatisfaction with the job and reporting abnormal sleep are good predictors of occupational absenteeism with sick leave. OBJECTIVE To identify risk factors for absenteeism among workers with sick leave in an oil company. METHODS A case-control study (120 cases and 656 controls) nested in a retrospective cohort study following up all employees of an oil company in the North-Northeast of Brazil from 2007 to 2009. The response variable used to represent absenteeism with sick leave was the average incidence of sick leave, defined as the ratio between total sick days and potential working days in the period. Logistic regression techniques were used to investigate the association between average incidence of sick leave > 5.0% over the period and the variables sex, position, age, time at work, shift work, smoking, arterial hypertension, body mass index, physical activity, coronary risk, sleep, glycemia, non-managed diabetes, cardiovascular, digestive, musculoskeletal, neurological and neoplastic diseases, straining body positioning during work, satisfaction at work, relationship with management, and concentrated attention at work. RESULTS Average incidence of sick leave higher than 5.0% in the cohort period was 15.5%. The logistic model revealed that workers with average incidence of sick leave higher than 5.0% were 2.6 times more likely to be female; 2.0 time more likely to be smokers; 1.8 time more likely to be former smokers; 2.2 times more likely to report abnormal sleep and 10.5 times more likely to report dissatisfaction with their than workers with average incidence of sick leave ≤ 5.0% in the period. CONCLUSIONS In this population, female gender, being a smoker or a former smoker, reporting dissatisfaction with the job and reporting abnormal sleep are good predictors of occupational absenteeism with sick leave.
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Abstract
The cost of employee absenteeism in the United States is significant in terms of sick pay, overtime costs, replacement personnel compensation, and lost productivity. Little is known about what workers consider when deciding to use sick time. Previous studies have examined work absence from an array of perspectives, including resulting work strain, job satisfaction, and job security, but absenteeism in the workplace has not been examined in terms of decision making. To scrutinize workers' decisions about using sick time, a descriptive pilot study was undertaken with a convenience sample (n = 94) of working college students. The responses to the survey revealed that the majority of the workers (73.4%) used sick time because they were too ill to work. These results are in direct opposition to previous research and suggest that workers may need education about preventing and managing minor illnesses before an absence is needed. Supporting and engaging employees and their significant others in healthy worker programs, regular surveillance examinations, and illness prevention strategies are wise investments in companies' financial futures. Future research should include a comparative study of worker absenteeism between worksites with occupational health nurses and those without nurses.
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Sandal CL, Click ER, Dowling DA, Guzik A. The decision-making process of workers in using sick time. Workplace Health Saf 2014; 62:318-24. [PMID: 25101929 DOI: 10.1177/216507991406200802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 05/27/2014] [Indexed: 11/15/2022]
Abstract
The cost of employee absenteeism in the United States is significant in terms of sick pay, overtime costs, replacement personnel compensation, and lost productivity. Little is known about what workers consider when deciding to use sick time. Previous studies have examined work absence from an array of perspectives, including resulting work strain, job satisfaction, and job security, but absenteeism in the workplace has not been examined in terms of decision making. To scrutinize workers' decisions about using sick time, a descriptive pilot study was undertaken with a convenience sample (n = 94) of working college students. The responses to the survey revealed that the majority of the workers (73.4%) used sick time because they were too ill to work. These results are in direct opposition to previous research and suggest that workers may need education about preventing and managing minor illnesses before an absence is needed. Supporting and engaging employees and their significant others in healthy worker programs, regular surveillance examinations, and illness prevention strategies are wise investments in companies' financial futures. Future research should include a comparative study of worker absenteeism between worksites with occupational health nurses and those without nurses.
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Melsom AM. Long-term sickness absence during pregnancy and the gender balance of workplaces. Scand J Public Health 2014; 42:627-34. [PMID: 25013213 DOI: 10.1177/1403494814541596] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS This study addresses how the gender composition of workplaces affects pregnant women's sickness absence. It also assesses whether an observed association may be explaine by differential selection to female- or male-dominated workplaces. METHODS The analyses are based on Norwegian registry data from 2003-2011. Using Poisson regressions with detailed control for occupational categories, I examine whether the number of absence days are associated with the proportion of females at the workplace. I address possible selection effects by Poisson regressions with fixed individual effects using only within-individual variation on women with two or more pregnancies during the time window. RESULTS The analyses indicate a positive and significant relationship between the female proportion in workplaces and sickness absence rates during pregnancy. Analyses limited to within-individual variation also show positive and significant effects of similar strength, indicating that the observed relationship is not due to differential selection of absence-prone pregnant workers to female-dominated workplaces. CONCLUSIONS The proportion of female individuals at workplaces is positively associated with sickness absence rates during pregnancy this association is not likely explained by occupational nor individual characteristics the results are consistent with absence culture theory and more lenient norms concerning sickness absence during pregnancy at female-dominated workplaces.
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Affiliation(s)
- Anne M Melsom
- Department of Sociology and Human Geography, University of Oslo, Oslo, Norway
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Ariansen AMS. Age, occupational class and sickness absence during pregnancy: a retrospective analysis study of the Norwegian population registry. BMJ Open 2014; 4:e004381. [PMID: 24793246 PMCID: PMC4025458 DOI: 10.1136/bmjopen-2013-004381] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 03/13/2014] [Accepted: 04/10/2014] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Western women increasingly delay having children to advance their career, and pregnancy is considered to be riskier among older women. In Norway, this development surprisingly coincides with increased sickness absence among young pregnant women, rather than their older counterparts. This paper tests the hypothesis that young pregnant women have a higher number of sick days because this age group includes a higher proportion of working class women, who are more prone to sickness absence. DESIGN A zero-inflated Poisson regression was conducted on the Norwegian population registry. PARTICIPANTS All pregnant employees giving birth in 2004-2008 were included in the study. A total number of 216 541 pregnancies were observed among 180 483 women. OUTCOME MEASURE Number of sick days. RESULTS Although the association between age and number of sick days was U-shaped, pregnant women in their early 20s had a higher number of sick days than those in their mid-40s. This was particularly the case for pregnant women with previous births. In this group, 20-year-olds had 12.6 more sick days than 45-year-olds; this age difference was reduced to 6.3 after control for class. Among women undergoing their first pregnancy, 20-year-olds initially had 1.2 more sick days than 45-year-olds, but control for class altered this age difference. After control for class, 45-year-old first-time pregnant women had 2.9 more sick days than 20-year-olds with corresponding characteristics. CONCLUSIONS The negative association between age and sickness absence was partly due to younger age groups including more working class women, who were more prone to sickness absence. Young pregnant women's needs for job adjustments should not be underestimated.
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Fredriksen EH, Harris J, Moland KM, Sundby J. "They ask whether this is real or fake": a qualitative norwegian study of pregnancy complaints and access to social benefits. Health Care Women Int 2013; 35:266-84. [PMID: 23790058 DOI: 10.1080/07399332.2013.794463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Women increasingly combine paid work and childbearing, but working full time throughout pregnancy is commonly experienced as overtaxing. We explored access to sick leave or medical care as experienced by Norwegian women suffering from pelvic girdle pain during pregnancy. Through a grounded theory approach we compared results from qualitative interviews and open Internet discussions, and found that women struggled with credibility and that their claims for sick leave or medical care were commonly disregarded. Support from peers was seen as instrumental in regaining control over their health and was a vehicle in developing critical health literacy.
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Dørheim SK, Eberhard-Gran M. What is the right level of sick leave among pregnant women? WOMENS HEALTH 2013; 9:125-6. [PMID: 23477316 DOI: 10.2217/whe.13.3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Brekke I, Berg JE, Sletner L, Jenum AK. Doctor-certified sickness absence in first and second trimesters of pregnancy among native and immigrant women in Norway. Scand J Public Health 2013; 41:166-73. [PMID: 23296157 DOI: 10.1177/1403494812472005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS The authors sought to estimate differences in doctor-certified sickness absence during pregnancy among immigrant and native women. METHODS Population-based cohort study of pregnant women attending three Child Health Clinics in Groruddalen, Oslo, and their offspring. Questionnaire data were collected at gestational weeks 10-20 and 28. The participation rate was 74%. A multivariate Poisson regression was used to analyse differences in sickness absence in pregnancy between immigrant and native women. RESULTS A total of 573 women who were employed prior to their pregnancies were included, 51% were immigrants. After adjusting for age, years of education, marital status, number of children, occupation, part-time/full-time work, health status, severe pregnancy-induced emesis and language proficiency, the immigrant/native differences in number of weeks with sickness absence decreased from 2.0 to 1.2 weeks. Part-time/full-time work, health status, severe pregnancy-induced emesis and language proficiency were significant predictors of sickness absence. CONCLUSION Immigrant women had higher sickness absence than native women during pregnancy. The difference in average number of weeks between native and immigrant women was partly explained by poorer health status prior to pregnancy, severe pregnancy-induced emesis and poorer proficiency in the Norwegian language among the immigrant women.
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Affiliation(s)
- Idunn Brekke
- Institute for Social Research, Oslo, Norway. Idunn.brekke@ samfunnsforskning.no
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Dørheim SK, Bjorvatn B, Eberhard-Gran M. Sick leave during pregnancy: a longitudinal study of rates and risk factors in a Norwegian population. BJOG 2012; 120:521-30. [DOI: 10.1111/1471-0528.12035] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2012] [Indexed: 10/27/2022]
Affiliation(s)
- SK Dørheim
- MoodNet Research Group; Division of Psychiatry; Stavanger University Hospital; Stavanger; Norway
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Røsand GMB, Slinning K, Eberhard-Gran M, Røysamb E, Tambs K. Partner relationship satisfaction and maternal emotional distress in early pregnancy. BMC Public Health 2011; 11:161. [PMID: 21401914 PMCID: PMC3063829 DOI: 10.1186/1471-2458-11-161] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 03/14/2011] [Indexed: 12/20/2022] Open
Abstract
Background Recognition of maternal emotional distress during pregnancy and the identification of risk factors for this distress are of considerable clinical- and public health importance. The mental health of the mother is important both for herself, and for the physical and psychological health of her children and the welfare of the family. The first aim of the present study was to identify risk factors for maternal emotional distress during pregnancy with special focus on partner relationship satisfaction. The second aim was to assess interaction effects between relationship satisfaction and the main predictors. Methods Pregnant women enrolled in the Norwegian Mother and Child Cohort Study (n = 51,558) completed a questionnaire with questions about maternal emotional distress, relationship satisfaction, and other risk factors. Associations between 37 predictor variables and emotional distress were estimated by multiple linear regression analysis. Results Relationship dissatisfaction was the strongest predictor of maternal emotional distress (β = 0.25). Other predictors were dissatisfaction at work (β = 0.11), somatic disease (β = 0.11), work related stress (β = 0.10) and maternal alcohol problems in the preceding year (β = 0.09). Relationship satisfaction appeared to buffer the effects of frequent moving, somatic disease, maternal smoking, family income, irregular working hours, dissatisfaction at work, work stress, and mother's sick leave (P < 0.05). Conclusions Dissatisfaction with the partner relationship is a significant predictor of maternal emotional distress in pregnancy. A good partner relationship can have a protective effect against some stressors.
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Affiliation(s)
- Gun-Mette B Røsand
- Norwegian Institute of Public Health, Division of Mental Health, PO Box 4404 Nydalen, N-0403 Oslo, Norway.
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Abstract
BACKGROUND Sick leave is a topical subject, particularly following the revision of the Agreement on a More Inclusive Working Life (the IA agreement). However, there has been little discussion about the extent to which sick leave may be related to work. MATERIAL AND METHODS The paper is based on a non-systematic literature search using PubMed combined with personal research and experience. RESULTS Various studies indicate that a significant proportion of all sick leaves may be due to illness caused by working conditions. Heavy physical work, awkward work postures and low job control are particularly important factors. People who suffer from work-related illnesses have a greater need for absence from work than people with similar illnesses caused by factors other than their work. Workplace interventions designed to prevent work-related illness may also prevent sick leave. Sick leaves which are due to an imbalance between an individual's resources and his/her job demands, may often be prevented or shortened by workplace interventions, irrespective of what causes the imbalance. INTERPRETATION It is my view that more importance should be attached to primary preventive measures to reduce work-related illness, combined with workplace interventions to accommodate people who carry a higher risk of sick leave. However, this is not given sufficient attention in the current IA agreement.
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Affiliation(s)
- Ingrid Sivesind Mehlum
- Department for occupational medicine and epidemiology, The National Institute of Occupational Health, PO Box 8149 Dep, 0033 Oslo, Norway.
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Madsen C, Gehring U, Walker SE, Brunekreef B, Stigum H, Naess O, Nafstad P. Ambient air pollution exposure, residential mobility and term birth weight in Oslo, Norway. ENVIRONMENTAL RESEARCH 2010; 110:363-71. [PMID: 20227069 DOI: 10.1016/j.envres.2010.02.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2009] [Revised: 01/27/2010] [Accepted: 02/22/2010] [Indexed: 05/03/2023]
Abstract
Environmental exposure during pregnancy may have lifelong health consequences for the offspring and some studies have association between maternal exposure to air pollution during pregnancy and offspring's birth weight. However, many of these studies do not take into account small-scale variations in exposure, residential mobility, and work addresses during pregnancy. We used information from the National Birth Registry of Norway to examine associations between ambient environmental exposure such as air pollution and temperature, and offspring's birth weight taking advantage of information on migration history and work address in a large population-based cohort. A dispersion model was used to estimate ambient air pollution levels at all residential addresses and work addresses for a total of 25,229 pregnancies between 1999 and 2002 in Oslo, Norway. Ambient exposure to traffic pollution for the entire pregnancy was associated with a reduction in term birth weight in crude analyzes when comparing children of the highest and lowest exposed mothers. No evidence for an association between exposure to traffic pollution at home and work addresses and term birth weight after adjustment for covariates known to influence birth weight during pregnancy. After stratification, small statistically non-significant reductions were present but only for multiparious mothers. This group also had less residential mobility and less employment during pregnancy. The overall findings suggest no clear association between term birth weight and traffic pollution exposure during pregnancy. However, mobility patterns could introduce possible confounding when examining small-scale variations in exposure by using addresses. This could be of importance in future studies.
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Affiliation(s)
- Christian Madsen
- Division of Epidemiology, Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, NO-0403 Oslo, Norway.
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González-Galarzo MC, García AM, Estarlich M, García García F, Esplugues A, Rodríguez P, Rebagliato M, Ballester F. [Prevalence of exposure to occupational risks in pregnant Spanish workers (the INMA Project-Valencia)]. GACETA SANITARIA 2009; 23:420-6. [PMID: 19481306 DOI: 10.1016/j.gaceta.2009.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2008] [Accepted: 01/09/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To describe the prevalence of exposure to occupational risks among pregnant women and analyze its relationship with personal and occupational characteristics using information collected in the Childhood and Environment (Infancia y Medio Ambiente [INMA])-Valencia cohort study. METHODS The INMA-Valencia cohort study started in 2004 with 855 pregnant women living in Valencia, Spain. Data on sociodemographic variables (age, education and country of birth) and occupational conditions (activity, occupation, type of contract, working hours and self-reported occupational exposure to physical load and psychosocial, physical, chemical and biological risks) in women with paid employment during pregnancy (n=649) were collected through face-to-face interviews with a structured questionnaire in week 32 of pregnancy. RESULTS The prevalences of reported exposure to physical and psychosocial load and to physical pollutants (including non-ionizing radiations) were 56%, 63% and 62%, respectively. The prevalence of reported exposure to chemicals (including cleaning products) and biological pollutants was 22% and 6%, respectively. In general, the characteristics most closely associated with exposure to occupational risks were younger age, non-Spanish nationality, lower education, having a temporary contract or being self-employed. CONCLUSIONS This study is the first to quantify the prevalence of exposure to occupational risks during pregnancy in a Spanish population-based sample. According to the data observed, surveillance and control actions should be intensified in pregnant workers, as some of the observed occupational exposures have been consistently associated with detrimental reproductive and developmental effects.
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