Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping review

Objective Evidence is needed to guide organisational decision making about workplace accommodations for pregnant physicians. Our objective was to characterise the strengths and limitations of current research examining the association between physician-related occupational hazards with pregnancy, ob...

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Main Authors: Stephanie Smith, Moss Bruton Joe, Shannon M Ruzycki, Sarah Fletcher, Candace M Marsters, Lenka Stafl, Sarah Bugden, Rita Gustainis, Victoria Nkunu, Renee Reimer, Christine Hyde, Erica Dance
Format: Article
Language:English
Published: BMJ Publishing Group 2023-02-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/2/e064483.full
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author Stephanie Smith
Moss Bruton Joe
Shannon M Ruzycki
Sarah Fletcher
Candace M Marsters
Lenka Stafl
Sarah Bugden
Rita Gustainis
Victoria Nkunu
Renee Reimer
Christine Hyde
Erica Dance
author_facet Stephanie Smith
Moss Bruton Joe
Shannon M Ruzycki
Sarah Fletcher
Candace M Marsters
Lenka Stafl
Sarah Bugden
Rita Gustainis
Victoria Nkunu
Renee Reimer
Christine Hyde
Erica Dance
author_sort Stephanie Smith
collection DOAJ
description Objective Evidence is needed to guide organisational decision making about workplace accommodations for pregnant physicians. Our objective was to characterise the strengths and limitations of current research examining the association between physician-related occupational hazards with pregnancy, obstetrical and neonatal outcomes.Design Scoping review.Data sources MEDLINE/PubMed, EMBASE, CINAHL/ EBSCO, SciVerse Scopus and Web of Science/Knowledge were searched from inception to 2 April 2020. A grey literature search was performed on 5 April 2020. The references of all included articles were hand searched for additional citations.Eligibility criteria English language citations that studied employed pregnant people and any ‘physician-related occupational hazards’, meaning any relevant physical, infectious, chemical or psychological hazard, were included. Outcomes included any pregnancy, obstetrical or neonatal complication.Data extraction and synthesis Physician-related occupational hazards included physician work, healthcare work, long work hours, ‘demanding’ work, disordered sleep, night shifts and exposure to radiation, chemotherapy, anaesthetic gases or infectious disease. Data were extracted independently in duplicate and reconciled through discussion.Results Of the 316 included citations, 189 were original research studies. Most were retrospective, observational and included women in any occupation rather than healthcare workers. Methods for exposure and outcome ascertainment varied across studies and most studies had a high risk of bias in data ascertainment. Most exposures and outcomes were defined categorically and results from different studies could not be combined in a meta-analysis due to heterogeneity in how these categories were defined. Overall, some data suggested that healthcare workers may have an increased risk of miscarriage compared with other employed women. Long work hours may be associated with miscarriage and preterm birth.Conclusions There are important limitations in the current evidence examining physician-related occupational hazards and adverse pregnancy, obstetrical and neonatal outcomes. It is not clear how the medical workplace should be accommodated to improve outcomes for pregnant physicians. High-quality studies are needed and likely feasible.
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spelling doaj-art-ddbee29b4f374f66876cd8c28654bd742025-08-20T03:15:23ZengBMJ Publishing GroupBMJ Open2044-60552023-02-0113210.1136/bmjopen-2022-064483Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping reviewStephanie Smith0Moss Bruton Joe1Shannon M Ruzycki2Sarah Fletcher3Candace M Marsters4Lenka Stafl5Sarah Bugden6Rita Gustainis7Victoria Nkunu8Renee Reimer9Christine Hyde10Erica Dance111 Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UKDepartment of Medicine, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, CanadaUniversity of British Columbia, Vancouver, British Columbia, CanadaDepartment of Neurology, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, CanadaDepartment of Medicine, University of Calgary, Calgary, Alberta, CanadaMemorial University of Newfoundland, St. John`s, Newfoundland, CanadaUniversity of Toronto, Toronto, Ontario, CanadaDepartment of Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, CanadaUniversity of British Columbia, Vancouver, British Columbia, CanadaDepartment of Pediatrics, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, CanadaDepartment of Emergency Medicine, University of Alberta, Edmonton, Alberta, CanadaObjective Evidence is needed to guide organisational decision making about workplace accommodations for pregnant physicians. Our objective was to characterise the strengths and limitations of current research examining the association between physician-related occupational hazards with pregnancy, obstetrical and neonatal outcomes.Design Scoping review.Data sources MEDLINE/PubMed, EMBASE, CINAHL/ EBSCO, SciVerse Scopus and Web of Science/Knowledge were searched from inception to 2 April 2020. A grey literature search was performed on 5 April 2020. The references of all included articles were hand searched for additional citations.Eligibility criteria English language citations that studied employed pregnant people and any ‘physician-related occupational hazards’, meaning any relevant physical, infectious, chemical or psychological hazard, were included. Outcomes included any pregnancy, obstetrical or neonatal complication.Data extraction and synthesis Physician-related occupational hazards included physician work, healthcare work, long work hours, ‘demanding’ work, disordered sleep, night shifts and exposure to radiation, chemotherapy, anaesthetic gases or infectious disease. Data were extracted independently in duplicate and reconciled through discussion.Results Of the 316 included citations, 189 were original research studies. Most were retrospective, observational and included women in any occupation rather than healthcare workers. Methods for exposure and outcome ascertainment varied across studies and most studies had a high risk of bias in data ascertainment. Most exposures and outcomes were defined categorically and results from different studies could not be combined in a meta-analysis due to heterogeneity in how these categories were defined. Overall, some data suggested that healthcare workers may have an increased risk of miscarriage compared with other employed women. Long work hours may be associated with miscarriage and preterm birth.Conclusions There are important limitations in the current evidence examining physician-related occupational hazards and adverse pregnancy, obstetrical and neonatal outcomes. It is not clear how the medical workplace should be accommodated to improve outcomes for pregnant physicians. High-quality studies are needed and likely feasible.https://bmjopen.bmj.com/content/13/2/e064483.full
spellingShingle Stephanie Smith
Moss Bruton Joe
Shannon M Ruzycki
Sarah Fletcher
Candace M Marsters
Lenka Stafl
Sarah Bugden
Rita Gustainis
Victoria Nkunu
Renee Reimer
Christine Hyde
Erica Dance
Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping review
BMJ Open
title Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping review
title_full Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping review
title_fullStr Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping review
title_full_unstemmed Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping review
title_short Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping review
title_sort pregnancy obstetrical and neonatal outcomes in women exposed to physician related occupational hazards a scoping review
url https://bmjopen.bmj.com/content/13/2/e064483.full
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