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未清除的麻醉气体及长时间工作与雌性兽医早产的关联。

Associations of unscavenged anesthetic gases and long working hours with preterm delivery in female veterinarians.

作者信息

Shirangi Adeleh, Fritschi Lin, Holman C D'Arcy J

机构信息

From the School of Population Health, Faculty of Medicine, Dentistry and Health Sciences, and the Western Australian Institute for Medical Research, the University of Western Australia, Perth, Australia.

出版信息

Obstet Gynecol. 2009 May;113(5):1008-1017. doi: 10.1097/AOG.0b013e31819fe996.

Abstract

OBJECTIVE

To examine whether occupational hazards such as anesthetic gases, radiation, pesticides, and working hours in veterinary practice are associated with preterm delivery (before 37 weeks of gestation) in female veterinarians.

METHODS

The Health Risks of Australian Veterinarians project was conducted as a questionnaire-based survey of all graduates of Australian veterinary schools during the 40-year period 1960-2000. Approximately 1,200 female veterinarians participated in the survey. Pregnancy was defined as the unit of analysis. We restricted analyses to pregnancies of those women who reported being employed when the pregnancy began and were working only in clinical practice. Of 1,355 pregnancies in total in the file, 744 pregnancies were eligible for the final analysis.

RESULTS

The prevalence of preterm birth in women exposed to unscavenged anesthetic gases was 7.3% compared with 5.7% in the general population. In a Cox proportional hazards model controlling for the potential confounders, there was a significant 2.5-fold increase (hazard ratio 2.56, 95% confidence interval [CI] 1.33-4.91) in the risk of preterm delivery in women exposed to unscavenged anesthetic gases for 1 or more hours per week compared with the unexposed group (women who did not perform surgery and those who performed surgery in the presence of a scavenger system). A dose-response relation also was found within this group when exposure was divided into finer categories. There was also a strong and monotonic increase in risk of preterm delivery and the number of hours worked per week with veterinarians working more than 45 hours a week (hazard ratio 3.69, 95% CI 1.40-9.72) compared with those working fewer than 45 hours per week.

CONCLUSION

Long working hours and performing surgery in the absence of a scavenger system for anesthetic gases are important risk factors for preterm birth in female veterinarians.

摘要

目的

探讨兽医工作中诸如麻醉气体、辐射、杀虫剂及工作时长等职业危害因素是否与女性兽医早产(妊娠37周前)有关。

方法

澳大利亚兽医健康风险项目是一项基于问卷调查的研究,对象为1960年至2000年这40年间澳大利亚各兽医学院的所有毕业生。约1200名女性兽医参与了此次调查。以妊娠作为分析单位。我们将分析限定于那些报告在妊娠开始时受雇且仅从事临床工作的女性的妊娠情况。在该档案中总计1355次妊娠中,744次妊娠符合最终分析条件。

结果

暴露于未清除麻醉气体的女性中早产发生率为7.3%,而普通人群中这一比例为5.7%。在一个控制了潜在混杂因素的Cox比例风险模型中,与未暴露组(未进行手术的女性以及在有清除系统的情况下进行手术的女性)相比,每周暴露于未清除麻醉气体1小时或更长时间的女性早产风险显著增加2.5倍(风险比2.56,95%置信区间[CI]1.33 - 4.91)。当将暴露情况分为更细致的类别时,在该组内也发现了剂量反应关系。与每周工作少于45小时的兽医相比,每周工作超过45小时的兽医早产风险也呈现出强烈且单调的增加(风险比3.69,95%CI 1.40 - 9.72)。

结论

长时间工作以及在没有麻醉气体清除系统的情况下进行手术是女性兽医早产的重要风险因素。

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