School of Medicine, University of California San Francisco, San Francisco, CA, USA.
Department of Obstetrics, Gynecology, and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, CA, USA.
Occup Med (Lond). 2019 Oct 1;69(6):428-435. doi: 10.1093/occmed/kqz094.
Occupational and environmental exposures during the prenatal period may be associated with adverse pregnancy outcomes and lifelong health effects. Yet, identification and evaluation of these potential hazards is lacking in routine obstetric care.
To assess the feasibility of incorporating a self-administered occupational and environmental exposure questionnaire into obstetric clinics.
A cross-sectional survey assessed prenatal clinic patients at a public hospital who were currently employed and <20 weeks gestation. Questionnaires evaluated job characteristics, workplace and hobby exposures, protective equipment use and symptoms during pregnancy.
Of 69 participants (96% response rate), 46% were predominantly Spanish-speaking. Primary occupations were caregiver (16%), cleaner (14%) and administrative assistant (14%). Overall, 93% were exposed to a workplace hazard, with most participants reporting physical stressors (82%) or organic solvent exposure (78%). Most women (74%) used some personal protective equipment. Nearly half (54%) reported at least one non-pregnancy symptom, and 52% were referred for follow-up with an occupational medicine practitioner. Household and hobby-related chemical exposures were common in our sample (91%). We observed moderate consistency between job task and chemical use responses: 67-99% of intentionally redundant questions were fully or partially matched. Closed- compared to open-ended activity questions identified a higher proportion of physical stressors (82% versus 12%) and cleaning product (76% versus 30%) exposures.
A self-administered questionnaire is an effective screening tool for identifying women with occupational and hobby-related exposures during pregnancy. Consistent incorporation of exposure assessment into prenatal care can improve clinical communications and early interventions for at-risk pregnant women.
孕期的职业和环境暴露可能与不良妊娠结局和终生健康影响有关。然而,在常规产科护理中,这些潜在危害的识别和评估仍存在不足。
评估在产科门诊纳入自我管理的职业和环境暴露问卷的可行性。
一项横断面调查评估了一家公立医院的产前门诊患者,这些患者目前正在工作且妊娠<20 周。问卷评估了工作特征、工作场所和业余爱好暴露、防护设备使用情况以及怀孕期间的症状。
在 69 名参与者中(96%的应答率),46%的人主要说西班牙语。主要职业是护理人员(16%)、清洁工(14%)和行政助理(14%)。总体而言,93%的人接触到工作场所的危害,大多数参与者报告身体压力源(82%)或有机溶剂暴露(78%)。大多数女性(74%)使用了一些个人防护设备。近一半(54%)报告至少有一种非妊娠症状,并且有 52%的人被转介给职业医学从业者进行随访。家庭和业余爱好相关的化学暴露在我们的样本中很常见(91%)。我们观察到工作任务和化学物质使用的回答之间存在中等一致性:故意重复的问题中有 67-99%完全或部分匹配。与开放式活动问题相比,封闭式问题确定了更高比例的身体压力源(82%对 12%)和清洁产品(76%对 30%)暴露。
自我管理的问卷是一种有效的筛查工具,可用于识别怀孕期间有职业和业余爱好相关暴露的女性。一致地将暴露评估纳入产前护理可以改善高危孕妇的临床沟通和早期干预。