Effects derived from occupational exposure to hazardous substances in pregnant working women: systematic review
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Keywords

Pregnancy; Hazardous Substances; Occupational Exposure; Risk Groups; Solvents; Chemical Pollution; Congenital Anomalies

How to Cite

1.
Barriocanal-Gómez P, del Pozo-Díez CM, Kudryavtseva O, Portillo Chicano I, Sanz-Valero J. Effects derived from occupational exposure to hazardous substances in pregnant working women: systematic review. Arch Prev Riesgos Labor [Internet]. 2021 Jul. 15 [cited 2024 Jul. 16];24(3):263-96. Available from: https://archivosdeprevencion.eu/index.php/aprl/article/view/154

Abstract

Objective: To review the effects derived from occupational exposure on pregnant working women exposed to hazardous substances.

Methods: Critical analysis of the works retrieved by systematic review in MEDLINE (PubMed), EMBASE, Cochrane Library, Scopus, Web of Science, LILACS and MEDES, up to January 2021. The Search Equation was developed by means of the descriptors «Pregnancy», «Hazardous Substances» and «Occupational Exposure», as well as using related Entry Terms and the filters «Humans» and «Adult: 19+ years». The quality of the articles was evaluated via the STROBE questionnaire and the level of evidence and the grade of recommendation via the SIGN criteria.

Results: Out of the 420 references retrieved (366 digitally and 54 manually) and after applying the inclusion and exclusion criteria, 35 articles were selected. The STROBE evaluation obtained a median of 15.32, and the SIGN criteria, a 2+ level of evidence and a C grade of recommendation. Article obsolescence was high (Burton-Kebler half-life: 22.0; Price index: 0.00%). In 25 out of 35 articles, the exposure is to organic solvents. In 22 articles, congenital anomalies were notified.

Conclusions: The reviewed articles exhibited high obsolescence and a degree of evidence and recommendation that did not allow to fully ensure the validity and reliability of the observations made. The results manifested the association between the exposure to dangerous substances and the occurrence of different damages regarding the health of a pregnant worker and her offspring. The most common exposure was to organic solvents and the most observed effect was congenital alterations.

https://doi.org/10.12961/aprl.2021.24.03.04
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References

Instituto Nacional de Seguridad y Salud en el Trabajo (INSST). Directrices para la evaluación de riesgos y protección de la maternidad en el trabajo. Madrid: INSST; 2011. https://bit.ly/2OqXyCm

Rodríguez Ortiz de Salazar B, Jardón Dato E, Maqueda Blasco J, Álvarez Sáenz JJ. Riesgos laborales durante el embarazo. Med Segur Trab. 2005;51:53-63.

Directiva 92/85/CEE del Consejo. Comunicación de la Comisión sobre las directrices para la evaluación de los agentes químicos, físicos y biológicos, así como los procedimientos industriales considerados como peligrosos para la salud o la seguridad de la trabajadora embarazada, que haya dado a luz o en período de lactancia. COM/2000/0466 final, de 5 de noviembre de 2000. https://bit.ly/30vpxaE

Ley 39/1999, de 5 de noviembre, para promover la conciliación de la vida familiar y laboral de las personas trabajadoras. Boletín Oficial del Estado 266, de 6 de noviembre de 1999. https://www.boe.es/eli/es/l/1999/11/05/39/con

Real Decreto Legislativo 1/1994, de 20 de junio, por el que se aprueba el texto refundido de la Ley General de la Seguridad Social. Boletín Oficial del Estado 154, de 29 de junio de 1994. https://www.boe.es/eli/es/rdlg/1994/06/20/1/con

Ley 31/1995, de 8 de noviembre, de prevención de Riesgos Laborales. Boletín Oficial del Estado 269, de 10 de noviembre de 1995. https://www.boe.es/eli/es/l/1995/11/08/31

Rodríguez Ortiz de Salazar B, Martínez Herrera JA, Álvarez Collado L, Silva Mato A. Prestación por riesgos laborales durante el embarazo en Madrid 2000-2004. Med Segur Trab. 2006;52:15-28.

Villar R, Benavides FG, Serra L, Serra C. Prestación por riesgo durante el embarazo e incapacidad temporal en una cohorte de trabajadoras del Parc de Salut Mar (Barcelona, España). Gac Sanit. 2019;33:455-61.

Real Decreto 298/2009, de 6 de marzo, por el que se modifica el Real Decreto 39/1997, de 17 de enero, por el que se aprueba el Reglamento de los Servicios de Prevención, en relación con la aplicación de medidas para promover la mejora de la seguridad y de la salud en el trabajo de la trabajadora embarazada, que haya dado a luz o en período de lactancia. Boletín Oficial del Estado 57, de 7 de marzo de 2009. https://www.boe.es/eli/es/rd/2009/03/06/298

Sejbaek CS, Pedersen J, Schlünssen V, Begtrup LM, Juhl M, Bonde JP, et al. The influence of multiple occupational exposures on absence from work in pregnancy: a prospective cohort study. Scand J Work Environ Health. 2020;46:60‐8. doi:10.5271/sjweh.384081 19.

Henrotin J‐B, Béringuier H, Groupe de Travail de L’étude GaT‐Hospi G de T de LG‐H. Travailler à l’hôpital durant la grossesse: une étude descriptive nationale rétrospective en France. Sante Publique. 2020;31:611‐21. doi:10.3917/spub.195.0611

Antolínez Ruiz P, Lafaurie Villamil MM. Estrés y sobrecarga laboral durante el embarazo: experiencias de médicas del sector asistencial en Bogotá. Hacia Promoc Salud. 2017;22:84‐100. doi:10.17151/hpsal.2017.22.1.7

Frey G, Schuster M, Oberlinner C, Queier‐Wahrendorf A, Lang S, Yong M. Pregnant Employee Protection Program in a Large Chemical Company. J Occup Environ Med. 2015;57:965‐72. doi:10.1097/JOM.0000000000000505

Bidstrup SB, Kaerlev L, Thulstrup AM, Bonde JPE. Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes. Dan Med J. 2015;62:A5119.

Nugteren JJ, Snijder CA, Hofman A, Jaddoe VWV, Steegers EAP, Burdorf A. Work‐related maternal risk factors and the risk of pregnancy induced hypertension and preeclampsia during pregnancy. The Generation R Study. PLoS One. 2012;7:e39263. doi:10.1371/journal.pone.0039263

Larsen AD. The effect of maternal exposure to psychosocial job strain on pregnancy outcomes and child development. Dan Med J. 2015;62:B5015.

Langlois PH, Hoyt AT, Desrosiers TA, Lupo PJ, Lawson CC, Waters MA, et al. Maternal occupational exposure to polycyclic aromatic hydrocarbons and small for gestational age offspring. Occup Environ Med. 2014;71:529‐35. doi:10.1136/oemed‐2013‐101833

Mayhoub F, Berton T, Bach V, Tack K, Deguines C, Floch‐Barneaud A, et al. Self‐reported parental exposure to pesticide during pregnancy and birth outcomes: the MecoExpo cohort study. PLoS One. 2014;9:e99090. doi:10.1371/journal.pone.0099090

Lojewski J, Flothow A, Harth V, Mache S. Employed and expecting in Germany: A qualitative investigation into pregnancy‐related occupational stress and coping behavior. Work. 2018;59:183‐99. doi:10.3233/WOR‐172673

Zachek CM, Schwartz JM, Glasser M, DeMicco E, Woodruff TJ. A screening questionnaire for occupational and hobby exposures during pregnancy. Occup Med (Lond). 2019;69:428‐35. doi:10.1093/occmed/kqz094

Ghatan CE, Fassiotto M, Jacobsen JP, Sze DY, Kothary N. Occupational Radiation Exposure during Pregnancy: A Survey of Attitudes and Practices among Interventional Radiologists. J Vasc Interv Radiol. 2016;27:1013‐1020.e3. doi:10.1016/j.jvir.2016.03.040

Jahnke SA, Poston WSC, Jitnarin N, Haddock CK. Maternal and Child Health Among Female Firefighters in the U.S. Matern Child Health J. 2018;22:922‐31. doi:10.1007/s10995‐018‐2468‐3

Henrotin J‐B, Vaissière M, Etaix M, Dziurla M, Malard S, Lafon D. Exposition aux risques professionnels pendant la grossesse : retour de services médicaux interentreprises. Gynecol Obstet Fertil Senol. 2018;46:20‐7. doi:10.1016/j.gofs.2017.10.029

Wanden-Berghe C, Sanz-Valero J. Systematic reviews in nutrition: standardized methodology. Br J Nutr. 2012;107:S3-7. doi:10.1017/S0007114512001432

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Gac Sanit. 2008;22:144-50. Doi:10.1157/13119325

Harbour R, Miller J. A new system for grading recommendations in evidence based guidelines. BMJ. 2001;323:334-36. doi:10.1136/bmj.323.7308.334

Ley 14/2007, de 3 de julio, de Investigación biomédica. Boletín Oficial del Estado 159, de 4 de julio de 2007. https://www.boe.es/eli/es/l/2007/07/03/14

Makelarski JA, Romitti PA, Rocheleau CM, Burns TL, Stewart PA, Waters MA, et al. Maternal periconceptional occupational pesticide exposure and neural tube defects. Birth Defects Res A Clin Mol Teratol. 2014;100:877-86. doi:10.1002/bdra.23293

Vaktskjold A, Talykova LV, Nieboer E. Congenital anomalies in newborns to women employed in jobs with frequent exposure to organic solvents--a register-based prospective study. BMC Pregnancy Childbirth. 2011;11:83. doi:10.1186/1471-2393-11-83

Testud F, D’Amico A, Lambert-Chhum R, Garayt C, Descotes J. Pregnancy outcome after risk assessment of occupational exposure to organic solvents: a prospective cohort study. Reprod Toxicol. 2010;30:409-13. doi:10.1016/j.reprotox.2010.06.004

Garlantézec R, Monfort C, Rouget F, Cordier S. Maternal occupational exposure to solvents and congenital malformations: a prospective study in the general population. Occup Environ Med. 2009;66:456-63. doi:10.1136/oem.2008.041772

Halliday-Bell JA, Gissler M, Jaakkola JJK. Work as a hairdresser and cosmetologist and adverse pregnancy outcomes. Occup Med (Lond). 2009;59:180-84. doi:10.1093/occmed/kqp017

Vaktskjold A, Talykova LV, Chashchin VP, Odland JØ, Nieboer E. Spontaneous abortions among nickel-exposed female refinery workers. Int J Environ Health Res. 2008;18:99-115. doi:10.1080/09603120701498295

Shirangi A, Fritschi L, Holman CDJ. Maternal occupational exposures and risk of spontaneous abortion in veterinary practice. Occup Environ Med. 2008;65:719-25. doi:10.1136/oem.2007.035246

Frey GM, Ott MG, Messerer P, Nasterlack M, Queisser-Luft A, Zober A. Pregnancy protection program in a large chemical company: design and initial survey results. J Occup Environ Med. 2007;49:507-18. doi:10.1097/JOM.0b013e31805c7454

Chevrier C, Dananché B, Bahuau M, Nelva A, Herman C, Francannet C, et al. Occupational exposure to organic solvent mixtures during pregnancy and the risk of non-syndromic oral clefts. Occup Environ Med. 2006;63:617-23. doi:10.1136/oem.2005.024067

Vaktskjold A, Talykova LV, Chashchin VP, Nieboer E, Thomassen Y, Odland JO. Genital malformations in newborns of female nickel-refinery workers. Scand J Work Environ Health. 2006;32:41-50. doi:10.5271/sjweh.975

Wennborg H, Magnusson LL, Bonde JP, Olsen J. Congenital malformations related to maternal exposure to specific agents in biomedical research laboratories. J Occup Environ Med. 2005;47:11-9. doi:10.1097/01.jom.0000150237.67801.93

Shaw GM, Nelson V, Iovannisci DM, Finnell RH, Lammer EJ. Maternal occupational chemical exposures and biotransformation genotypes as risk factors for selected congenital anomalies. Am J Epidemiol. 2003;157:475-84. doi:10.1093/aje/kwg013

Shaw GM, Selvin S, Carmichael SL, Schaffer DM, Nelson V, Neri E. Assessing combined chemical exposures as risk factors for neural tube defects. Reprod Toxicol. 2001;15:631-35. doi:10.1016/s0890-6238(01)00180-0

Schüz J, Kaletsch U, Meinert R, Kaatsch P, Michaelis J. Risk of childhood leukemia and parental self-reported occupational exposure to chemicals, dusts, and fumes: results from pooled analyses of German population-based case-control studies. Cancer Epidemiol Biomarkers Prev. 2000;9:835-38.

Lorente C, Cordier S, Bergeret A, De Walle HE, Goujard J, Aymé S, et al. Maternal occupational risk factors for oral clefts. Occupational Exposure and Congenital Malformation Working Group. Scand J Work Environ Health. 2000;26:137-45. doi:10.5271/sjweh.523

Hrubá D, Kukla L, Tyrlík M. Occupational risks for human reproduction: ELSPAC Study. European Longitudinal Study of Pregnancy and Childhood. Cent Eur J Public Health. 1999;7:210-15.

Khattak S, K-Moghtader G, McMartin K, Barrera M, Kennedy D, Koren G. Pregnancy outcome following gestational exposure to organic solvents: a prospective controlled study. JAMA. 1999;281:1106-09. doi:10.1001/jama.281.12.1106

Seidler A, Raum E, Arabin B, Hellenbrand W, Walter U, Schwartz FW. Maternal occupational exposure to chemical substances and the risk of infants small-for-gestational-age. Am J Ind Med. 1999;36:213-22. doi:10.1002/(sici)1097-0274(199907)36:1<213::aid-ajim30>3.0.co;2-a

García AM, Fletcher T. Maternal occupation in the leather industry and selected congenital malformations. Occup Environ Med. 1998;55:284-86. doi:10.1136/oem.55.4.284

Hewitt JB, Tellier L. Risk of adverse outcomes in pregnant women exposed to solvents. J Obstet Gynecol Neonatal Nurs. 1998;27:521-31. doi:10.1111/j.1552-6909.1998.tb02618.x

Doyle P, Roman E, Beral V, Brookes M. Spontaneous abortion in dry cleaning workers potentially exposed to perchloroethylene. Occup Environ Med. 1997;54:848-53. doi:10.1136/oem.54.12.848

Agnesi R, Valentini F, Mastrangelo G. Risk of spontaneous abortion and maternal exposure to organic solvents in the shoe industry. Int Arch Occup Environ Health. 1997;69:311-16. doi:10.1007/s004200050153

Laumon B, Martin JL, Collet P, Bertucat I, Verney MP, Robert E. Exposure to organic solvents during pregnancy and oral clefts: a case-control study. Reprod Toxicol. 1996;10:15-9. doi:10.1016/0890-6238(95)02013-6

Swan SH, Beaumont JJ, Hammond SK, VonBehren J, Green RS, Hallock MF, et al. Historical cohort study of spontaneous abortion among fabrication workers in the Semiconductor Health Study: agent-level analysis. Am J Ind Med. 1995;28:751-69. doi:10.1002/ajim.4700280610

Irwin DE, Savitz DA, St André KA, Hertz-Picciotto I. Study of occupational risk factors for pregnancy-induced hypertension among active duty enlisted Navy personnel. Am J Ind Med. 1994;25:349-59. doi:10.1002/ajim.4700250305

Taskinen H, Kyyrönen P, Hemminki K, Hoikkala M, Lajunen K, Lindbohm ML. Laboratory work and pregnancy outcome. J Occup Med. 1994;36:311-19. doi:10.1097/00043764-199403000-00008

McAbee RR, Gallucci BJ, Checkoway H. Adverse reproductive outcomes and occupational exposures among nurses: an investigation of multiple hazardous exposures. AAOHN J. 1993;41:110-9. doi:10.1177/216507999304100301

Roeleveld N, Zielhuis GA, Gabreëls F. Mental retardation and parental occupation: a study on the applicability of job exposure matrices. Br J Ind Med. 1993;50:945-54. doi:10.1136/oem.50.10.945

Cordier S, Ha MC, Ayme S, Goujard J. Maternal occupational exposure and congenital malformations. Scand J Work Environ Health. 1992;18:11-7. doi:10.5271/sjweh.1613

Goulet L, Thériault G. Stillbirth and chemical exposure of pregnant workers. Scand J Work Environ Health. 1991;17:25-31. doi:10.5271/sjweh.1738

Ahlborg G, Hogstedt C, Bodin L, Bárány S. Pregnancy outcome among working women. Scand J Work Environ Health. 1989;15:227-33. doi:10.5271/sjweh.1858

Kyyrönen P, Taskinen H, Lindbohm ML, Hemminki K, Heinonen OP. Spontaneous abortions and congenital malformations among women exposed to tetrachloroethylene in dry cleaning. J Epidemiol Community Health. 1989;43:346-51. doi:10.1136/jech.43.4.346

McDonald JC, Lavoie J, Côté R, McDonald AD. Chemical exposures at work in early pregnancy and congenital defect: a case-referent study. Br J Ind Med. 1987;44:527-33. doi:10.1136/oem.44.8.527

Hemminki K, Kyyrönen P, Lindbohm ML. Spontaneous abortions and malformations in the offspring of nurses exposed to anaesthetic gases, cytostatic drugs, and other potential hazards in hospitals, based on registered information of outcome. J Epidemiol Community Health. 1985;39:141-7. doi:10.1136/jech.39.2.141

Axelsson G, Lütz C, Rylander R. Exposure to solvents and outcome of pregnancy in university laboratory employees. Br J Ind Med. 1984;41:305-12. doi:10.1136/oem.41.3.305

Troncoso-Piñeiro P, González de Giarratana AE, Rivadulla-Lema I, Torres-Romero MG, Sanz-Valero J. Neoplasias en trabajadores expuestos al aluminio y/o sus compuestos: Revisión sistemática. Med Segur Trab. 2018;64:312-26.

Álvarez Velásquez S, Sanz Valero J. Ventajas de la quimioterapia domiciliaria en los enfermos adultos con neoplasias: revisión sistemática. Hosp Domic. 2020;4:25-41. doi:10.22585/hospdomic.v4i1.98

Muñoz-Cobo-Orosa B, Varela-Serrano C, Rodriguez-Ledott M, Sanz-Valero J. Lesiones malignas de la piel en trabajadores del sector pesquero: revisión sistemática. Arch Prev Riesgos Labor. 2021;24:47-61. doi:10.12961/aprl.2021.24.01.05

Glasziou P, Vandenbroucke JP, Chalmers I. Assessing the quality of research. BMJ. 2004;328:39-41. doi:10.1136/bmj.328.7430.39

Manterola C, Asenjo-Lobos C, Otzen T. Jerarquización de la evidencia: Niveles de evidencia y grados de recomendación de uso actual. Rev Chil Infectol. 2014;31:705-18. doi:10.4067/S0716-10182014000600011

Correa A, Stewart WF, Yeh HC, Santos-Burgoa C. Exposure measurement in case-control studies: reported methods and recommendations. Epidemiol Rev. 1994;16:18-32. doi:10.1093/oxfordjournals.epirev.a036142

Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Int J Surg. 2014;12:1500-24. doi:10.1016/j.ijsu.2014.07.014

Melián-Fleitas L, Franco-Pérez ÁM, Sanz-Valero J. Análisis bibliométrico y temático de la producción científica sobre salud laboral relacionada con nutrición, alimentación y dieta, indexada en MEDLINE. Med Segur Trab. 2019;65:10-23.

Hernández Hernández H, González Perfetti AE, Torres Romero MG, Rivadulla Lema I, Troncoso Piñeiro P, Sanz-Valero J. Características de las trabajadoras embarazadas y procedimientos de protección de la maternidad: estudio multicéntrico. Rev Asoc Esp Med Trab. 2020;29:340-50.

Domingo-Pueyo A, Sanz-Valero J, Wanden-Berghe C. Efectos sobre la salud de la exposición laboral al cromo y sus compuestos: revisión sistemática. Arch Prev Riesgos Labor. 2014;17:142-53. doi:10.12961/aprl.2014.17.3.03

Mancheño Potenciano MC, Izquierdo García MÁ, editores. Exposición laboral a disolventes. Madrid: Unión Sindical de Madrid Región de CCOO; 2008. https://bit.ly/3jYhmMb

Ballester Arias AR, García AM. Asociación entre la exposición laboral a factores psicosociales y la existencia de trastornos musculoesqueléticos en personal de enfermería: revisión sistemática y meta-análisis. Rev Esp Salud Publica. 2017;91:e201704028.

Calera Rubio AA, Roel Valdés JM, Casal Lareo A, Gadea Merino R, Rodrigo Cencillo F. Riesgo químico laboral: elementos para un diagnóstico en España. Rev Esp Salud Publica. 2005;79:283-95. doi:10.1590/S1135-57272005000200014

Vargas Marcos F. Prevención y control del riesgo de los productos químicos. Rev Esp Salud Publica. 1996;70:409-20.

Saavedra-Ontiveros D, Arteaga-Martínez M, Serrano-Medina B, Reynoso-Arizmendi F, Prada-Garay N, Cornejo-Roldán LR. Contaminación industrial con solventes orgánicos como causa de teratogénesis. Salud Publica Mex. 1996;38:3-12.

Cordier S, Garlantézec R, Labat L, Rouget F, Monfort C, Bonvallot N, et al. Exposure during pregnancy to glycol ethers and chlorinated solvents and the risk of congenital malformations. Epidemiology. 2012;23:806-12. doi:10.1097/EDE.0b013e31826c2bd8

National Institute for Occupational Safety and Health (NIOSH). The effects of workplace hazards on female reproductive health. Cincinnati, USA: NIOSH; 1999. https://bit.ly/2P3qvb8

Pak VM, Powers M, Liu J. Occupational chemical exposures among cosmetologists: risk of reproductive disorders. Workplace Health Saf. 2013; 61:522-8;quiz529. doi:10.1177/216507991306101204

Delvigne A, Vandromme J. Assessment of environmental knowledge and needs among assisted reproductive technology professionals. J Assist Reprod Genet. 2020;37:2347-55. doi:10.1007/s10815-020-01888-2

Kumar S, Sharma A, Kshetrimayum C. Environmental and occupational exposure and female reproductive dysfunction. Indian J Med Res. 2019;150:532-45. doi:10.4103/ijmr.ijmr_1652_17

Snijder CA., te Velde E, Roeleveld N, Burdorf A. Occupational exposure to chemical substances and time to pregnancy: a systematic review. Hum Reprod Updat. 2012;18:284-300. doi:10.1093/humupd/dms005

Bernabeu-Martínez MA, Ramos Merino M, Santos Gago JM, Álvarez Sabucedo LM, Wanden-Berghe C, Sanz-Valero J. Guidelines for safe handling of hazardous drugs: A systematic review. PLoS One. 2018;13:e0197172. doi:10.1371/journal.pone.0197172

Hagger MS. What makes a ‘good’ review article? Some reflections and recommendations. Health Psychol Rev. 2012;6:141-46. doi:10.1080/17437199.2012.705556

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