title: [The influence of chemical and physical factors in the work environment on the amount of risk for abnormal pregnancy outcome].
abstract: The authors present a review of the literature on adverse effects of chemical and physical factors in the work environment on the course and outcome of pregnancy together with the results of their own study. The objective of the study was to identify the magnitude and frequency of exposures to chemical and physical factors at workposts where pregnant women were employed and to asses to what extent the existing exposure increased the risk for complications in pregnancy outcome The study involved the collection of information on factors with potential adverse effect on the course and outcome of pregnancy in employed women who were hospitalised in the Polish Mother Memorial Hospital in Lódź during the years 1992-94. The study was carried out in the group of 526 women with abnormal pregnancy outcome (N), including preterm birth (PB)--256; low birth weight < 2500 g (LBW)--232; small for gestational age (SGA)--196; asphyxia (APG)--116; and congenital malformations (M)--71. The control group (C) was composed of 683 women. As the reports on the work environment indicated working conditions in the group of women with abnormal pregnancy outcome were worse than in the control group; the presence of potentially harmful factors in the work environment were reported 57% of women in group N and 51.2% of women in group C. The increase in the risk of abnormal pregnancy outcome was relatively law (OR = 1.26). Taken into account the duration of exposure to these factors (period of employment under conditions of exposure to physical and/or chemical factors) it was revealed that pregnancy is at risk if women continue to work under such work conditions by the end of the second trimester. In this group of women odd ratio for abnormal pregnancy outcome accounted for 1.80 and it was statistically significant. The employment in the period preceding pregnancy and during the first trimester enhanced the risk insignificantly. A similar situation was observed if the risk of abnormal pregnancy outcome was assessed separately for exposure to chemical factors and to physical factors. A conclusion of great practical importance can be then drawn: expecting mothers should be prevented from working under harmful work conditions after the first trimester of gestation. Therefore, doctors attending occupationally working pregnant women should be obliged to make very careful inquiries about their working conditions. Logistic regression analysis helped to reveal and adverse effect of physical factors only in regard to newborns' body weight, but if failed to show negative effect of chemical factors on pregnancy outcome. On the other hand, the analysis highlighted a significant influence on certain social situations, lifestyles and mothers' health status on pregnancy outcome; a positive effect of higher education in the case of preterm birth and asphyxia; and a negative effect of mother's single status, smoking during pregnancy and the poor health condition during pregnancy on the incidence of congenital malformations.
authors.affiliation: Zakładu Fizjologii Pracy in Ergonomii Instytutu Medycyny Pracy im. Lodzi.
authors.forename: T
authors.initials: T
authors.lastname: Makowiec-Dabrowska
authors.forename: Z
authors.initials: Z
authors.lastname: Radwan-Włodarczyk
authors.forename: W
authors.initials: W
authors.lastname: Koszada-Włodarczyk
authors.forename: J
authors.initials: J
authors.lastname: Siedlecka
authors.forename: J
authors.initials: J
authors.lastname: Wilczyński
mesh_terms: D001238:Asphyxia Neonatorum / Q000453:epidemiology; D003080:Cold Temperature / Q000009:adverse effects; D003201:Computers; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D005260:Female; D015386:Hazardous Substances / Q000009:adverse effects*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D009622:Noise / Q000009:adverse effects*; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D011044:Poland; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D018570:Risk Assessment; D014732:Vibration / Q000009:adverse effects*
chemical_list: D015386:Hazardous Substances