Deprivation, occupational hazards and perinatal outcomes in pregnant workers.
BACKGROUND
Recent global economic difficulties have widened social inequalities, but their impact on pregnant workers is not known.


OBJECTIVE
To investigate the association between deprivation, exposure to occupational hazards and adverse perinatal outcomes in pregnant workers.


METHODS
A cross-sectional study performed in 2014 in French occupational health services. Eligible workers were women who had worked during their pregnancy and had a medical visit by occupational health physicians (OHPs) after delivery and at the time of returning to work. Deprivation was measured using the EPICES scale (Evaluation of Precariousness and Inequalities in Health Examination Centres). Information on birth outcomes was self-reported. Occupational risks for pregnancy were assessed by OHPs. Jobs were coded by the occupational health team using standardized French nomenclature. The groups (deprivation/no deprivation) were compared using univariate (chi-squared test) and multivariate Poisson regression analyses.


RESULTS
Of 1402 pregnant workers, 293 (21%) were classed as deprived. This group more frequently encountered occupational hazards, particularly for physical exposures (P < 0.001), and had a higher risk of cumulated occupational hazards of three or more for pregnancy [adjusted relative risk (RRa) = 4.2; 95% confidence interval (CI) 2.2-7.9]. Our findings suggest that deprivation and exposure to three or more occupational hazards during pregnancy cumulatively increased the risk of pre-term birth (RRa = 3.9; 95% CI 1.2-12.4).


CONCLUSIONS
Our data suggest that deprived pregnant workers are an occupationally vulnerable group.
Département épidémiologie en entreprise, Institut National de Recherche et Sécurité, 1 rue du Morvan Vandoeuvre-Les-Nancy, 54519 Cedex, France, jeanbernardhenrotin@wanadoo.fr.
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Henrotin
Santé Travail Béziers Coeur d'Hérault, 79 avenue Georges Clémenceau, Béziers, 34502 Cedex, France.
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Vaissière
Santé Travail Loire Nord, 11 petite rue des tanneries CS70035, 42335 Roannes Cedex, France.
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Etaix
Département épidémiologie en entreprise, Institut National de Recherche et Sécurité, 1 rue du Morvan Vandoeuvre-Les-Nancy, 54519 Cedex, France.
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Dziurla
Département épidémiologie en entreprise, Institut National de Recherche et Sécurité, 1 rue du Morvan Vandoeuvre-Les-Nancy, 54519 Cedex, France.
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Radauceanu
Département Etudes et assistances médicales, Institut National de Recherche et Sécurité, 65 boulevard Richard-Lenoir, 75011 Paris, France.
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Malard
Consultation de pathologies professionnelles, Hôpital Raymond Poincaré, 104 Boulevard Raymond Poincaré, 92380 Garches, France.
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Lafon
D000328:Adult; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D009784:Occupational Diseases / Q000453:epidemiology*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
EPICES score; individual social deprivation; occupational hazards; pre-term birth.; pregnancy at work