Occupational determinants of adverse pregnancy outcomes: work in healthcare and exposure to welding fumes and metal dust

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Quansah11PhD.pdf

2151-07 http://eprints.org/relation/hasVolatileVersion http://etheses.bham.ac.uk/id/document/15742 http://eprints.org/relation/hasVersion http://etheses.bham.ac.uk/id/document/15742 http://eprints.org/relation/hassmallThumbnailVersion http://etheses.bham.ac.uk/id/document/15742 http://eprints.org/relation/hasVolatileVersion http://etheses.bham.ac.uk/id/document/15743 http://eprints.org/relation/hasVersion http://etheses.bham.ac.uk/id/document/15743 http://eprints.org/relation/haspreviewThumbnailVersion http://etheses.bham.ac.uk/id/document/15743 http://eprints.org/relation/hasVolatileVersion http://etheses.bham.ac.uk/id/document/15744 http://eprints.org/relation/hasVersion http://etheses.bham.ac.uk/id/document/15744 http://eprints.org/relation/hasIndexCodesVersion http://etheses.bham.ac.uk/id/document/15744 15742 2 26287 document 15742 small.png image/png 0944521baec66da4f4d3068d72b9ec0a MD5 3225 2011-10-31 13:01:51 http://etheses.bham.ac.uk//id/eprint/676/2/small.png 676 2 2 image/png thumbnail_small Thumbnail Documents conversion from application/pdf to thumbnail_small en staffonly

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http://eprints.org/relation/isVersionOf http://etheses.bham.ac.uk/id/document/15741 http://eprints.org/relation/isVolatileVersionOf http://etheses.bham.ac.uk/id/document/15741 http://eprints.org/relation/isIndexCodesVersionOf http://etheses.bham.ac.uk/id/document/15741 archive 4031 disk0/00/00/06/76 2011-10-31 13:01:41 2019-01-23 09:52:37 2011-10-31 13:01:41 thesis show 0 Quansah Reginald Jaakkola Jouni Skelton John ftp://ubira.bham.ac.uk/eTheses/676_Quansah/ University of Birmingham Occupational determinants of adverse pregnancy outcomes: work in healthcare and exposure to welding fumes and metal dust unpub RA0421 RG 10col_mede Research related to this thesis is published as Quansah R, Jaakkola JJK. Occupational exposures and adverse pregnancy outcomes among nurses: a systematic review and meta-analysis. J Womens Health 2010; 19: 1851–1862 http://dx.doi.org/10.1089/jwh.2009.1876 Quansah R, Gissler M, Jaakkola JJK. Work as a nurse and a midwife and adverse Pregnancy outcomes: A Finnish nationwide population-based study. J Womens Health. 2009; 18: 2071–2076. http://dx.doi.org/10.1089/jwh.2008.1062 Quansah R, Gissler M, Jaakkola JJK. Work as a physician and adverse pregnancy outcomes: a Finnish nationwide population-based Registry study. Eur J Epidemiol. 2009; 24: 531–536. http://dx.doi.org/10.1007/s10654-009-9369-0 Quansah R, Jaakkola JJK. Paternal and maternal exposure to welding fumes and metal dusts or fumes and adverse pregnancy outcomes. Int Arch Occup and Environ Health. 2009; 82: 529–537. http://dx.doi.org/10.1007/s00420-008-0349-6 The goal of this thesis is to (i) systematically review all epidemiologic studies reporting on the relationship between occupational exposures and adverse pregnancy outcomes among nurses and physicians, (ii) compare the risk of adverse pregnancy outcomes between singleton newborns of nurses, midwives, and physicians and those of women in other occupations (reference groups) and (iii) investigate the risk of adverse pregnancy outcomes among parents exposed to welding fumes or metal dust. Data were obtained from all epidemiologic studies reporting on the relation between occupational exposures and adverse pregnancy outcomes among nurses and physicians, the 1990–2006 Finnish Medical Birth Register, and the Finnish Prenatal Environment and Health Study (FPEHS). Occupational exposure to anaesthetic gases was associated with spontaneous abortion and congenital malformation among nurses and physicians. Chemotherapy agents were associated with spontaneous abortion among nurses. There was moderate to substantial heterogeneity in the studied relations. In the FHCPS, singleton newborns of nurses have increased risk of low birth weight, post-term delivery, and small-for-gestational-age compared to those of teachers (reference group). Maternal employment as a midwife was not related to adverse pregnancy outcomes. The risk of high birth weight and post-term delivery were lower among singleton newborns of the physicians compared to those of other upper-level employees (reference group), but the risk of SGA and LGA did not differ between the newborns of physicians and those of the reference group. In the FPEHS, paternal exposure to welding fumes only was related to small-for-gestational-age. Maternal exposure to metal dust only was related to low birth weight and pre-term delivery and the joint effect of welding fumes and metal dust was related to small-for-gestational age. In conclusion, maternal employment as a nurses and parental occupational exposure to welding fumes or metal dust may increase the risk of adverse pregnancy outcomes. 2011-07 2010-08 graduation eng author unchecked This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder. restricted 393 University of Birmingham School of Health and Population Sciences d_ph na 2011-07 graduation