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Risks for adverse pregnancy outcomes and infections in daycare workers: an overview of current epidemiological
Anca Radauceanu1, Myriam Bouslama2
1French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), Vandoeuvre-lès-Nancy Cedex, France (Department of Epidemiology).
Insights
Childcare workers face occupational risks, including viral infections like cytomegalovirus and parvovirus B19, which can impact pregnancy outcomes. Prevention strategies focus on worker awareness, monitoring, and immunization.
Area of Science:
- Occupational Health
- Maternal and Child Health
- Infectious Diseases
Background:
- Childcare providers, predominantly women of childbearing age, face occupational hazards.
- Exposure to biological and physical agents in daycare settings poses risks for adverse pregnancy outcomes.
- Existing literature on pregnancy outcomes and infectious hazards for childcare workers is limited and requires synthesis.
Purpose of the Study:
- To examine existing literature on pregnancy outcomes and infectious hazards associated with employment in daycare settings.
- To identify specific occupational risk factors for cytomegalovirus and Parvovirus B19 infections in childcare workers.
- To inform prevention strategies for protecting pregnant childcare workers.
Main Methods:
- A Medline search was conducted to identify original studies published between 1980 and 2018.
- 33 studies were included: 10 focusing on pregnancy issues and 23 on infectious risks.
- Literature review and synthesis of findings related to occupational exposures and pregnancy outcomes.
Main Results:
- Pregnancy issues in daycare workers are rarely studied, with inconsistent reports on spontaneous abortion, congenital malformations, and fetal growth retardation.
- Increased risk of primary cytomegalovirus infection during pregnancy linked to specific work practices (e.g., number of children, diaper changes, glove use) and duration of employment.
- Parvovirus B19 infection risk associated with daycare employment, personal factors (e.g., nulliparity), and number of siblings, particularly during outbreaks.
Conclusions:
- Occupational viral infections, particularly cytomegalovirus and Parvovirus B19, represent significant hazards for pregnant childcare workers.
- Specific work practices and personal factors increase the risk of these infections.
- Prevention strategies should include enhanced worker awareness, serological monitoring, education on preventive measures, and ensuring comprehensive immunization of children and staff.
Abstract:
Childcare providers are overwhelmingly women of childbearing age. Occupational risks in this sector include exposure to biological (infectious) or physical (standing, carrying loads) hazards, many of which are associated with adverse pregnancy outcomes such as children with congenital infections, low birth weight or prematurity. Here, the authors examined literature on pregnancy outcomes and infectious hazards related to employment in daycare settings. Overall, 33 original studies (10 reporting pregnancy issues, 23 focusing on infectious risks) published in 1980-2018 were retained following a Medline search. Pregnancy issues in daycare workers have rarely been studied, and inconsistent risks of spontaneous abortion, congenital malformations and fetal growth retardation have been reported. Literature pertaining to infectious risks in daycare settings is extensive. The risk of a primary cytomegalovirus infection during pregnancy was increased for daycare workers caring for >6 children and younger children, changing diapers ≥3 days/week, not wearing gloves when changing diapers, and having employment in daycare for ≤2 years. Personal factors (nulliparity, ethnicity) were also independent risk factors. Parvovirus B19 (B19V) infections appear to be related to employment in daycare, but also to having one's own children and an increased number of siblings. Consequently, the risk of a primary B19V infection during an outbreak is of most concern among younger nulliparous workers caring for large numbers of young infected children. Since the main occupational hazard is viral infection, feasible prevention strategies include improving workers' awareness, serological monitoring during pregnancy, educating on appropriate preventive measures, and ensuring age-appropriate immunization of children and staff in childcare facilities. Int J Occup Med Environ Health. 2020;33(6):733-56.
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