Biomechanical and organisational constraints of pregnant women at work: definition of exposure levels using a consensus method (Delphi)

OBJECTIVES: To identify the biomechanical and organisational constraints that influence pregnancy outcomes and define the exposure levels at which the risks for pregnancy become significant. SETTING AND PARTICIPANTS: We applied a consensus method (Delphi) consisting of a literature review followed by expert opinions on exposure levels. The group of experts was made up of 12 people from different medical specialities and working in various structures in France. OUTCOME MEASURES: The studied variables were: (1) exposure: night work/shift work, weekly hours at work, lifting of heavy loads, prolonged standing and multiple exposure and (2) pregnancy outcomes: prematurity, low birth weight and spontaneous miscarriages. RESULTS: The consensus method resulted in the following recommendations. The time spent working must not exceed 40 hours/week; in the absence of a consensus on the level of exposure, night and/or shift work must be avoided; prolonged standing must not exceed 3 hours/day; lifting must be limited to carrying loads <11 kg, with a daily load <100 kg; multiple exposure must be avoided, in particular: vibration, night work/shift work, time spent working exceeding 40 hours/week, prolonged standing and lifting of heavy loads. CONCLUSIONS: These results could help the occupational physician to address the question of whether an exposed employee should remain at work, considering her individual characteristics (medical history, family situation, socioeconomic level, etc) in consultation with pregnancy specialists (obstetricians, midwives)

Sci Total Environ

BACKGROUND: There is growing evidence in the scientific literature that individuals living near fields are more exposed to agricultural pesticides than people living further away. OBJECTIVE: The main objective of this systematic review was to identify the non-dietary determinants of pesticide exposure related to the drift pathway in residents living in agricultural areas, including spatial indictors related to agricultural activities, hygiene practices, behaviors and sociodemographic parameters. METHODS: Three databases were consulted (PubMed, Web of sciences, Scopus). At least two experts selected the eligible studies. RESULTS: A total of 27 original studies (2002-2020) fulfilled the eligibility criteria of this review. These publications explored pesticide exposure of individuals through measurements in biological samples (n = 13), environmental samples (n = 11) or both (n = 3). Spatial indicators, including residential proximity to fields, crop acreage around the residence and amounts of pesticides applied in the vicinity were identified as determinants of pesticide exposure in many studies (n = 17), including publications considered to be of very good or good quality (n = 12). Season of spraying tended to increase the levels of pesticides measured in five publications out of seven. Meteorological parameters and physical barriers showed an inconsistent and complex influence on the presence and levels of pesticides in urine samples and house dust. Frequent housekeeping reduced the presence of pesticides at home and consequently in biological matrices in three studies out of six. Finally, the effect of the occupants' sociodemographic characteristics, behaviors, and hygiene practices on the exposure measurement was less well documented and results were fairly inconsistent. DISCUSSION AND CONCLUSION: This study consolidates our knowledge of the determinants influencing pesticide exposure levels in people living in agricultural areas. Nevertheless, the available scientific data is still too limited to serve as a basis for developing risk management measures. More research is needed to improve knowledge of the determinants of exposure

Environ Res

OBJECTIVE: To investigate the association between occupational exposures to carbonaceous unintentionally emitted nanoscale particles (UNPs) during pregnancy and the child's language development and behaviour at two years old. METHODS: Using data from the French Longitudinal Study of Childhood - ELFE, we selected mothers who worked during pregnancy and their children. Exposure to carbonaceous UNPs was assessed by the MatPUF (job-exposure matrix for ultrafine particles). Children's lexical development was analysed using 'the Mac Arthur - Bates communicative development inventories-words and sentences-short form' (MB-CDI) in a multivariate binary logistic regression. Their risk for autism spectrum disorders was studied using 'the Modified-CHecklist for Autism in Toddler' (M-CHAT) according to the recommended thresholds (low risk = 0-2; intermediate risk = 3-6 and high risk = 7-23) in unordered multinomial logistic regression models. RESULTS: Maternal occupational exposure to carbonaceous UNPs was associated with delayed child language development (ORadj: 1.34; 95 % CI: 1.00, 1.80) but not with behavioural disorders (autism spectrum disorders) at two years old. CONCLUSION: This is the first epidemiological study to show a significant association between maternal occupational exposure to carbonaceous nanoscale particles and child language development at 2 years old