REVIEW PAPER
Risks for adverse pregnancy outcomes and infections in daycare workers: an overview of current epidemiological evidence and implications for primary prevention
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1
French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), Vandoeuvre-lès-Nancy Cedex, France
(Department of Epidemiology)
2
French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), Paris, France
(Department of Expertise and Technical Advice)
Online publication date: 2020-09-29
Corresponding author
Anca Radauceanu
French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), Department
of Epidemiology, 1 rue du Morvan, 54519 Vandoeuvre-lès-Nancy Cedex, France
Int J Occup Med Environ Health. 2020;33(6):733-56
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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