Predictors of the return to work for pregnant employees on preventive leave: Patients from an occupational medicine consultation in Switzerland.

According to the Swiss legislation on maternity protection in the workplace (OProMa), if pregnant workers are exposed to occupational hazards and no protective measures are taken, a gynecologist will prescribe a certificate of preventive leave and the women must stop working. Returning to work is only possible if job adjustments are made. This study aims to evaluate the burden of absences on companies and to examine the predictors of the return to work for pregnant workers on preventive leave, by examining both the probability of return to work and the time required to return to work. The study sample includes data on 258 workplaces of pregnant workers on preventive leave, collected during an occupational medicine consultation aimed at supporting the implementation of the OProMa. Information is available on the worker (age, date of consultation), the hazards to which she is exposed, the company's knowledge of the OProMa and whether a risk analysis exists. Descriptive statistics and multivariate regression analysis are carried out. In 58% of the workplaces, it was not possible to return to work before the end of the pregnancy. This corresponds to an average absence of 4.5 months. In 42% of the workplaces, a return to work was possible thanks to workplace adaptations. A conforming risk analysis and a full knowledge of the OProMa for companies, and an early visit to the occupational medicine consultation for workers are good predictors of the likelihood of returning to work. Younger age and exposure to certain types of risks are factors that influence the duration of preventive leave. The implementation of OProMa in Switzerland poses serious challenges, but early identification of occupational hazards and practices that anticipate compliance with the law in the company increase the return to work in safety for pregnant workers.

A narrative review on factors associated with job interruption during pregnancy.

Most women continue to work during pregnancy. However, some of them have to stop working before giving birth. Absence from work poses several challenges for employers and employees, as well as for society. The literature on absence from work during pregnancy and its determinants remains inconsistent and rather scarce. To conduct a narrative literature review on the factors associated with work interruption and on existing interventions aimed at reducing the absence prevalence during pregnancy. The review refers to published peer-reviewed articles dealing with all types of work interruption among pregnant women. Keyword searches were performed in the electronic databases PubMed, EMBASE, and Google Scholar, covering the period 2000-2022. The review, which includes 42 papers, presents a broad and comprehensive picture of factors and interventions associated with absence from work among pregnant workers. The factors appear at different levels and include factors related to the pregnant women, such as individual health and socio-demographic factors; employer and workplace-related factors, such as risk exposures and working conditions; factors related to the role of the healthcare provider; and factors related to the national context (social benefits/insurance). The determinants of absence from work during pregnancy are complex and multifactorial and involve multiple stakeholders. The discussion addresses gaps and needs in the literature on pregnancy at work and in the field of occupational health. Int J Occup Med Environ Health. 2023;36(3):303-23.

Gender and work in ergonomics: recent trends.

Since the establishment of the Gender and Work Technical Committee (TC) of the International Ergonomics Association (IEA) in 2006, many researchers have addressed the role of sex and gender in ergonomics, producing a great deal of new information. This special issue aims to present new ways of viewing women's work and gender differences in work-related injury risks in an era of rapidly changing labour market configurations. It offers innovative methods for integrating sex and gender into ergonomic analysis and for designing work environments. It shares reflections on the intersection of vulnerabilities according to certain identity markers. Finally, it contributes to establishing milestones standards of practice so that the consideration of sex and gender can be more systematically modelled in ergonomics research and interventions, for example, in training ergonomists or in knowledge transfer initiatives.Practitioner summary: This editorial article provides an overview of the background and the content of the Special Issue 'Gender and Work in Ergonomics: Recent trends'.

[Protection of pregnant and breastfeeding workers in Switzerland: a practical guide]. / Protection des travailleuses enceintes et allaitantes en Suisse : guide pratique.

Specific working conditions may endanger pregnant women's and their children's health. Switzerland has specific legislation for the protection of pregnant and breastfeeding employees. However, the implementation of these provisions presents important shortcomings. Attending physicians or gynaecologists-obstetricians who care for pregnant women have a central role in controlling the efficacy of protective measures put in place for their patients at work. What are the occupational exposures at risk and their health impact ? What are the collaboration with the different actors involved in the protection of maternity at work ? What steps should be taken if occupational dangers are identified? What tools can be used ? This article answers and explore these questions.

Certaines conditions de travail peuvent nuire à la santé des femmes enceintes et de leurs enfants. La Suisse dispose d'une législation spécifique pour la protection des employées enceintes et allaitantes. Or, l'application de ces dispositions est lacunaire. Les médecins traitants ou les gynécologues-obstétriciens qui suivent des femmes enceintes ont un rôle central dans le contrôle d'efficacité des mesures de protection prises pour leurs patientes au travail. Quels sont les expositions professionnelles à risque et leur impact sanitaire ? Quelles sont les collaborations avec les différents acteurs impliqués dans la protection de la maternité au travail ? Quelles démarches entreprendre en cas d'identification de dangers ? Quels outils peuvent être utilisés ? Cet article permet de répondre à ces questions et de les approfondir.

Midwives and protection of pregnant workers in Western Switzerland: Practices, difficulties and contributions.

BACKGROUND: Switzerland's maternity protection legislation aims to protect the health of pregnant employees and their unborn children by regulating their potential occupational exposure to hazards and strenuous activities. This legislation provides a role for obstetricians, but not for midwives. AIMS: Identify the practices of Switzerland's French-speaking midwives that favour the implementation of maternity protection legislation and reflect on the profession's role in supporting pregnant employees. METHODS: 356 midwives answered an online questionnaire. The analysis focuses on the 205 midwives who perform pregnancy consultations in their practice. Data were analysed in two stages using STATA software: 1) simple descriptive and correlational statistics and 2) hierarchical cluster analysis to identify typologies of practices by grouping similar responses. FINDINGS: Despite having no officially defined role in Switzerland's maternity protection legislation, its midwives actively participate in protecting pregnant employees , especially those with more knowledge of the legislation, those with more years of experience and those practicing independently. The barriers that midwives face when trying to provide greater support for pregnant employees are linked significantly to their lack of knowledge about the legislation, a lack of recognition for their role in the current legislation and a lack of continuing education about the occupational health risks associated with pregnancy at work. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Their profession and specific practices give midwives privileged access to pregnant employees. Midwives' knowledge of the legislation, their awareness of the occupational risks and hazards facing pregnant employees and the conviction that their profession has the potential to make a difference could all be improved. The role of midwives should be-and deserves to be-formally and legally recognised and integrated into Switzerland's maternity protection legislation.

Evolution of gynaecologists' practices regarding the implementation of Swiss legislation on maternity protection at work between 2008 and 2017.

BACKGROUND: In accordance with the International Labour Organization’s Maternity Protection Convention (No. 183) and European Union Directive 92/857CEE (1992), Switzerland’s Labour Law and its Maternity Protection Ordinance (OProMa) aim to protect the health of pregnant employees and their future children while enabling them to pursue their working activities. Gynaecologists-obstetricians have a key role in this legislation, particularly through the prescription of preventive leave for patients who would otherwise face dangerous or arduous tasks in the absence of an adequate risk analysis or suitable protective measures. However, international and national literature suggests that gynaecologists-obstetricians may encounter difficulties in fulfilling their role. AIMS: This study aimed to: (1) describe the practices and difficulties encountered by gynaecologists-obstetricians in the practical implementation of the OProMa; and (2) compare the evolution of these practices and difficulties between 2008 and 2017. METHODS: A survey by questionnaire was conducted in 2008 and repeated in 2017. Both surveys focused on gynaecologists-obstetricians working in the French-speaking part of Switzerland (in private practices, hospitals or both). Descriptive and comparative analyses were carried out. RESULTS: 83 gynaecologists-obstetricians responded in 2008 and 93 in 2017: response rates of 47% and 32%, respectively. In 2017, gynaecologists-obstetricians were more likely to ask questions about occupational risks faced by their patients when consulted by working mothers about their pregnancies. The estimated percentage of patients exposed to an occupational risk remained constant (20% in 2008 and 22% in 2017). Communication and collaboration with employers were reported to be difficult in both surveys, even though these are key elements in the implementation of the OProMa. Collaboration with occupational physicians, however, was more frequent in 2017. CONCLUSION: In 2017, gynaecologists-obstetricians showed a greater awareness of occupational risks and collaborated more frequently with occupational health specialists. However, the application of the OProMa remained limited over the studied time period. Improving training of gynaecologists-obstetricians in this field could be a significant factor in encouraging better implementation of the current legislation. Moreover, gynaecologists-obstetricians need to be given the necessary support to enable their clinical practice to evolve towards a more preventive type of medicine. Collaboration with relevant stakeholders, including occupational physicians, midwives and workers, should be encouraged.

Implementation of the Swiss ordinance on maternity protection at work in companies in French-speaking Switzerland.

BACKGROUND: Switzerland's Ordinance on Maternity Protection at Work (OProMa) requires that companies take the necessary measures to ensure that pregnant employees can continue working without danger. OBJECTIVE: To investigate the extent of compliance with OProMa within companies in French-speaking Switzerland as well as factors which facilitate and obstruct the ordinance's implementation. METHODS: A stratified random telephone survey of 202 companies from the healthcare and food industry was conducted. Descriptive and correlational statistics were calculated. Responses to open questions were analysed thematically. RESULTS: Only a minority of companies performed risk analyses or adapted employees' workstations, as per the legislation. OProMa was implemented more effectively in larger companies than smaller ones, in public rather than private ones, in the healthcare sector rather than the food industry, and when the person responsible for the wellbeing of pregnant employees within the company had undergone specific training on the subject. Data extrapolation suggested that only 2% of pregnant employees in French-speaking Switzerland's food industry and 12% in its healthcare sector are properly protected according to OProMa's provisions. CONCLUSIONS: Maternity protection in French-speaking Switzerland's companies urgently requires improvement. In addition to the apparent need for stronger incentives and for monitoring of companies, our findings indicate a need to provide them with resources to meet OProMa's provisions.

Implementation of maternity protection legislation: Gynecologists' perceptions and practices in French-speaking Switzerland.

BACKGROUND: In several countries, maternity protection legislations (MPL) confer an essential role to gynecologist-obstetricians (OBGYNs) for the protection of pregnant workers and their future children from occupational exposures. This study explores OBGYNs' practices and difficulties in implementing MPL in the French-speaking part of Switzerland. METHODS: An online survey was sent to 333 OBGYNs. Data analysis included: 1) descriptive and correlational statistics and 2) hierarchical cluster analysis to identify patterns of practices. RESULTS: OBGYNs evoked several problems in MPL implementation: absence of risk analysis in the companies, difficult collaboration with employers, lack of competencies in the field of occupational health. Preventive leave was underused, with sick leave being prescribed instead. Training had a positive effect on OBGYNs' knowledge and implementation of MPL. Hierarchical cluster analysis highlighted three main types of practices: 1) practice in line with legislation; 2) practice on a case-by-case basis; 3) limited practice. OBGYNs with good knowledge of MPL more consistently applied its provisions. CONCLUSION: The implementation of MPL appears challenging for OBGYNs. Collaboration with occupational physicians and training might help OBGYNs to better take on their role in maternity protection. MPL in itself could be improved.

"They say we have a choice, but we don't": A gendered reflection on work-family strategies and planning systems of atypical schedules within male-dominated occupations in Canada and Switzerland.

For parents working in the transportation industry, atypical schedules are often a daily puzzle. Schedule planning systems allowing workers to choose shifts may affect job strenuousness and work-family balance (WFB) for both female and male workers. How could ergonomic interventions related to the implementation of those systems better consider gender dynamics regarding WFB strategies, and minimize inequities among workers? This article presents a joint analysis of two independent case studies related to ergonomic interventions in transport companies in Canada and Switzerland. Direct observation and semi-structured interviews shed light on the characteristics of schedule planning systems and their interaction with men's and women's WFB strategies. Issues related to each step of the planning process (shift construction, schedule choice, day-to-day schedule management) are discussed to inform interventions aimed at facilitating WFB, and ultimately gender equity, in atypical schedule contexts.

Implementation, mechanisms and effects of maternity protection legislation: a realist narrative review of the literature.

PURPOSE: Most industrialized countries have introduced maternity protection legislation (MPL) to protect the health of pregnant workers and their unborn children from workplace exposure. This review aimed to assess this legislation's level of implementation, barriers and facilitators to it, and its expected or unexpected effects. METHODS: A realist narrative review was conducted. Keyword searches of the PubMed, CINAHL, PsycINFO, MIDIRS, Sociological abstracts and Google Scholar electronic databases were performed in March 2018. RESULTS: The 42 publications included show that the implementation of MPL is deficient in most countries. Allowing pregnant women to withdraw from work on preventive leave or sick leave is favored over workplace adaptations or worker reassignments. The publications highlight mechanisms which encourage or obstruct the enforcement of legislation at the levels of the individual, the physical and social environment, and the macrosocial context. The delay between the conception and implementation of maternity protection measures appears to be a major barrier to the efficacy of MPL. The literature also suggests that unexpected adverse effects, such as degradation in working relationships or discrimination can obstruct the implementation of protective measures. CONCLUSIONS: This study showed the need for a better implementation of MPL during pregnancy. Further research and recommendations for improvements in MPL should consider the diverse mechanisms and effects of its implementation. Barriers and adverse effects of this implementation do not only ensure a lack of information or awareness about MPL, but are also linked to contradictions between requirements to protect employment and protect pregnancy.

Protection of pregnant women at work in Switzerland: practices, obstacles and resources. A mixed-methods study protocol.

INTRODUCTION: Like most industrialised countries, Switzerland has introduced legislation to protect the health of pregnant workers and their unborn children from workplace exposure. This legislation provides for a risk assessment, adaptations to workplaces and, if the danger is not eliminated, preventive leave (prescribed by a gynaecologist). This study's first objective is to analyse the degree to which companies, gynaecologists and midwives implement the law. Its second objective is to understand the obstacles and resources of this implementation, with a focus on how relevant stakeholders perceive protective measures and their involvement with them. METHODS AND ANALYSIS: Data will be collected using mixed methods: (1) online questionnaires for gynaecologists and midwives; telephone questionnaires with company human resources (HR) managers in the healthcare and food production sectors; (2a) case studies of 6-8 companies in each sector, including interviews with stakeholders such as women workers, HR managers and occupational health physicians; (2b) two focus groups, one involving occupational physicians and hygienists, one involving labour inspectors.Quantitative data will be analysed statistically using STATA software V.15. Qualitative data will be transcribed and thematically analysed using MaxQDA software. ETHICS AND DISSEMINATION: The Human Research Ethics Committee of the Canton Vaud (CER-VD) has certified that this research study protocol falls outside of the field of application of the Swiss Federal Act on Research Involving Humans.The publications and recommendations resulting from this study will form the starting point for future improvements to the protection of pregnant women at work and their unborn children.This study started in February 2017 and will continue until January 2020.