Occupational determinants of reproductive health disorders in medical workers
https://doi.org/10.31089/1026-9428-2026-66-5-323-333
EDN: izhtip
Abstract
Preserving the reproductive health of female medical workers is a priority task of occupational medicine and demographic policy. The review analyzes current data from peer-reviewed publications from international (PubMed, MEDLINE, Scopus) and Russian (eLibrary, RSCI) scientific databases on the impact of harmful industrial factors on the reproductive health of female medical workers. Original studies, systematic reviews, and meta-analyses containing quantitative risk assessments were selected: odds ratio (OR), relative risk (RR), and etiological proportion (EP).
The presented analysis convincingly shows a statistically significant association between exposure to harmful occupational factors and reproductive health disorders in medical professionals, including pregnancy complications and decreased fertility.
Contributions:
Fesenko M.A. — research concept and design, data analysis and interpretation; approval of the final version;
Golovaneva G.V. — research concept and design, data analysis and interpretation, editing;
Miteleva T.Y. — collecting and processing material, writing text;
Vujtsik P.A. — collecting material, writing the text of the article section;
Khalturina Yu.V. — collecting material, writing the text of the article section;
Utkina N.S. — collecting material, writing the text of the article section;
All co-authors — approving the final version of the article and ensuring the integrity of all parts of the article.
Funding. The study had no funding.
Conflict of interests. The authors declare no conflict of interest.
Received: 01.04.2026 / Accepted: 28.05.2026 / Published: 00.00.2026
About the Authors
Marina A. FesenkoRussian Federation
Head of the Laboratory for Prevention of Reproductive Health Disorders in Workers, Izmerov Research Institute of Occupational Health, Dr. of Sci. (Med.)
e-mail: fesenkoma@irioh.ru
Galina V. Golovaneva
Russian Federation
Leading Researcher, Laboratory for Prevention of Reproductive Health Disorders in Workers, Izmerov Research Institute of Occupational Health, Dr. of Sci. (Med.)
e-mail: galstella@mail.ru
Tatyana Yu. Miteleva
Russian Federation
Senior Researcher, Laboratory for Prevention of Reproductive Health Disorders in Workers, Izmerov Research Institute of Occupational Health, Cand. of Sci. (Med.)
e-mail: miteleva@irioh.ru
Petr A. Vuytsik
Russian Federation
Researcher, Laboratory for Prevention of Reproductive Health Disorders in Workers, Izmerov Research Institute of Occupational Health; Assistant, Department of Occupational Health, Aviation, Space and Diving Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University)
e-mail: pv1985@mail.ru
Yuliya V. Khalturyna
Russian Federation
Junior Researcher, Laboratory for Prevention of Reproductive Health Disorders in Workers, Izmerov Research Institute of Occupational Health
e-mail: julia.vladimirovna.103@gmail.com
Natalya S. Utkina
Russian Federation
Obstetrician-gynecologist, Clinic of Occupational and Work-Related Diseases, Izmerov Research Institute of Occupational Health
e-mail: tasha_2205@mail.ru
References
1. Joseph B., Joseph M. The health of the healthcare workers. Indian J. Occup. Environ. Med. 2016; 20(2): 71–2. https://clck.ru/3TG563
2. Trubetskov A.D., Kameneva A.D. The use of the workability index in occupational medicine (literature review). Gigiena i Sanitariya. 2022; 101(6): 645–648. https://doi.org/10.47470/0016-9900-2022-101-6-645-648 (in Russian).
3. Kosarev V.V., Babanov S.A. Occupational diseases of medical workers: monograph. M.: INFRA-M, 2026. 2026. ISBN: 9785160062204 (in Russian).
4. Lang T.A., Sesik M. How to write statistics in medicine: a guide for authors, editors, and reviewers [Kak opisy`vat` statistiku v medicine: rukovodstvo dlya avtorov, redaktorov i recenzentov]. M.: Prakticheskaya medicina; 2016. ISBN 978-5-98811-325-6 (in Russian).
5. Baudin C., Vacquier B., Thin G., Chenene L., Guersen J., Partarrieu I. et al. Occupational exposure to ionizing radiation in medical staff: trends during the 2009–2019 period in a multicentric study. Eur. Radiol. 2023; 33(8): 5675–5684. https://doi.org/10.1007/s00330-023-09541-z
6. Кeskin А., Аci R., Аri M. The effect of ionizing radiation on health professionals working in the radiology department. Aurum Journal of Health Sciences. 2023; 5(3): 129–134. https://izlik.org/JA52SU33FH
7. Wang T.Y., Grines C., Ortega R., Dai D., Jacobs A.K., Skelding K.A. et al. Women in interventional cardiology: Update in percutaneous coronary intervention practice patterns and outcomes of female operators from the National Cardiovascular Data Registry. Catheter Cardiovasc. Interv. 2016; 87: 663–8. https://doi.org/10.1002/ccd.26118
8. Capranzano P., Kunadian V., Mauri J., Petronio A.S., Salvatella N., Appelman Y. et al. Motivations for and barriers to choosing an interventional cardiology career path: results from the EAPCI Women Committee worldwide survey. EuroIntervention. 2016; 12: 53–59. https://pubmed.ncbi.nlm.nih.gov/26151955/
9. National Council on Radiation Protection and Measurements. NCRP Report 174: Preconception and prenatal radiation exposure: Health effects and protective guidance. NCRP Publications. 2013. https://aapm.org/pubs/ncrp/detail.asp?docid=2
10. Saada M., Sanchez-Jimenez E., Roguin A. Risk of ionizing radiation in pregnancy: just a myth or a real concern? Europace. 2023; 25(2): 270–276. https://doi.org/10.1093/europace/euac158
11. Vu C.T., Elder D.H. Pregnancy and the working interventional radiologist. Semin. Interv. Radiol. 2013; 30: 403–7. https://clck.ru/3TG5bc
12. Razavimoghadam M., Sefidkar R., Ehrampoush M.H., Teimouri F., Hassanabadi M.H.Z., Nokhostin F. The association of widely used electromagnetic waves exposure and pregnancy and birth outcomes in Yazd women: a cohort study. BMC Pregnancy Childbirth. 2025; 25(1): 427. https://doi.org/10.1186/s12884-025-07512-4
13. König A.M., Pöschke A., Mahnken A.H. Health risks for medical personnel due to magnetic fields in magnetic resonance imaging. Rofo. 2025; 197(2): 135-144. https://doi.org/10.1055/a-2296-3860
14. Park J., Stanford J.B., Porucznik C.A., Christensen K., Schliep K.C. Daily perceived stress and time to pregnancy: a prospective cohort study of women trying to conceive. Psychoneuroendocrinology. 2019; 110: 104446. https://doi.org/10.1016/j.psyneuen.2019.104446
15. Babanov S.A., Strizhakov L.A., Agarkova I.A., Tezikov Yu.V., Lipatov I.S. Workplace factors and reproductive health: causation and occupational risks assessment. Ginekologiya. 2019; 21(4): 33–43. https://doi.org/10.26442/20795696.2019.1.190227 (in Russian).
16. Bukhtiyarov I.V., Geregey A.M., Krasnova S.V., Konyukhov A.V., Sazhina M.V., Malakhova I.S., et al. The thermal state of body when using personal protective equipment against biological factors. Gigiena i sanitariya. 2022; 101(1): 1321–1327. https://doi.org/10.47470/0016-9900-2022-101-11-1321-1327 (in Russian).
17. Braz M.G., Carvalho L.I.M., Chen C.O. et al. High concentrations of waste anesthetic gases induce genetic damage and inflammation in physicians exposed for three years: a cross-sectional study. Indoor Air. 2020; 30: 512–520. https://doi.org/10.1111/ina.12643
18. Warembourg C., Cordier S., Garlantézec R. An update systematic review of fetal death, congenital anomalies, and fertility disorders among health care workers. Am. J. Ind. Med. 2017; 60: 578–590. https://doi.org/10.1002/ajim.22711
19. Oliveira L.A., P El Dib R., Figueiredo D.B.S., Braz L.G., Braz M.G. Spontaneous abortion in women occupationally exposed to inhalational anesthetics: a critical systematic review. Environ. Sci. Pollut. Res. Int. 2021; 28(9): 10436–10449. https://doi.org/10.1007/s11356-020-11684-1
20. Ying T., Yuanqing W. Occupational exposure to inhalational anesthetics and the risk of spontaneous abortion: a systematic review and meta-analysis. Front. Public Health. 2026; 14: 1766912. https://doi.org/10.3389/fpubh.2026.1766912
21. García-Álvarez J.M., Escribano-Sánchez G., Osuna E., Molina-Rodríguez A., Díaz-Agea J.L., García-Sánchez A. Occupational Exposure to Inhalational Anesthetics and Teratogenic Effects: A Systematic Review. Healthcare (Basel). 2023; 11(6): 883. https://doi.org/10.3390/healthcare11060883
22. Braz L.G., Braz J.R.C., Cavalcante G.A.S., Souza K.M., Lucio L.M.C., Braz M.G. Comparison of waste anesthetic gases in operating rooms with or without an scavenging system in a Brazilian University Hospital. Rev. Bras. Anestesiol. 2017; 67(5): 516–520. https://doi.org/10.1016/j.bjan.2017.02.001 (Portuguese).
23. МР 1.2.0321-23. 1.2. Hygiene, toxicology, and sanitation. Assessment and classification of reproductive toxicants. Guidelines. https://clck.ru/3TG3sW (in Russian).
24. The National Institute for Occupational Safetyand Health. Methyl methacrylate. Accessed November 12, 2019. https://www.cdc.gov/niosh/npg/npgd0426.html
25. Limchantra I.V., Fong Y., Melstrom K.A. Surgical smoke exposure in operating room personnel: a review. JAMA Surg. 2019; 154(10): 960–967. https://clck.ru/3TG9Fe
26. Board on Population Health and Public Health Practice. Health Risks of Indoor Exposure to Particulate Matter: Workshop Summary. Washington, DC: National Academies Press; 2016. https://clck.ru/3TG9Uh
27. Connor T.H., Mackenzie B.A., Debord D.G. et al. NIOSH list of antineoplastic and other hazardous drugs in healthcare settings, 2016. Cincinnati: NIOSH; 2016. https://clck.ru/3TG9XL
28. National Institute for Occupational Safety and Health. Antineoplastic agents. Hazardous drug exposures in healthcare. Atlanta: CDC; 2017.
29. Santos A.N., Oliveira R.J., Pessatto L.R. et al. Biomonitoring of pharmacists and nurses at occupational risk from handling antineoplastic agents. Int. J. Pharm. Pract. 2020; 28(5): 506–511. https://doi.org/10.1111/ijpp.12590
30. Villa A., Molimard M., Sakr D. et al. Nurses’ internal contamination by antineoplastic drugs in hospital centers: a cross-sectional descriptive study. Int. Arch. Occup. Environ. Health. 2021; 94(8): 1839–1850. https://doi.org/10.1007/s00420-021-01706-x
31. Liu S., Huang Y., Huang H., Hu S., Zhong X., Peng J. et al. Influence of occupational exposure to antineoplastic agents on adverse pregnancy outcomes among nurses: A meta-analysis. Nurs. Open. 2023. 10(9): 5827–5837. https://doi.org/10.1002/nop2.1853
32. Dourson M., Charnley G., Scheuplein R. Differential sensitivity of children and adults to chemical toxicity. II. Risk and regulation. Regul. Toxicol. Pharmacol. 2002; 35(3): 448–467. https://clck.ru/3TG9tq
33. Lee A., Lee A., Kuczmarska-Haas A., Dalwadi S.M., Gillespie E.F., Ludwig M.S., Holliday E.B., Chino F. Family Planning, Fertility, and Career Decisions Among Female Oncologists. JAMA Netw. Open. 2022; 5(10): e2237558. https://pubmed.ncbi.nlm.nih.gov/36315148/
34. Likstanov M.I., Kuz`menko S.A., Vavin G.V., Kovalivnich O.V., Mozes K.B., Elgina S.I. et al. Formation of immunity against SARS-CoV-2 among employees of a large general hospital. Meditsina v Kuzbasse. 2021; 1: 22–25. https://elibrary.ru/uwtstr
35. Continuing essential Sexual, Reproductive, Maternal, Neonatal, Child and Adolescent Health services during COVID-19 pandemic. World Health Organization, UNFPA, UNICEF. 2020. https://clck.ru/3TzjCc
36. Maher M., Owens L. SARS-CoV-2 infection and female reproductive health: A narrative review. Best Pract. Res. Clin. Endocrinol. Metab. 2023; 37(4): 101760. https://doi.org/10.1016/j.beem.2023.101760
37. Xu K., Sun W., Yang S., Liu T., Hou N. The impact of COVID-19 infections on pregnancy outcomes in women. BMC Pregnancy Childbirth. 2024; 24(1): 562. https://doi.org/10.1186/s12884-024-06767-7
38. Schwartz D.A., Avvad-Portari E., Babál P., Baldewijns M., Blomberg M., Bouachb A., et al. Placental Tissue Destruction and Insufficiency From COVID-19 Causes Stillbirth and Neonatal Death From Hypoxic-Ischemic Injury. Arch. Pathol. Lab. Med. 2022; 146: 660–676. https://clck.ru/3TGB5o
39. Huang C.C., Huang Y.T., Wu M.P. A nationwide population analysis of antenatal and perinatal complications among nurses and nonmedical working women. Taiwan J. Obstet. Gynecol. 2016; 55(5): 635–640. https://doi.org/10.1016/j.tjog.2015.06.015
40. Lee W., Jung S.W., Lim Y.M., Lee K.J., Lee J.H. Spontaneous and repeat spontaneous abortion risk in relation to occupational characteristics among working Korean women: A crosssectional analysis of nationally representative data from Korea. BMC Public Health. 2019; 19: 1339. https://doi.org/10.1186/s12889-019-7728-7
41. Boivin D.B., Boudreau P., Kosmadopoulos A. Disturbance of the Circadian System in Shift Work and Its Health Impact. J. Biol. Rhythms. 2022; 37(1): 3–28. https://doi.org/10.1177/07487304211064218
42. Kolokolov O.V, Salina E.A., Lvova O.I. Sleep disorders and oncological diseases. S.S. Korsakov Journal of Neurology and Psychiatry. 2024; 124(5 2): 125–131. https://elibrary.ru/xulhpa (in Russian).
43. Ono M., Dai Y., Fujiwara T., Fujiwara H., Daikoku T., Ando H. et al. Influence of lifestyle and the circadian clock on reproduction. Reprod. Med. Biol. 2025; 24(1): 12641. https://clck.ru/3TGBQW
44. Moen B.E., Baste V., Morken T., Alsaker K., Pallesen S., Bjorvatn B. Menstrual characteristics and night work among nurses. Ind. Health. 2015; 53(4): 354–60. https://doi.org/10.2486/indhealth.2014-0214
45. Sugiyama М., Shiraishi М., Hagihara N. A systematic review of observational studies on the association between shift work, including night shifts, and irregular menstrual cycles. Japanese Journal of Nursing and Health Sciences. 2024; 22: 56–67. https://doi.org/10.20705/jjnhs.22.0_56
46. Wang F., Xie N., Wu Y., Zhang Q., Zhu Y., Dai M. et al. Association between circadian rhythm disruption and polycystic ovary syndrome. Fertil. Steril. 2021; 115: 771–81. https://doi.org/10.1016/j.fertnstert.2020.08.1425
47. Beroukhim G., Esencan E., Seifer D.B. Impact of sleep patterns upon female neuroendocrinology and reproductive outcomes: a comprehensive review. Reproductive Biology and Endocrinology. 2022; 20(1): 16. https://doi.org/10.1186/s12958-022-00889-3
48. Ankita S. The Impact of Night Shift Duties on Female Reproductive Health among Healthcare Professionals. Indian Journal of Continuing Nursing Education. 2024; 25(2): 153–157. https://doi.org/10.4103/ijcn.ijcn_156_23
49. Kim K., Lee M.Y., Chang Y., Ryu S. Nightshift work and irregular menstrual cycle: 8-year follow-up cohort study. Occup. Med (Lond). 2024; 74(2): 152–160. https://doi.org/10.1093/occmed/kqad162
50. Mayama M., Umazume T., Watari H., Nishiguchi S., Moromizato T., Watari T. Frequency of night shift and menstrual cycle characteristics in Japanese nurses working under two or three rotating shifts. J. Occup. Health. 2020; 62(1): 12180. https://doi.org/10.1002/1348-9585.12180
51. Xie F., Hu K., Fu R., Zhang Y., Xiao K., Tu J. Association between night shift work and the risk of type 2 diabetes mellitus: a cohort-based meta-analysis. BMC Endocr. Disord. 2024; 24(1): 268. https://doi.org/10.1186/s12902-024-01808-w
52. Gaskins A.J., Rich-Edwards J.W., Lawson C.C., Schernhammer E.S., Missmer S.A., Chavarro J.E. Work schedule and physical factors in relation to fecundity in nurses. Occup. Environ. Med. 2015; 72(11): 777–83. https://doi.org/10.1136/oemed-2015-103026
53. Anderson M., Goldman R.H. Occupational Reproductive Hazards for Female Surgeons in the Operating Room: A Review. JAMA Surg. 2020; 155(3): 243–249. https://doi.org/10.1001/jamasurg.2019.5420
54. Kader M., Bigert C., Andersson T., Selander J., Bodin T., Skröder H. et al. Shift and night work during pregnancy and preterm birth-a cohort study of Swedish health care employees. Int. J. Epidemiol. 2022; 50: 1864–74. https://doi.org/10.1093/ije/dyab135
55. Nazanin I., Omid A., Kiana G., AmirHossein A., Shadi S. Reproductive outcomes among female health care workers. BMC Women’s Health. 2024; 24: 44. https://doi.org/10.1186/s12905-024-02890-x
56. Lai K., Garvey E.M., Velazco C.S. et al. High infertility rates and pregnancy complications in female physicians indicate a need for culture change. Ann. Surg. 2023; 277(3): 367–72. https://doi.org/10.1097/SLA.0000000000005724
57. Aksenova E.I., Kamynina N.N., Turzin P.S. Occupational stress in medical workers: review of foreign practices. Moscow; 2023. https://elibrary.ru/ryvovo (in Russian).
58. Bratukhin A.G., Magazeva E.A. Individual prevention of environmental and personal factor impact on reproductive health of medical workers. Sovremennye Problemy Nauki i Obrazovaniya. 2016; (5): 124. https://elibrary.ru/wwvgwb (in Russian).
59. Rangel E.L., Castillo-Angeles M., Easter S.R., Atkinson R.B., Gosain A., Hu Y.Y., Cooper Z., Dey T., Kim E. Incidence of Infertility and Pregnancy Complications in US Female Surgeons. JAMA Surg. 2021; 156(10): 905–915. https://clck.ru/3TGFE2
60. Hamilton A.R., Tyson M.D., Braga J.A., Lerner L.B. Childbearing and pregnancy characteristics of female orthopaedic surgeons. J. Bone Joint Surg. Am. 2012; 94: 77. https://doi.org/10.2106/JBJS.K.00707
61. Scott V.C.S., Lerner L.B., Eilber K.S., Anger J.T., Ackerman A.L. Reevaluation of birth trends and pregnancy complications among female urologists: have we made any progress? Neurourol. Urodyn. 2020; 39: 1355–62. https://clck.ru/3TGFJJ
62. Lerner L.B., Stolzmann K.L., Gulla V.D. Birth trends and pregnancy complications among women urologists. J. Am. Coll. Surg. 2009; 208: 293–7. https://doi.org/10.1016/j.jamcollsurg.2008.10.012
63. Centers for Disease Control and Prevention. FastStats — infertility. Centers for Disease Control and Prevention. 2022. https://clck.ru/3TzmgF
64. Todd A.R., Cawthorn T.R., Temple-Oberle C. Pregnancy and parenthood remain challenging during surgical residency: a systematic review. Acad. Med. 2020; 95(10): 1607–15. https://doi.org/10.1097/ACM.0000000000003351
65. Kassab J.G., Garcia Keeme-Sayre A., Lipshultz L.I. Physician infertility: a structured literature review. J. Assist. Reprod Genet. 2024; 41(9): 2227–2235. https://doi.org/10.1007/s10815-024-03216-4
66. Association of American Medical Colleges. Active physicians by sex and specialty, 2017. https://clck.ru/3Tzmn7 (accessed: November 12, 2019).
67. Xepoleas M.D., Munabi N.C.O., Auslander A., Magee W.P., Yao C.A. The experiences of female surgeons around the world: a scoping review. Hum. Resour. Health. 2020; 18(1): 80. https://doi.org/10.1186/s12960-020-00526-3
68. Murashko M. "Emergency medical care — 2025". 24th All-Russian scientific and practical congress. Ministerstvo Zdravookhraneniya Rossiiskoi Federatsii. (31 Oct 2025) https://clck.ru/3TzmqT (in Russian).
69. Semyonova N.V., Vyaltcin A.S., Zavyalova A.V., et al. Hygienic assessment of working conditions of paramedics in emergency medical service mobile teams. Mezhdunarodnyi Zhurnal Prikladnykh i Fundamentalnykh Issledovanii. 2018; (4): 81–85. https://elibrary.ru/xpbwwd (in Russian).
70. Ratushnaya N.Sh. Integral assessment in a differentiated approach to harmful and hazardous working conditions in medical workers. Saratovskii Nauchno-Meditsinskii Zhurnal. 2024; 20(1): 56–60. https://elibrary.ru/qnwwwn (in Russian).
71. Krasovskiy V.O., Karamova L.M., Basharova G.R. Occupational health risks in emergency medical service mobile teams. Skoraya Meditsinskaya Pomoshch. 2020; 21(4): 17–23. https://doi.org/10.24884/2072-6716-2020-21-4-17-23 (in Russian).
72. Vasilev A.V. Problems of assessing combined effects of noise and other physical factors on human health. Izvestiya Samarskogo Nauchnogo Tsentra Rossiiskoi Akademii Nauk. 2012; 14(6): 158–165. https://elibrary.ru/pxwlxz (in Russian).
73. Butorin A.V., Demchenko V.G. Occupational and non-occupational factors affecting the health of workers at urban emergency medical stations in Omsk. Medial. 2017; 2(20): 48–50. https://elibrary.ru/zsschj (in Russian).
74. Bolobonkina T.A., Dementyev A.A. Comparative hygienic characteristics of working conditions of emergency medical station staff in modern conditions. Nauchno-Meditsinskii Vestnik Tsentralnogo Chernozemya. 2019; (77): 71–76. https://elibrary.ru/sfspbu (in Russian).
75. Nevo T., Peleg R., Kaplan D.M., Freud T. Manifestations of verbal and physical violence towards doctors: a comparison between hospital and community doctors. BMC Health Serv. Res. 2019; 19(1): 888. https://doi.org/10.1186/s12913-019-4700-2
76. Korekhova M.V., Novikova I.A., Soloviev A.G. Occupational stress in emergency medical service paramedics. Russian Journal of Occupational Health and Industrial Ecology [Med. truda i prom. ekol.]. 2019; 59(7): 417–423. https://doi.org/10.31089/1026-9428-2019-59-7-417-423 (in Russian).
77. Kuxtina E.G., Solenova L.G., Fedichkina T.P. et al. Night shift work and health disorder risk in female workers. Gigiena i sanitariya. 2015; 94(5): 86–91. https://elibrary.ru/uduvnh (in Russian).
Review
For citations:
Fesenko M.A., Golovaneva G.V., Miteleva T.Yu., Vuytsik P.A., Khalturyna Yu.V., Utkina N.S. Occupational determinants of reproductive health disorders in medical workers. Russian Journal of Occupational Health and Industrial Ecology. 2026;66(5):323-333. (In Russ.) https://doi.org/10.31089/1026-9428-2026-66-5-323-333. EDN: izhtip
JATS XML






































