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Rekha Shanmugam
Sri Ramachandra Institute of Higher Education and Research, IndiaPresentation Title:
Impact of inadequate sanitation on urinary tract infections and adverse pregnancy outcomes: A public health concern
Abstract
Poor sanitation in hot workplaces is a significant public health issue, especially for pregnant women, who are more susceptible to urogenital tract infections due to physiological and immunological changes. It may increase pathogen exposure, causing illnesses such as urinary tract infections that can harm fetal health if left untreated. This study links informal workplace sanitation to adverse pregnancy outcomes, emphasizing the need for better sanitation to protect reproductive health.
An observational cohort study was conducted with 457 pregnant women workers in eight informal work sectors. Area heat stress measurements were taken using a Wet Bulb Globe Temperature 3M Quest temp monitor. Quantitative data on physiological heat strain indicators such as Core Body Temperature (CBT) and urine Specific Gravity (USG) were collected. A structured questionnaire captured women's perceptions about the health impacts of heat stress and inadequate sanitary facilities at the workplace.
Workplace heat exposures exceeded the threshold limit value for safe manual work for 81% of women (Avg. WBGT=28.4°C±1.2°C). Of the 260 women who had inadequate/no toilets at their workplaces, 74% of women reported experiencing urogenital problems periodically. Above standard CBT prevalence in about ~28% of women indicated heat strain and moderate dehydration that corroborated sufficiently with their perceptions. 34% of women had USG >1.020, a proxy of dehydration. 80% versus 41% of these women experienced symptoms of dehydration and heat-related health symptoms. Women with urogenital issues had the incidence of adverse pregnancy outcomes rose by approximately 1.9 times (95% CI: 1.1-3.5).
We found that pregnant women are at a high risk of developing HRIs and urogenital issues due to heat exposure and inadequate sanitation facilities. The preliminary evidence indicates that interventions like temporary toilets will avert health risks and enhance the reproductive health of millions of women workers who form the backbone of a country's economy in developing nations.
Biography
Rekha Shanmugam completed her PhD at 38 years from Sri Ramachandra Institute of Higher Education and Research, India. She is a project scientist now and is co-leading the Wellcome Trust Heat in Pregnancy India project at the Department of Environmental Health Engineering, Faculty of Public Health of Sri Ramachandra Institute of Higher Education and Research, India. She has over 35 publications cited over 410 times, and her publication h-index is 4. She has been a dedicated research professional with eight years of public health experience as a senior research fellow. She presented the research findings at 20 national and international conferences. She is interested in women’s health and conducted my doctoral research on “Determining the connections between occupational heat stress and adverse pregnancy outcomes”. Her post-doctoral research as a project scientist in a Heat in Pregnancy-India project funded by WELLCOME TRUST aims to investigate the underlying biological mechanisms, including the effects of heat exposure on maternal lactation and birth outcomes. Her future goal is to develop an intervention to assist the disadvantaged population, which endures heat in silence, in adjusting to its effects.
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