Current literature suggests differences in the prevalence of incontinence symptoms by occupation in women [1]. We hypothesized that infrequent urination in the workplace may contribute to increased lower urinary tract symptoms (LUTS), including incontinence, in women. To inform our hypothesis, we conducted a secondary analysis of existing data from the Boston Area Community Health (BACH) Survey, a large population-based study of Boston residents, with detailed LUTS data and occupational groupings.

At baseline, women provided information on their presence of LUTS and occupation. Using the United States Department of Labor’s Standard Occupational Classification (SOC) system, we categorized women into 1 of 11 groups. We used a response option of at least “a few times” or more to explore the relation between SOC groups and LUTS presence. LUTS examined included storage symptoms, voiding symptoms, incontinence, and bladder pain in the past month. Women also recalled the frequency of urinary tract infections in the past year. Prevalence estimates were weighted to account for the BACH sampling design. Prevalence ratios (PRs, 95% CI) were calculated by log-link generalized linear models with robust variance estimation, adjusting for age, education, and fluid intake.  Women in the Office and Administrative Support SOC group were used as the reference group given their potential for fewer workplace restrictions in toileting.

Of the 2,789 women who provided complete data, 61% reported currently working for pay; 11% were retirees, 10% disabled, 7% homemakers, and 7% unemployed. Office and Administrative Support (n=510, 18%) and Service (n=866, 31%) were the most common SOC groups. Overall, 63% of women reported one or more LUTS; ranging from 54% to 82% across the SOCs. The most common LUTS were storage symptoms (increased daytime urinary frequency, nocturia, and urgency); least common were voiding (hesitancy, slow stream), and incontinence symptoms (non-stress/non-urgency incontinence). Women in Computing, Engineering, and Science (n=59) had an increased prevalence of overall LUTS (PR=1.3, 1.1-1.5), as well as hesitancy (PR=4.0, 1.6-10.5) and daytime urinary frequency (PR=1.9, 1.5-2.5), compared to the reference group, p<0.05. Women in Service had a higher prevalence of nocturia (PR=1.4, 1-1.8), p<0.05, and women in Production (n=193), Transportation and Material Moving (n=58), and Management, Business, and Finance (n=202) had a lower prevalence of at least 2 or more individual LUTS, including urgency, intermittency, urgency incontinence, hesitancy, and increased frequency of urinary tract infections, compared to the reference group, p<0.05. Women in Healthcare (n=133), Education (n=415), and Unemployed women (n=140) did not have a significantly higher or lower prevalence of LUTS compared to women in the reference group.

Women in Computing, Engineering, and Science occupations were 30% more likely to report LUTS, including storage and voiding symptoms, compared to women in Office and Administrative Support positions even after adjusting for age, education, and fluid intake.

Our cross-sectional findings suggest that LUTS vary across women by occupational groups. Future studies should examine this relationship prospectively to inform the influence of toileting in the workplace on LUTS and the influence of LUTS on occupational status.

Pierce H, Perry L, Chiarelli P, Gallagher R. A systematic review of prevalence and impact of symptoms of pelvic floor dysfunction in identified workforce groups. J Adv Nurs 2016.