The Guardian
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Female surgeons at risk of fertility problems from radiation in operating theaters


As more women are venturing into the profession of medicine, a new study has found that they are more than twice as likely to suffer fertility problems due to radiation and other hazards of the operating theatres.

While experts had suspected for some years that working as a surgeon harms women’s chances of having a baby, and assumed that stress and physical demands of the role explained the trend, the new analysis argues that there are direct medical risks from working as a surgeon, including from radiation, surgical smoke, anaesthetic gases and other toxic substances.

The authors of the study published in the journal JAMA Surgery, are calling for hospitals to make alternative roles available for women of childbearing age after identifying links between infertility and the specialism.According to the study, the potential consequences range from difficulty getting pregnant, spontaneous abortion, preterm delivery, growth restriction and congenital abnormalities.

The study points to a survey of 1,021 female surgeons in the United States, across different specialisms that found 32 percent of respondents reporting difficulty with fertility, compared to 10.9 percent in the general population.The same study saw a pregnancy complication rate of 35.3 percent, compared to 14.

According to the authors, exposure to radiation in operating theatres occurs via use of radioactive tracers – chemical compounds that can be tracked as they spread around the body -and mechanical imaging techniques, noting that as technology has advanced, so has the growth in “hybrid” operating rooms, which combine imaging and surgical functions5 per cent generally.

The authors, from Western Health Surgical Department in Australia and Harvard Medical School, said: “Occupational hazards exist in the operating room that may be factors in increased rates of infertility and adverse pregnancy outcomes for surgeons.“It is important for the workplace and surgeons to understand what information is available.

“At a minimum, workplaces need to comply with existing guidelines or standards, recognising that these may not be protective for reproductive outcomes, and so that it may be wise to do more.“Alternative work duties and/or conditions should be readily available.”
They add, however: “Priority should be given to controlling exposure rather than restricting surgeons’ activity.”

Meanwhile, previous studies have shown that the toxic effects of radiation exposure on the developing foetus include prenatal death, growth restriction, cognitive difficulties and a heightened risk of childhood cancer. The study also investigated the impact of surgical smoke, the substance created by processes such as the electrical cauterisation of wounds. Surgery on the gall bladder and pancreas, as well as on fatty tissues produces particularly large levels of surgical smoke, with contents to include various gaseous chemical compounds, particulate matter as well as some bacteria and viruses.

Also, previous research has linked some of the toxins to low birth weight, preterm labour and infertility.The authors also believe that inhaling anaesthetic gases, many of which contain nitrous oxide, can also damage fertility. According to them, there may also be a danger from exposure to chemotherapy drugs via inhalation or skin contact.

Although they call for hospital bosses to consider measures to protect female surgeons of childbearing age, the authors warned that “without careful consideration of the evidence”, new policies may lead to unfair discrimination.Council member of the Royal College of Surgeons, Scarlett McNally, said: “The Royal College of Surgeons of England welcomes this review and is an avid supporter of women in surgery.

“Surgical training is lengthy and often coincides with the child-bearing years. The additional considerations of pregnancy need to be factored in. “It is right this review has taken place and highlighted areas where pregnant surgeons can be supported further to allow for a healthy pregnancy, and continue to contribute as excellent surgeons.”


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