Perceptions of Polymethyl Methacrylate Cement Exposure Among Female Orthopaedic Surgeons

Harper, Katharine D.; Bratescu, Rachel; Dong, David; Incavo, Stephen J.; Liberman, Shari R.

doi:10.5435/jaaosglobal-d-19-00117

Cited by 8 publications

(12 citation statements)

References 13 publications

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“…A recent survey was extended to the Ruth Jackson Orthopaedic Society to better define PMMA usage among female orthopaedic surgeons. 35 After education on the adverse effects of PMMA, the survey found that 41.7% of respondents would leave the operating theater when pregnant, and 24.7% of respondents would leave when breastfeeding. In addition, 8.4% of respondents agreed that this potential Image showing electrocautery with an integrated suction device.…”

Section: Polymethylmethacrylate Exposurementioning

confidence: 99%

Occupational Hazards for the Practicing Orthopaedic Surgeon: A Standard Review

Patel

Judd

Harm

et al. 2022

J Am Acad Orthop Surg

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Orthopaedic surgeons are exposed to various occupational hazards in a busy daily practice which can cause potential physical injury and additional mental stress. By better understanding the hazards that are faced in the operating theater and the preventive measures that can be taken to avoid injury, orthopaedic surgeons can remain effective in their patient care duties. Infectious exposures, radiation exposure, noise pollution, chemical hazards, and physical demands are frequently encountered at the time of surgery and should be attenuated or avoided when possible. Simple preventive measures can prolong careers and protect the operating surgeon from musculoskeletal injuries and even solid organ damage and malignancy. Important consideration should be taken to recognize potential occupational hazards and act prophylactically before injury has occurred, and constant vigilance is required to avoid additive injury over time from physical and chemical insults. Level of Evidence: Level V O rthopaedic surgeons face many occupational hazards daily, and it is of paramount importance to be aware of and understand how to mitigate potential injuries. Total costs from all occupational injuries can exceed $190 billion annually in the United States inclusive of necessary health care and lost productivity. 1 Although not specific to orthopaedic surgeons, recent statistics highlight the dangers that surgeons face, indicating that work in a hospital setting may contribute to more nonfatal occupational injuries than even employment in construction or manufacturing. Indeed, of 313 total industries surveyed, the hospital industry ranks as the third most expensive when considering economic losses from occupational injuries. 2 General awareness and prevention of occupational safety among orthopaedic surgeons have increased in recent years, but there are many subtle occupational dangers that often go unnoticed and can be difficult to modify. Infectious exposure from sharp instruments or needles, physical insults such as radiation or noise pollution, and chemical exposure from inhalants or topical substances are some of the inherent hazards of participating in surgery. The purpose of this review article was to not only inform surgeons of these hazards Kishan Patel, DO Hyrum Judd, DO

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Section: Polymethylmethacrylate Exposurementioning

confidence: 99%

Occupational Hazards for the Practicing Orthopaedic Surgeon: A Standard Review

Patel

Judd

Harm

et al. 2022

J Am Acad Orthop Surg

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“…A summary of these papers can be seen in Table I and key results in Supplementary Table ii. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Out of the 19 studies, 11 included female orthopaedic surgeon respondents only, and four included both male and female orthopaedic surgeons; this was a total of 4,327 survey responses (3,394 female, 993 male). Out of the remaining four studies, two were analyses of training programmes, and two were responses from training programme directors.…”

Section: Resultsmentioning

confidence: 99%

Pregnancy, parenthood, and fertility in the orthopaedic surgeon

Morgan,

Li,

Kasetti

et al. 2023

Bone Joint J

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AimsAs an increasing number of female surgeons are choosing orthopaedics, it is important to recognize the impact of pregnancy within this cohort. The aim of this review was to examine common themes and data surrounding pregnancy, parenthood, and fertility within orthopaedics.MethodsA systematic review was conducted by searching Medline, Emcare, Embase, PsycINFO, OrthoSearch, and the Cochrane Library in November 2022. The Preferred Reporting Items for Systematic Reviews and Meta Analysis were adhered to. Original research papers that focused on pregnancy and/or parenthood within orthopaedic surgery were included for review.ResultsOf 1,205 papers, 19 met the inclusion criteria. Our results found that orthopaedic surgeons have higher reported rates of obstetric complications, congenital abnormalities, and infertility compared to the general population. They were noted to have children at a later age and voluntarily delayed childbearing. Negative perceptions of pregnancy from fellow trainees and programme directors were identified.ConclusionFemale orthopaedic surgeons have high rates of obstetric complications and infertility. Negative perceptions surrounding pregnancy can lead to orthopaedic surgeons voluntarily delaying childbearing. There is a need for a pregnancy-positive culture shift combined with formalized guidelines and female mentorship to create a more supportive environment for pregnancy within orthopaedic surgery.Cite this article: Bone Joint J 2023;105-B(8):857–863.

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“…A position statement [ 24 ] from the Ruth Jackson Orthopaedic Society acknowledged that exposure to radiation and MMA can contribute to challenges faced by female orthopaedic surgeons, but it also cites Linehan’s [ 13 ] study which did not detect MMA in serum or breast milk in two breastfeeding surgeons following MMA exposure during joint arthroplasty. Nevertheless, a survey [ 25 ] sent to members of the Ruth Jackson Orthopaedic Society revealed a lack of consensus among female orthopaedic surgeons about the risks of MMA during pregnancy and breastfeeding. 90% of respondents claimed that they were familiar with the risks of MMA, while about 40% reported that they would leave the room during MMA use if pregnant [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, a survey [ 25 ] sent to members of the Ruth Jackson Orthopaedic Society revealed a lack of consensus among female orthopaedic surgeons about the risks of MMA during pregnancy and breastfeeding. 90% of respondents claimed that they were familiar with the risks of MMA, while about 40% reported that they would leave the room during MMA use if pregnant [ 25 ]. This study also suggests that it is possible that beliefs regarding MMA exposure may deter individuals from pursuing careers where MMA is regularly used [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…90% of respondents claimed that they were familiar with the risks of MMA, while about 40% reported that they would leave the room during MMA use if pregnant [ 25 ]. This study also suggests that it is possible that beliefs regarding MMA exposure may deter individuals from pursuing careers where MMA is regularly used [ 25 ]. Therefore, it would be worthwhile to investigate if attitudes toward MMA may lead to exclusion of female orthopaedic surgeons in a male-dominated specialty.…”

Section: Discussionmentioning

confidence: 99%

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Is methylmethacrylate toxic during pregnancy and breastfeeding?--- a systematic review

et al. 2021

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Introduction Methyl methacrylate (MMA) is commonly used in the fields of dentistry and orthopaedic surgery. However, there remain concerns for the occupational hazards of MMA, particularly during pregnancy and breastfeeding. Methods We performed a systematic review of studies on effects that MMA may have in pregnancy in the context of exposure during orthopaedic surgery and dentistry. Review articles, studies lacking statistical data, single case reports and other evidence level V studies were excluded. Results Nine studies were included. One basic science study demonstrated an increase in neuronal cell lysis and shrunken cell bodies when neocortical neurons were exposed to MMA monomer. Three animal studies exposed pregnant rodents to MMA via intraperitoneal injection or inhalation. Exposed fetuses in two studies had an increase in gross abnormalities such as hemangiomas, while there was no increase in teratologic effects in the third study. In dental workers exposed to MMA, two retrospective cohort studies did not find a statistically significant increase in birth defects or miscarriage. After exposure to MMA during total joint arthroplasty, two studies found that MMA levels were undetectable in the mothers’ serum or breast milk. One study measuring the airborne levels of MMA during simulated joint arthroplasty found that concentrations never exceeded 1% of the recommended limit set forth by the Occupational Safety and Health Administration (OSHA). Conclusions Potential teratologic effects of MMA cannot be excluded by existing evidence. However, the typical MMA exposure levels for dental and orthopaedic personnel appear to be substantially less than currently proposed exposure limits.

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Perceptions of Polymethyl Methacrylate Cement Exposure Among Female Orthopaedic Surgeons

Cited by 8 publications

References 13 publications

Occupational Hazards for the Practicing Orthopaedic Surgeon: A Standard Review

Occupational Hazards for the Practicing Orthopaedic Surgeon: A Standard Review

Pregnancy, parenthood, and fertility in the orthopaedic surgeon

Is methylmethacrylate toxic during pregnancy and breastfeeding?--- a systematic review

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