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Background  This study aimed to investigate the association between exposure to occupational hazards for pregnancy and sick leave (SL) in pregnant workers.    Methods  A cross-sectional study was performed in French occupational health services in 2014. Occupational hazards for pregnancy were assessed by occupational health physicians (OHPs). After delivery and at the time of returning to work, 1,495 eligible workers were interviewed by OHPs. Information on SL was self-reported. Risk ratios (RRs) were calculated from multivariable analyses based on a generalized linear model with a Bernoulli distribution and a log link adjusted for selected confounders for binary outcomes or zero-inflated negative binomial regression for count outcomes.    Results  Among recruited workers, 74.9% presented “at least one SL” during pregnancy. After adjustment, the cumulative index of occupational hazards (0, 1–2, 3–4, ≥ 5 risks) for pregnancy was significantly associated with “at least one SL” during pregnancy in a dose–response relationship. This gradient was also observed with “early SL” (<15 week gestation): from 1 to 2 risks, RR = 1.48 (95% confidence intervals (CIs): 0.92-2.38); from 3 to 4 risks, RR = 2.03 (95% CI: 1.25-3.30); equal to or higher than five risks, RR = 2.90 (95% CI: 1.89-4.44); with “duration of absence” (adjusted mean): from 1 to 2 risks, m = 38.6 days; from 3 to 4 risks, m = 46.8 days; equal to or higher than five risks, m = 53.8 days. We also found that deprivation, pregnancy at risk, assisted reproductive therapy, work-family conflicts, home-work commuting felt as difficult and young age are associated with a higher risk of SL.    Conclusions  Our results support the assertion that pregnant workers exposed to occupational hazards for pregnancy without medical complications are also at risk of taking SL during pregnancy. More prevention in the workplace for pregnant workers exposed to occupational hazards could reduce SL.

Exposure to occupational hazards for pregnancy and sick leave in pregnant workers: a cross-sectional study