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Do nurses have a different physical health profile? A systematic review of experimental and observational studies on nurses' physical health.

AIM
To review the evidence on nurses' health systematically.


BACKGROUND
Nurses are one of the most important resources of a health system. They are subjected to biological, socio-economic, cultural and health system factors that determine their health. Although mental and physical health problems seem to prevail among nurses, literature is often contradictory. The literature on health styles, health behaviours and self perceived health of nurses is also unclear.


DESIGN
Systematic review of experimental and observational studies on nurses' health.


METHODS
Forty-three databases searched. 2692 references identified as of potential interest; 187 studies included. Only the results from studies on physical health are presented. No meta-analysis was possible. The Scottish Intercollegiate Guidelines Network system was used to rate evidence.


RESULTS
Nurses were at greater risk of musculoskeletal injuries and more prone to blood-borne pathogens infections than other health care workers. They were at greater risk of breast cancer than other female health care workers. Nurses in hospitals were more at risk of tuberculosis. They did not have excess risk of cancer in general, Hodgkin's disease, stomach, colon, rectum, pancreatic, ovary, kidney, brain or thyroid cancer or of lymphosarcoma. They have a higher prevalence of occupational allergies than clerical workers.


DISCUSSION
Nurses suffer more from musculoskeletal disorders which is consistent with the nature of nursing work. They are at greater risk of acquiring tuberculosis, particularly if they work in pulmonary, medicine or Human Immunodeficiency Virus wards which might be due to repeated contact with infected patients. Nurses are also more prone to blood-borne pathogens infections which might be explained by exposure while working. The proneness to occupational allergies can be explained by exposure to a series of chemical agents.


RELEVANCE TO CLINICAL PRACTICE
Without sound knowledge on nurses' health and it is not possible to develop specific occupational health programmes.