EUROPEAN JOURNAL OF OCCUPATIONAL HEALTH NURSING

Reproductive Toxicants in the Workplace: Bridging Evidence, Regulation, and Occupational Nursing Practice in the Era of Bisphenol A

Editorial Board EJOHN — 2026-03-31

The growing recognition of endocrine-disrupting chemicals (EDCs) as critical determinants of occupational health has marked a paradigm shift in workplace risk assessment and prevention. Among these agents, Bisphenol A (BPA) has emerged as a paradigmatic example of a ubiquitous chemical with profound implications for reproductive health. The accompanying article by De-Pedro-Jiménez et al. provides a timely and rigorous interpretative analysis of BPA as a reprotoxic agent, highlighting not only its biological effects but also its practical implications for Occupational Health Nursing.

This editorial seeks to contextualize these findings within the broader framework of occupational hygiene, emphasizing the urgent need to integrate scientific evidence, regulatory evolution, and nursing practice. It argues that BPA exposure is not merely a toxicological concern but a call to redefine preventive strategies, strengthen health surveillance, and consolidate the leadership role of occupational nurses in addressing emerging reproductive risks.

Insomnia in the Workplace: Implications for Occupational Health and the Role of Nursing

MANUEL ROMERO-SALDAÑA — 2026-03-31

Sleep is a fundamental biological process essential for physical, cognitive, and emotional functioning. Insomnia, defined as persistent difficulty initiating or maintaining sleep accompanied by daytime impairment, has become one of the most prevalent sleep disorders worldwide. In occupational settings, insomnia is increasingly recognized as a significant public health issue, affecting worker safety, productivity, and overall well-being.

The relationship between work and sleep is bidirectional. Occupational factors such as shift work, psychosocial stress, workload, and exposure to artificial light can disrupt circadian rhythms and contribute to insomnia. Conversely, insufficient or poor-quality sleep negatively impacts cognitive performance, decision-making, and emotional regulation, increasing the risk of occupational accidents and chronic disease (1,2).

This article explores insomnia in the workplace from an occupational health perspective, incorporating recent evidence on workplace-based interventions and highlighting the role of Occupational Health Nursing.

Epidemiology and Occupational Determinants of Insomnia

Insomnia affects approximately 10–30% of the adult population, with higher prevalence among workers exposed to irregular schedules and high job strain (3). Shift workers, particularly those engaged in night and rotating shifts, are at increased risk due to circadian misalignment (4).

Key occupational determinants include:

Shift work and night work: Disruption of circadian rhythms leading to sleep difficulties (4).
Psychosocial stress: High job demands and low control are strongly associated with insomnia (5).
Environmental factors: Noise, temperature, and light exposure negatively affect sleep (6).
Technological factors: Increased screen exposure and work-life boundary blurring contribute to sleep disturbances (7).

These determinants often interact, increasing vulnerability among workers.

Bisphenol A as a Reproductive Toxicant: An Interpretive Approach from Occupational Nursing

Domingo De-Pedro-Jiménez — 2026-03-31

Introduction: Bisphenol A (BPA) is a ubiquitous endocrine disruptor whose occupational exposure poses a risk to workers across multiple industrial sectors. The revision of Royal Decree (RD) 665/1997 through RD 612/2024 requires specific protection against reprotoxic agents; however, a gap remains between scientific evidence and health surveillance protocols within Occupational Nursing.

Aim: To analyse the scientific evidence regarding BPA as a reprotoxic disruptor from the perspective of Occupational Nursing, identifying implications for health surveillance and preventive education among exposed workers.

Method: A qualitative interpretative analysis was conducted following Braun and Clarke’s six-step approach based on a systematic review retrieved from PubMed using the MeSH combination “Bisphenol A Compounds” AND “Endocrine Disruptors.” Study quality was assessed according to PRISMA criteria.

Results: Five categories of effects were identified: alterations in female fertility, alterations in male fertility, effects on assisted reproduction, gestational and foetal effects, and other endocrine effects. From the analysis, four thematic categories emerged relevant to Occupational Nursing: reproductive health surveillance, protection during exposure, detection of endocrine disruption symptoms, and health education and prevention.

Conclusions: BPA represents a significant reprotoxic risk for workers. Occupational Nurses must ensure the early detection of endocrine disruption symptoms, provide comprehensive health education, and participate in risk assessment processes. This analysis reinforces the nursing role in occupational health, aligning practice with RD 612/2024 and current trends in reproductive protection at work.

Prevalence of Insomnia and Daytime Sleepiness among Healthcare Professionals: A Cross-sectional Study

Eugenia de Casia García García — 2026-03-31

Objectives: To analyse the prevalence of insomnia and daytime sleepiness among healthcare professionals working at a tertiary-level hospital in Barcelona.

Methods: An observational, descriptive, cross-sectional study was conducted using an anonymous survey administered to healthcare professionals at Hospital Clínic of Barcelona between January and April 2025. The Insomnia Severity Index (ISI; range 0–28) and the Epworth Sleepiness Scale (ESS; range 0–24) were applied, together with sociodemographic variables (age, sex, work shift, and professional category). Frequencies were calculated and comparisons between groups were performed.

Results: A total of 154 complete questionnaires were analysed. The sample was predominantly female (81.8%), with the most frequent age group being 41–50 years (33.8%). The overall prevalence of insomnia was 83.8% (45.5% mild, 33.8% moderate, and 4.5% severe). Insomnia prevalence was higher among men than women (89.3% vs 82.5%), although this difference was not statistically significant (p=0.381). Insomnia was more frequent in participants aged <50 years compared with those aged ≥50 years (88.6% vs 77.3%;p=0.058), with no significant differences according to work shift. Pathological daytime sleepiness was observed in 41.6% of participants and was slightly more frequent in women (42.9% vs 35.7%;p=0.488). Daytime sleepiness was more prevalent among participants aged ≥50 years (45.5% vs 38.6%), with significantly higher mean ESS scores (10.23 ± 4.24 vs 8.76 ± 4.94;p=0.025).

Conclusions: This study reveals a high prevalence of insomnia and daytime sleepiness among healthcare professionals, reinforcing the need to implement specific strategies for the detection, prevention, and promotion of sleep health within the hospital setting.

Sleep and modifiable cardiovascular risk factors in nursing staff

Lucrecia Ana Blasco Baselga — 2026-03-31

Introduction. The aim of the study was to evaluate the prevalence of cardiovascular risk factors (CVRF) and to analyse the influence of sex, work shift and job position on sleep quality and other CVRF.

Methods. This was a multicenter prevalence study conducted in 2023 using a survey among nursing staff at three Spanish hospitals.

Sleep quality was assessed using the Oviedo Questionnaire; nicotine addiction with the Fagerström Test; physical activity with the IPAQ questionnaire; adherence to the Mediterranean diet with the PREDIMED questionnaire; and perceived stress with the Cohen scale.

Results. A total of 727 workers participated in the study. Rotating-shift workers (71.65%) exhibited poorer sleep quality (p<0.001), lower levels of physical activity (p<0.001), and higher perceived stress (p<0.001) compared to day-shift workers. Hypercholesterolemia (p<0.05) and hypertension (p<0.05) were more prevalent among day-shift workers. Women reported higher perceived stress (p<0.01) and poorer sleep quality (p<0.05) than men, whereas men had a higher prevalence of cardiovascular events (13%). Workers who had experienced a cardiovascular event or had higher perceived stress showed worse sleep quality (p<0.01).

Conclusions. There is evidence that the negative health effects associated with shift work increase with age. Sleep quality, hypertension, and stress are particularly affected. Shift work and physical activity appear to negatively influence sleep quality, which is worse among rotating-shift workers.

Comparing Two Independent Proportions Using the Z-Test: Improving the Statistical Quality of Our Studies

Domingo De-Pedro-Jiménez — 2026-03-31

In health sciences research, it is common to compare percentages or proportions between groups without using appropriate statistical techniques to validate whether the differences are significant. This simplistic approach relies on the visual comparison of values in tables or graphs, ignoring sampling variability and confidence intervals. As a result, statistically or clinically relevant differences are erroneously assumed, leading to incorrect conclusions and affecting decision-making. This error is frequent in basic epidemiological studies or publications with low methodological rigor.

Let's look at two examples below. Remember that the p-value measures the probability of observing differences, assuming that no real difference exists (null hypothesis). If p < 0.05, we reject the null hypothesis. The 95% confidence interval (CI) shows the plausible range of the real difference; if it does not include 0, there is evidence of a difference.