Topics:

• What Are The Risks For Pregnant Employees?
• What Can You Do To Prevent Harm?
• What Can You Do To Manage Risk?
• What Can A Pregnant Woman Do To Decrease The Risk To Herself And Her Baby?
• What Can Employers Do To Promote A Safe Work Place For Pregnant Women?
• References

What Are The Risks For Pregnant Employees?

Women in their reproductive years make up almost half of all employees.  Eighty percent of women will become pregnant during their working life.  Most work during pregnancy, and return to work after their baby is born.  Work, during normal pregnancy, is not usually a problem.  The changing nature of employment has caused new hazards for expectant parents, including those who do not realize they are pregnant. 
 

Prolonged sitting, repetitive movements, new technologies and exposure to chemicals may put a woman at risk of having a low birthweight, or premature baby.  Workplaces can strengthen practices to reduce the health and safety risks.

All employees face some workplace risks to their health. The sources of risk are varied, and include: chemical, physical, biological, ergonomic, psychological, and safety hazards.  Pregnant women are at even greater risk of harm, not only to themselves, but also to their developing children.

The hazards listed on the chart below, increase the risk for adverse pregnancy outcomes including: birth defects; low birthweight; prematurity; and miscarriage.  Certain occupations and exposures are linked to specific adverse pregnancy outcomes.1

What Can You Do To Prevent Harm?

Strict adherence to health and safety standards will reduce harm, but occupational exposure limits are rarely derived with the pregnant worker in mind.2  Material Safety Data Sheets may not contain sufficient information.  Consultation with programs like Motherisk3 will provide additional information specific to the needs of the pregnant employee.  Pregnant employees, employers, and physicians need to work together to successfully prevent, and manage risk to the pregnant woman and her unborn child.

Knowledge of the physiological changes that occur during pregnancy helps an employer to prevent unnecessary exposure.  Steps can then be taken to eliminate, or reduce, risk.  Awareness and education about risk factors and their effects on the pregnant woman need to occur in all workplaces. 

The organizational culture also influences the success of wellness, health, and safety strategies.  Supportive workplace practices assist healthy women assume responsibility in the workplace.  An 'open door' management style will help employees feel free to approach their employer early in pregnancy.
 

Hazard Type	Hazards	Occupation
Chemical	chemotherapeutic  agents, anesthetic  gases, metals,  organic solvents,  pesticides	health-care, research, manufacturing, agriculture,  welding, pharmacy,  painting, decorating,  printing, construction,  drycleaning
Physical	radiation noise, vibration,  hot and cold work  environments	nuclear power plant, x-ray cold storage; airports
Biological	viruses (Rubella,  CMV, parvovirus,  HIV), parasites  (toxoplasmosis)	health care, personal care,  child care, veterinary  medicine, teaching
Ergonomic	posture, lifting,  bending, repetitive  work, rapid pace	nursing, therapy, clerical,  assembly-line, warehouse
Psychological	stressful work,  shift work,  long hours	health care, management, manufacturing
Safety	aggression,  violence	police, mental health,  pharmacy, health care

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What Can You Do To Manage Risk?

Employees in one workplace may incur different risks than employees in other workplaces because of the characteristics of the workplace, and the type of work. 

For example, pregnant health care workers may need to alter their schedules if they work long hours, shift work, or are involved in strenuous work.  Guidelines for strenuous work during pregnancy have been developed by the Society of Obstetricians and Gynaecologists.5

Management of risks for injury to pregnant women and their unborn children follows the same principles as those for all employees.  There are some exceptions depending on the stage of pregnancy. 

Both the employer and the employee have a responsibility to manage the effects of workplace hazards.  The Ontario Human Rights Code explains that the employer is required to accommodate women "who have special needs because of pregnancy."6
 

The Code provides ideas of ways to accommodate, such as changing job duties, and allowing for breaks as necessary.  The employee is required to communicate her needs to her employer.  She may be required to demonstrate that her needs are medically supported.7

The physiological changes associated with pregnancy may alter the susceptibility of the pregnant worker.8   The fetus is much more susceptible than an adult to injury because of rapid growth and development.  The degree of risk, and type of injury, change as a pregnancy progresses.

When assessing risk, previous prenatal history, and present health status need to be considered.  Lifestyle may exacerbate the risks that the pregnant worker confronts. It is not always possible to separate the lifestyle and workplace hazards when assessing the risk. 

Workplace programs need to approach the pregnant employee in a holistic way: 
• prenatal education in the workplace;
• supporting behaviour change;
• establishing wellness practices; and
• working to minimize chemical, biological, and physical hazards.

Besides the medical effects of workplace hazards, there are also ethics and human rights to consider.  Cost to the employer, the interests of the pregnant woman, communication with the attending physician, and possible solutions, all provide a context in which to manage risks.  What is an acceptable risk for one woman may not be for another. The values and options of the expectant parent must be explored.

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What Can A  Pregnant Woman Do  To Decrease The Risk  To Herself  And Her Baby?

•  Recognize the signs and symptoms of preterm labour.

•  Let her employer and coworkers know early in pregnancy that she is pregnant; well informed coworkers and managers can provide a supportive environment.

• Take responsibility for finding out about her environment by: checking for exposure to hazards; checking Material Safety Data sheets;  and confirming her safety by talking with her employer, Health and Safety Committee, or Occupational Health Nurse.

•  Prevent exposure to dangerous substances by: washing hands before eating; avoiding hazardous chemicals; and complying fully with Universal Precautions.

•  Continue practicing, or adopt healthy lifestyle practices.
•  Modify work habits if necessary.

What Can Employers Do To Promote A Safe Work Place For Pregnant Women?

•  Provide a smoke-free environment.
•  Ensure good ventilation.
•  Regularly maintain scavenging systems, for example, in operating suites.
•  Be flexible.
•  Offer alternative work assignments for pregnant women involved with: heavy lifting; chemicals; strenuous work; shiftwork; and radiation.
•  Limit overtime.
•  Provide prenatal information. 
•  Train supervisors.
•  Encourage employees to check Material Safety
   Data Sheets.
•  Provide protective equipment.
•  Provide short breaks at least every two hours.

"Pregnancy-Friendly workplace practices" go a long way toward protecting a mother and her unborn child from unnecessary exposure to hazards in the workplace.  As new technologies, products and services are introduced, employers need to be alert to the effects on the reproductive health of employees. 

Creativity and flexibility in the workplace are key to providing a supportive workplace during an exciting, yet potentially risky, time in the lives of the pregnant worker and her child.

References

1. Bentur, Y., Zalzstein, E., Koren, G., "Occupation Exposures Known to Be Human Reproductive Toxins." Maternal-Fetal Toxicology: A Clinician's Guide. Marcel Dekker, 2001 p.508.
2. Youakim, Sami, "The Pregnant Worker", The Canadian Journal of CME, October 1999, p.180.
3. Motherisk, Hospital for Sick Children, (416) 813-6780, www.motherisk.org/enviro/index.php3.
4. Youakim, Sami, "The Pregnant Worker" The Canadian Journal of CME, October 1999, p.176.
5.  Schuurmans, N., and Lalonde, A., Healthy Beginnings: Your handbook for pregnancy and birth.  Ottawa, The Society of Obstetricians and Gynaecologists of Canada.  Second edition, 2000. p.45.
6. Pregnancy Before, During & After: Know Your Rights. Ontario Human Rights Commission, 1999, p. 3.
7. Pregnancy Before, During & After: Know Your Rights. Ontario Human Rights Commission, 1999, p.4.
8. Youakim, Sami, "The Pregnant Worker" The Canadian Journal of CME, October 1999, p. 180.