Pregnancy

Agents considered harmful to health and  present in the work environment represent a potent risk to the pregnant woman and  developing foetus. For example, anaesthetic gases are associated with an increased risk of miscarriage.  Formaldehyde is associated with increased risks of defects ranging from birth malformations to spontaneous abortions.   This module is presented with rather a lot of lists rather than flowing text. That is somewhat necessary given the wide range of diverse risks to pregnancy in the workplace.

Adverse pregnancy outcomes include: Maternal morbidity or mortality Birth defects. Spontaneous abortion Low birth weight (<2500g) Pre-term delivery (<37wks gestation) Industries at risk       Agriculture ( a wide range of physical, chemical and biological hazards) Healthcare       Pharma: Preparation of cytotoxic drugs and teratogens (eg  antibiotics) and oestrogen       Working with ionising (eg nuclear facilities) and non-ionising radiation (eg X-rays)       Lead (Pb) work       Construction, Diving: Work at raised atmospheric pressure       This list is not exhaustive   Chemical Hazards Solvents Anaesthetic gases Paint Pesticides  Physical Hazards   Physical violence (e.g. police, hospital workers, other public service) Lifting Ionizing radiation Heat stress   SMALL increased risk associated with :- Heavy physical work Prolonged standing But irrespective of any foetal risk , the physiological demands of late pregnancy (>28 weeks) may indicate difficulty with long working hours , shift work, heavy physical work prolonged standing. There is a good case for the OH clinician to be advising adjustments here.     Biological hazards Infections: -       Varicella in late pregnancy        Zika virus       Rubella (-> Congenital Rubella Syndrome)       CMV       Toxoplasma       Chlamydia psittaci (from birds - > enzootic abortion)       Coxiella burnetti (Q fever)       Parvovirus B19 (slapped cheek disease or fifth disease).   Covid-19     As pregnancy progresses the hazards may change markedly and the risk assessment should be repeated. Measures to control exposures should be taken for women potentially exposed to ionising radiation or hazardous chemicals. If adequate control cannot be achieved, the pregnant worker should be allocated alternative duties suspended from duties. There is no evidence of risk from computer monitor screens. Morning sickness may temporarily make work impossible or adjustments in working hours may be warranted.