Reproductive Hazards

If you work in a laboratory or clinic setting and you are pregnant or potentially pregnant, you may contact the KSU Department of Environmental Health and Safety (EHS) for guidance on preventing workplace exposures to reproductive hazards and to voluntarily report your pregnancy (785-532-5856). Specific reporting and controls are recommended for employees that work with radioactive isotopes.

The EHS Occupational Safety section can assist you by conducting a workplace hazard assessment to determine the nature of the potential exposures in your specific work setting and make recommendations about controls to avoid exposure. These controls can include administrative practices (e.g., this might include altering your work practices or substituting less hazardous chemicals for more hazardous materials), engineering controls (such as the use of biosafety cabinets or fume hoods), or the use of personal protective equipment (PPE). Cursory or general guidance is provided in this document, but to ensure that the nature of the controls you employ are protective for your specific circumstances, call EHS and ask to speak to an Occupational Safety representative, the Radiation Safety Officer, or the director for information and/or to schedule an assessment.

Confidentiality

You may make inquiries to EHS regarding exposures and hazards of the work setting without identifying your specific circumstances or identity. Once you have made a written official declaration of pregnancy , if the conditions of your work circumstances place you or your unborn child at risk, it may be necessary to communicate with your supervisor or other department representative to make recommendations about safety.

You can discuss your concerns with an EHS Occupational Safety representative without needing to disclose your circumstances to your department. General information shared is kept confidential. However, if alterations to work are necessary for safety, your supervisor may need to be informed of your condition.

An assessment can be conducted of your work area to discern the risks present. This may be conducted without disclosing information with others in the laboratory and can be treated as a routine laboratory inspection.

Radiation Safety

Ionizing radiation is a known reproductive hazard. It has been linked to birth defects and other reproductive problems. Exposure to ionizing radiation at work could increase your chances of having reproductive problems. It is important to follow all controls and safety protocols when working with sources of ionizing radiation.

There are specific federal and state regulations and license requirements that apply to pregnant workers exposed to radiation or radioactive materials. The EHS Radiation Safety section ensure compliance to these requirements and also manages the purchase, use, and disposal of radioactive materials for Kansas State University. The program provides monitoring for personnel exposures to radioisotopes. To provide you with adequate monitoring during pregnancy, you should report your condition to the Radiation Safety Officer by completing a Declaration of Pregnancy form. Review the guidelines in the Radiation Safety Manual and fill out the declaration form. If there is potential for specific exposure, EHS Radiation Safety may issue you a fetal monitor.

Chemical Safety

There are workplace hazards that could be harmful for pregnant or breastfeeding women, or for members of the worker’s household if a worker carries home contaminants from the workplace on clothes, skin, and shoes. It is important to follow all safety protocols and use appropriate PPE when working in the laboratory or clinic setting.

If you are pregnant, it is important to discuss your workplace activities and the materials you use both in the workplace and at home with your OB/GYN. Additionally, Contact EHS Occupational Safety to discuss the materials you work with and to coordinate a workplace hazard assessment as needed. A hazard assessment may also include air sampling depending on the nature of the hazards present.

Complete the University-specific Laboratory Safety training through the Vivid Learning System to learn about basic laboratory safety controls and hazards to anticipate in the laboratory.

The following is a list of potential reproductive hazards that may be present in the laboratory or research clinic setting. This list is not exhaustive. For a review of the specific chemicals in your work area, Contact EHS Occupational Safety/Industrial Hygiene. Review the Safety Data Sheets (SDS) for information about the health hazards of a specific material. If the material is a known reproductive hazard, this should be identified within the SDS.

Anesthetic Gases

Antineoplastic (Chemotherapy) Drugs

Chemical Disinfectants and Sterilants

Glutaraldehyde

Ethylene oxide

Formaldehyde (very limited evidence)

Solvents

Lead and other Heavy Metals (use in research or as radiation shielding)

Additional information on some materials used routinely within the campus settings is provided below.

Formaldehyde/Embalming Fluids/Fixatives

Limited research studies are available on the reproductive hazards to a fetus resulting from airborne exposures to formaldehyde. In the laboratory, ventilation and the use of fume hoods greatly reduce the potential for exposure when using proper work practices. Higher hazards exist from potential ingestion, which can occur from poor sanitation practices. Methanol/alcohol is a teratogen via ingestion.

If you work routinely with formaldehyde solutions (>4%), sampling required. Individuals with exposures at or above regulated “action” levels may be required to enroll in the EHS Formaldehyde Medical Surveillance program. Contact Occupational Safety for additional information.

Anatomy Classrooms and Work with Preserved Carcasses, Cadavers or Specimens.

Anatomy coursework is generally conducted in specially designed classrooms and on downdraft tables that exhaust chemical vapors present in embalming fluids or other fixatives. Routine sampling in these areas for formaldehyde is conducted by Occupational Safety. If you are conducting this type of work outside of these classroom settings, contact Occupational Safety for an assessment of your work area.

Respirators may be used to protect workers from airborne contaminants. Use of a respirator by employees requires enrollment in the KSU Respiratory Protection program, medical clearance, training, and fit testing. Voluntary use of respiratory protection by non-employees such as students taking anatomy courses does not require enrollment in the KSU program, but you may Contact EHS for advice, information for your physician, respirator fit testing, and training. You must check with your OB/GYN if it is safe to use a respirator during your pregnancy. In cases where the levels of formaldehyde are below the permissible exposure level, carbon impregnated masks are an alternative to a traditional respirator.

Always wear scrubs and/or lab coat when in these settings. Disposable gowns/scrubs are an option and may be disposed after each use. These clothing articles should be worn in addition to the minimum PPE described in the PPE section. Remove gowns/scrubs/lab coats upon exiting the lab/clinic/classroom and place them in a sealed bag for transport. Your department may have a program to launder your items.

Work with 4% Formalin

Unless you are making solutions in the laboratory, most work with formalin should not present a serious hazard when work is infrequent and/or for short lengths of time as long as you are following proper laboratory safety protocol, including proper hygiene and hand washing and you wear appropriate PPE. Any preparations of volatile chemicals should be performed in a properly functioning chemical fume hood.

Anesthetic Gases

Studies have found an association between exposure to anesthetic gases and reproductive problems. It is important to follow the safety protocol established for your workplace and specific work activities and use appropriate PPE. It is also important to use waste gas scavenging devices. Information about waste anesthetic gas hazards and recommended controls is available from EHS.

Infectious Agents

The following information is adopted from the Centers for Disease Control (CDC) information on reproductive health and the workplace .

Working with or exposure to certain bacteria, viruses, or other infectious agents could increase your chances of having a miscarriage, a baby with a birth defect, or other reproductive problems. Some infections can pass to an unborn baby during pregnancy and cause a miscarriage or birth defect.

Infections like seasonal influenza (the flu) and pneumonia can cause more serious illness in pregnant women (CDC).

These and other infections can pass to the unborn baby during pregnancy, or cause more severe illness to a pregnant woman:

Exposure Control

General Guidelines

Make sure your vaccines are up to date. Seasonal influenza (flu) and other illnesses can cause more serious illness in pregnant women.

a) Get your seasonal flu shot. If you are pregnant, you should get the flu shot (inactivated vaccine) and not the nasal vaccine (LAIV, live attenuated nasal vaccine).

b) Do not get the MMR (measles mumps rubella) vaccine during pregnancy. If you are a pregnant healthcare worker who is not vaccinated and not immune, do not work with rubella-infected patients. Rubella infection is dangerous for pregnant women and their babies.

c) Learn more about vaccines for pregnant women.

Wash your hands often if you are around someone who is sick.

Lab, Animal Care, Clinic

a) Report your condition (voluntary) and any changes to your work activities.

b) Complete the Bloodborne Pathogens training online

c) Follow recommended infection control guidelines (standard precautions) carefully. If you follow these guidelines, you will be generally at no higher risk of catching a harmful infection from a patient than other workers. Learn more about infection control in general healthcare settings.

d) If working with pathogens as part of an IACUC protocol, an OHSP Form 4 and 5 should be filled out and submitted to indicate a change in status. A new consultation with Via Christi Occupational Health will be triggered by those forms.

e) Complete the Laboratory Safety training. Follow safety guidelines for laboratory workers. These guidelines will help you prevent laboratory-acquired infection when followed correctly.

f) For laboratory work with concentrated cultures of pathogens, contact the EHS Occupational Safety section.

g) Ensure that you are using biosafety cabinet that is appropriate to the type of work activity and materials that you are using. Contact EHS Occupational Safety section if you are not sure.

Physical/Energy Hazards

Beyond chemicals and infectious agents, physical hazards can pose a risk to the unborn child. This includes radiation, which is covered under the Radiation Safety section. Loud noises and potentially vibrations can pose a risk. Excessive heat can also become a concern. Generally, there are few instances of these hazards in the lab or clinic setting. If you believe that you do have this type of exposure, consult with the EHS Industrial Hygiene group. They can conduct noise level readings of your area and suggestion shielding or other controls depending on the nature of the hazard.

Long or irregular work shifts, as well as lifting bending and standing for long periods can present additional risk to pregnant women. Always consult with your OB/GYN about your work and any changes to your working conditions.

Resources

CDC/National Institute for Occupational Safety and Health (NIOSH) Reproductive Health and the Workplace:

Webpage: http://www.cdc.gov/niosh/topics/repro/default.html

What you should know: http://www.cdc.gov/niosh/topics/repro/femaleHealthImpact.html

The Effects of Workplace Hazards on Female Reproductive Health:

Webpage: http://www.cdc.gov/niosh/docs/99-104/

Document: http://www.cdc.gov/niosh/docs/99-104/pdfs/99-104.pdf

Related Articles

Collins, J., et al (2001) A review of adverse pregnancy outcomes and formaldehyde exposure in human and animal studies. Regulatory Toxicology and Pharmacology 34, p17-34.