Dan Markiewicz
Trends suggest that environmental health and safety pros should become more involved in protecting fetal health. More women of childbearing age are in the workforce, in all occupations, than ever. And more than one-half of U.S. children are now born to working mothers.

But many EHS pros are not proactively addressing fetal health. They could be scared off by privacy or discrimination issues, mistakenly believing there’s nothing they can do to protect a fetus unless the employee asks for help.

This is a cop-out. You can take many steps to help protect fetal health at work without jeopardizing anyone’s privacy or violating any rights. Here are six you should consider:

Six steps to safety - 1. Establish policies and procedures dealing with reproductive health.

More specfically, every workplace should anticipate, recognize, evaluate, and control workplace teratogens.

A teratogen (meaning “monster making”) is an agent, such as a chemical substance, that may cause a physical effect in a developing embryo or fetus, often without causing any discernable harm to the person who is pregnant. Some studies claim that there may be more than one-million pregnancy terminations annually in the U.S. that may have a teratogenic relationship.

2. Learn about teratogens and reproductive health using Web-based resources.

Three excellent examples come to mind:

  • NIOSH publication No. 99-104, “The Effects of Workplace Hazards on Female Reproductive Health,” was issued in February, 1999. This good but brief read can be found on the Web at www.cdc.gov/niosh.

  • A more expansive and actively updated example is The Center for the Evaluation of Risks to Human Reproduction (CERHR), found on the Web at http://cerhr.niehs.nih.gov. The National Toxicology Program and the National Institute of Environmental Health Sciences established CERHR in 1998.

  • The American College of Occupational and Environmental Medicine’s (ACOEM) guidelines on “Reproductive and Developmental Hazard Management” can be found on the web at www.acoem.org/paprguid/guides/rdhaz.htm.

3. To control teratogens, you first need to recognize them.

This is not an easy task. A single, comprehensive list of teratogens unfortunately does not exist.

Differences of opinion come into play. For example, some lists include non-chemical suspect teratogens such as noise or hyperthermia, but most do not. You should defer to CERHR as the definitive source for known and suspect teratogens — but also recognize the importance of other sources.

The Environmental Defense Fund maintains the largest list of “developmental toxins” (including teratogens) on the Web at www.scorecard.org (see Health Effects: Developmental Toxicity Definition).

4. Do not rely solely on material safety data sheets to identify teratogens.

MSDSs are prone to error and may be incomplete or outdated.

5. Determine if potential teratogenic agents can be replaced with safer materials.

If not, keep teratogen exposure to female employees at the lowest practical level. It’s not enough to just meet regulatory or recommended exposure limits (see sidebar).

6. Be cautious — but not overly cautious.

We occasionally find a doctor who prescribes orders that a pregnant employee should face “no” exposure. This is not an acceptable recommendation. If it were, then given the part-per-trillion argument (one second in 32,000 years is equivalent to one part per trillion) the doctor’s waiting room may be off-limits to pregnant patients because of ambient air levels of chemicals such as lead.

It would be foolish to ignore medical orders, but try to convince the doctor to specify a percent of an established exposure limit — 25 percent or 10 percent of the OSHA PEL. Provided that there are good engineering controls, such as exhaust ventilation, this at least provides a manageable situation.

Remember, more than 95 percent of all babies are born normal and healthy. Just because a chemical stinks, or stings a pregnant employee, does not mean the fetus suffers the same effects. Chemicals such as ammonia, chlorine, nitric acid, sulfuric acid, and sodium hydroxide — “stink or sting” chemicals — have been closely studied and are not considered teratogenic risks.

Bottom line: A fetus (or baby if you prefer the term) is the most delicate and vulnerable “visitor” who will ever be at your workplace. Treat the visitor with utmost care.

Sidebar: Control Measures For Teratogens in your Workplace

  • Material review and approval (Web searches, MSDSs)

  • Substitution or elimination - is it feasible?

  • Medical approval or monitoring of at-risk employees as needed.

  • Hazard communication training

  • Engineering controls (such as exhaust ventilation)

  • Baseline industrial hygiene exposure monitoring

  • Use of administrative controls and PPE

  • Periodic re-evaluation

Sidebar: Misleading Risk Research

Here’s a major reason why permissible exposure limits (PELs) and threshold limit values (TLVs) are insufficient to assure safe limits for teratogens: Of the more than 100,000 chemicals in commercial use, only about 50 have been adequately studied for human reproductive effects. There’s a lot that we don’t know. And even when we think we have it right, we can be surprised.

Thalidomide, for example, was a prescribed drug that many women took years ago. It was observed that a significant number of women who took the drug delivered babies with limb deformities. But animal research did not suggest the risk was great — the dose of Thalidomide taken by women was well below that noted to cause deformities during animal testing. More than 8,000 mg/kg of Thalidomide was needed to produce deformities in hamster offspring. Chicken and mice required more than 500 mg/kg of Thalidomide before teratogenic effects were observed.

Eventually, and unfortunately, it was learned that Thalidomide produced teratogenic effects in humans at well below 1 mg/kg. This may be an isolated case, but it illustrates the point that we must be very cautious when dealing with exposure limits and teratogens.