MANAGING BEST PRACTICES: Uncertainty over an emerging risk
Thatâ€™s because breast-milk is superior to baby formula because it includes the motherâ€™s disease-fighting antibodies along with great nutrition. And thereâ€™s benefit for the mother, too. Women who breastfeed have a 50 percent less chance of developing breast cancer, according to new research â€“ though more studies are needed to determine why.
So employers can expect continued growth in breastfeeding among working women. Mothers may pump and store their breast-milk at work and provide it to their infants at another time.
But along with the rise in breastfeeding comes concern over chemicals in breast-milk. The U.S. Food and Drug Administration recognizes and advises which pharmaceuticals should not be used while breastfeeding, such as aspirin. Meanwhile, little research and guidance exists regarding workplace chemicals in breast-milk.
Recent developmentsThatâ€™s bound to change. Biomonitoring (measuring chemicals in human tissues and fluids) is a rapidly evolving technology, and breast-milk is a popular body fluid to monitor because it is the least invasive and best means to sample for chemicals stored in body fat. Consider these developments:
Knowledge gapsBut despite growing awareness and potential liabilities, how much do U.S. employers know about the topic of breastfeeding? Are they taking a consistent approach to control risks?
After all, no regulations exist that require U.S. employers to assess risks for workers who are breastfeeding. Employers in Europe, though, are required to assess and control this risk following guidelines established by Council Directive 92/85/EEC.
I was able to get a snapshot of current attitudes among safety and health professionals by conducting a survey of industrial hygienists attending a course on â€œImplementing Reproductive and Developmental Health Programsâ€ at the 2004 American Industrial Hygiene Conference. Bottom line: Thereâ€™s a lot of uncertainty about how to best protect breastfeeding employees and their infants:
Will breast-milk be safe for infant consumption if an employer is in full compliance with OSHA chemical exposure standards? In my workshop, zero IHâ€™s answered â€œyes,â€ 12 said â€œno,â€ and 30 said â€œdonâ€™t know.â€
Do supplier material safety data sheets provide enough information to determine if a chemical may concentrate in breast-milk? â€œNo,â€ answered all 42 IHâ€™s.
Has the American Conference of Governmental Industrial Hygienists recommended any Biological Exposure Indices for workplace chemicals in breast-milk? One IH said â€œyes,â€ 22 said â€œno,â€ and 19 didnâ€™t know.
Has the FDA set safe limits of industrial/environmental chemicals in breast-milk? Zero IHâ€™s said â€œyes,â€ 22 said â€œno,â€ and 20 didnâ€™t know.
Opinion was divided over this question: Does an employer have a legal obligation to protect an employeeâ€™s breast-milk from contamination caused by exposure to workplace chemicals? Twelve IHâ€™s said â€œyes,â€ ten said â€œno,â€ and 20 didnâ€™t know.
Opinion was also divided over this question: Should an employer abide by all recommendations from an employeeâ€™s pediatrician regarding the safeguarding of breast-milk from contamination at work? â€œYes,â€ answered 15 IHâ€™s. â€œNo,â€ said 10. And 17 answered â€œdonâ€™t know.â€
Emerging consensusHere is where professionals were pretty much of one mind regarding potential risks of women breastfeeding while possibly exposed to toxic chemicals on the job:
Employers do have a moral obligation to protect an employeeâ€™s breast-milk from contamination caused by exposure to workplace chemicals, according to 34 of the 42 IHâ€™s surveyed.
Employees who breastfeed have a right to know if workplace chemicals might be in their breast-milk, said 34 of the 42 IHâ€™s polled.
It is in the employerâ€™s best interest to address health concerns arising from information that an employee finds online, said 39 of the 42 IHâ€™s.
An infant is not biologically equivalent to a small adult, agreed 41 of the IHâ€™s.
The concentration of chemicals in breast-milk can be higher than found in the motherâ€™s blood plasma, said 26 of the IHâ€™s surveyed. Sixteen said they didnâ€™t know.
Infant health problems alleged to result from breast-milk contaminated with workplace chemicals will not be handled through the employerâ€™s workersâ€™ compensation program, 41 of 42 IHâ€™s agreed.
If an employee is not satisfied with an employerâ€™s position on protecting breast-milk, she should have more options available to her than simply quitting work, said 35 IHâ€™s.
And finally, 26 of the IHâ€™s believe that research within the next two years will discover infant health problems that result from breast-milk contaminated by a common industrial chemical. Not one IH would deny the possibility.
Policies in the making?So there you have it. In my very much unscientific sampling of professionals from major corporations, small businesses, universities, and other organizations, most believe breastfeeding risks are an issue that will only become more problematic for employers in time. They see the stakes as being high, with liabilities and settlements falling outside the workersâ€™ comp shield for employers. And you can see professionals laying the groundwork for policy positions: Breastfeeding employees have a right to know about risks, there is a moral if not legal obligation to address their concerns, and OSHA chemical exposure standards and MSDSs are inadequate for conducting risk assessments.
Itâ€™s also clear that professionals have knowledge gaps when it comes to assessing the risks of toxic chemicals in breast-milk. We all need to ramp up our knowledge of breastfeeding employees and the risks they might encounter on the job.