Although scientific data concerning the reproductive health effects of many occupational exposures is limited, the goal of creating a safe work environment for pregnant workers can be facilitated by awareness of inherent risks and then adopting procedures to minimize risk exposure.

This information, along with all safety guidelines and procedures, should be communicated to all workers, regardless of their gender or reproductive status. The key to a safe working environment is communication, planning ahead, and educating your workers on how to use protective equipment properly, and avoiding unnecessary risks.

Any pregnant workers or workers planning to become pregnant should consult with their health care provider to determine what, if any, additional precautions are needed based on their individual situation. It is the responsibility of the worker to communicate their needs to their manager as soon as possible to in order for risk reduction to begin when it can be most effective, and also to determine if additional reasonable accommodations are necessary and if they can be made.

Areas requiring special attention to risk reduction include:

• Radiological – X-ray exposure presents a significant risk to the pregnant worker. Ideally, all exposure should be avoided. If this is not possible, the pregnant worker must, as all workers should, wear appropriate shielding protection and wear a monitoring badge. Pregnant workers should never, under any circumstances, hold film cassettes in place during radiographic procedures.
• Biological
  1. Rabies and tetanus are preventable through vaccination and all workers should have vaccinations as recommended by the worker's healthcare provider in conjunction with current CDC Advisory Committee on Immunization Practices recommendations.
  2. Zoonotic diseases such as salmonellosis, brucellosis, leptospirosis, and chlamydiosis present hazards associated with fever and the drugs used in treatment. Diseases such as Venezuelan equine encephalitis and listeriosis have direct harmful effects on the developing fetus. Awareness of the agents and exposure avoidance is very important, when possible.
  3. Toxoplasmosis is known to cause damage to the developing fetus. Exposure to cat feces should be avoided by pregnant workers. If this is not possible, then protective gloves and thorough hand washing must be employed. Since Toxoplasma oocysts are not infectious for the first 24 hours after shedding, litter boxes should be cleaned and feces removed completely every 24 hours.
  4. The hazards associated with animal bites, wound infections and cat scratch disease are proportional to the severity of the wound and the resultant treatment. The use of protective gloves, thorough hand washing and chemical restraint of fractious and aggressive animals reduce these risks.
  
  
• Chemical
  1. Care should be used when handling any pesticide, hormone or chemotherapeutic agent. Read and understand the warnings on the label and circular. Pregnant workers should not apply pesticides. If this is not possible, adequate ventilation of the area is essential and absorption through the skin should be minimized through the use of protective gloves, aprons and coveralls. Handling of hormones and chemotherapeutic agents require the same precautions.
  2. Exposure to high levels of anesthetic gases by pregnant workers is known to increase the incidence of miscarriages and congenital abnormalities in newborns. Ideally, pregnant workers should not be exposed to anesthetic gases. If this is not possible, special attention should be paid to the maintenance of anesthetic machines to assure leak free operation and efficient scavenger systems used to remove waste gases.
  3. A Material Safety Data Sheets (MSDS) manual should be readily available for reference by all workers. Additional information on MSDS can be found on the Occupational Safety and Health Administration (OSHA) Web site at www.osha.gov.
• Regulatory Issues
  1. The Pregnancy Discrimination Act (an amendment to Title VII of the Civil Rights Act of 1964) makes it unlawful to discriminate on the basis of pregnancy, childbirth, or related medical conditions. Additional information is on the U.S. Equal Employment Opportunity Commission (EEOC) Web site at www.eeoc.gov.
  2. The Family and Medical Leave Act (FMLA) requires that covered employers must grant eligible employees up to a total of 12 weeks of unpaid leave during any 12 month period for various reasons including the employee's own serious health condition and for the care of a newborn child. Additional information can be found on the Department of Labor Web site at www.dol.gov.
  3. The Health Insurance Portability and Accountability Act (HIPAA) primarily provides rights and protections for participants and beneficiaries in group health plans, but also prohibits discrimination against employees and dependents based on their health status and protects the confidentiality of an employee's health information. Additional information may also be found at www.dol.gov.
  4. The Americans with Disabilities Act (ADA) prohibits discrimination against people with disabilities in employment. The Pregnancy Discrimination Act mentioned above states disabilities caused or contributed to by pregnancy, childbirth or related medical conditions shall be treated the same as disabilities caused or contributed to by other medical conditions for all job-related purposes. Therefore the ADA may be applicable in certain situations. More information is available on the DOL Web site at www.dol.gov.

References
Compendium of Veterinary Standard Precautions: Zoonotic Disease Prevention in Veterinary Personnel; National Association of State Public Health Veterinarians, Veterinary Infection Control Committee; http://www.avma.org/services/Compendium_of_Veterinary_Standard_Precautions.pdf (PDF)
Model Infection Control Plan for Veterinary Practices; National Association of State Public Health Veterinarians (NASPHV) Veterinary Infection Control Committee (VICC); http://www.avma.org/services/model_infection_control_plan.rtf (.rtf)
J Am Vet Med Assoc 2008 May 15; 232(10):1445-7 (http://www.avma.org/onlnews/javma/may08/080515n.asp) Study links occupational exposures with risk of miscarriage
What Precautions Should We Take for Pregnant Workers (AVMA PLIT) http://avmaplit.com/uploadedFiles/AVMAPLIT/Publications/Safety_and_Loss_Control/Precautions%20For%20Pregnant%20Workers.pdf (PDF, 32Kb)
Fort Meade Regional Veterinary Laboratory Service, Standard Operating Procedure. Occup Med 1999 Apr-Jun; 14(2):225-34 Anesthesia hazards to animal workers. Meyer RE.
J Am Vet Med Assoc 1996 Jul 1; 209(1):75-7 Commentary and recommendations on control of waste anesthetic gases in the workplace. American College of Veterinary Anesthesiologists
J Am Vet Med Assoc 2001 Apr 15; 218(8):1251-2 Practices should take precautions to protect pregnant workers. Crimmins WF, Vice President of Loss Control, Mack and Parker, Inc., 55 East Jackson Blvd., Chicago, IL 60604
J Am Vet Med Assoc 1999 Nov 15; 215(10):1433-5 Survey of occupational hazards in large animal practices. Poole AG, Shane SM, Kearney MT, McConnell DA.
J Am Vet Med Assoc 1998 May 1; 212(9):1386-8 Survey of occupational hazards in companion animal practices. Poole AG, Shane SM, Kearney MT, Rehn W.

For more information, please contact: Membership & Field Services, Council on Veterinary Service