Pregnancy is a life-changing event that comes with a slew
of anxieties. If you work in a lab, those worries are likely to be
compounded by concerns about chemicals and other potential hazards.
Well, there is good news and bad news. The good news is that a
number of studies have shown that lab workers have no or only
slightly increased risk of pregnancy problems compared to the
general population. The bad news is that those studies aren't
conclusive, some chemicals may cause heightened risk,
and--according to Allen Niemi, director of occupational safety and
health services at Michigan Technological University in
Houghton--very few U.S. academic institutions have policies to
provide guidance. Most of the existing policies deal with exposure
to ionizing radiation.
Adding to the challenge is the fact that women very often hide a
pregnancy early on because they want to avoid unwelcome attention.
Many women don't want to be treated differently or to deal with
questions and reactions from co-workers. "I personally kept a
pregnancy secret for about 7 months when I was working in the
construction industry, where sight of a woman alone was enough to
cause unwanted attention," says Linda Tapp, president of Crown
Safety, an occupational safety, health, and ergonomics consulting
firm in Cherry Hill, New Jersey.
Aside from radiation, few U.S. organizations have policies
regarding pregnant lab workers, which means women are on their own
when it comes to worrying about exposure during pregnancy.
Catcalls aren't often heard in science labs, but women in
science have other legitimate reasons to wait as long as they can
to report their pregnancy. They may, for example, be concerned
about the impact a pregnancy might have on their working
relationship with colleagues and supervisors and hence their
long-term career prospects. But a fetus is most vulnerable to
chemical or radiological hazards during the first trimester, and
for that reason, Tapp says, women working with potential hazards
should report a pregnancy as soon as they know.
Overall, Not Much Risk
Most broad population studies comparing lab workers with nonlab
workers show little overall increase in the risk of pregnancy
complications or birth defects, although one study showed a
tendency toward low birth weights and shorter gestational lengths
in cases where either parent worked in a chemical factory. Still,
the studies may not be large enough to reveal some associations,
says Barbara Grajewski, a senior epidemiologist with the National
Institute for Occupational Safety and Health.
"The Achilles' heel of these studies is that there are so many
things lab folks are exposed to, it's hard to nail down which
exposure is a problem," says Grajewski. Nevertheless, there has
been progress. "The common thread that runs through these studies
is ... solvents, sometimes general, sometimes specific." Organic
solvents have long been suspects, but recent reports have begun to
pinpoint specific agents, including chloroform and benzene. "That's
sort of exciting. People keep [blaming] solvents, but which
solvents?" she adds.
Not all dangers are due to chemical agents. There is some
evidence that prolonged standing and working the night shift can
lead to reproductive problems, says Grajewski.
Radiation
Radiological exposure has been linked to miscarriages, low birth
weight, and other problems. But here too there are some
uncertainties. "I think the jury is still out on what low-dose
radiation does in terms of reproductive health outcomes," says
Grajewski. Regulations regarding radiation exposure are complicated
by the fact that several agencies have guidelines, and they aren't
identical. Some states also have agreements with federal agencies
to substitute state policies for federal ones. So check with your
radiation safety officer to find out the regulations that apply to
you.
In any case, once a woman declares her pregnancy, any
institution is legally required to ensure that the fetus is limited
to a radiation exposure of 0.5 rem, according to Robert Zoon, a
radiation safety officer at the National Institutes of Health
(NIH). The woman must stop doing tasks that cause exposure once the
exposure to the fetus approaches that limit. However, if a woman
does not declare herself pregnant, the institution is under no
obligation to limit exposure to the fetus, only to the worker, Zoon
says. Dose is generally monitored using radiation badges or an
electronic detection device.
Personal Guarantees
Aside from radiation, few U.S. organizations have policies
regarding pregnant lab workers, which means women are on their own
when it comes to worrying about exposure during pregnancy. Recent
studies are reassuring in showing that, overall, lab workers have
little increased risk compared to anyone else, but particular
hazards could pose a much greater risk.
How do you determine that risk? First off, it's important to
consider the most serious hazards, such as teratogens and
biological agents capable of infecting the fetus. "You need to
learn about those risks and how they can be safely managed before
making the decision whether or not to work with them," says W.
Emmett Barkley, director of the office of laboratory safety at the
Howard Hughes Medical Institute in Chevy Chase, Maryland.
Niemi proposes a systematic approach to gathering information
for women who are or want to become pregnant, as well as any woman
of childbearing age who can't be certain she won't become pregnant.
The first step is to list the hazards you could be exposed to
through your own work or through a co-worker's work, including
chemical, biological, and radioactive agents. Then get two or three
sources of health information about each one. Material safety data
sheets (MSDS) are a good place to start. Other resources include
the National Institute for Occupational Safety and Health, the
Occupational Safety and Health Administration, and the Merck Index.
State agencies are also useful sources.
Next, Niemi says, take the list of problem reagents to your
doctor and talk about it in the context of the potential means of
exposure. A visit with a safety officer is also in order in
considering how to minimize exposure. Many companies and
organizations also have industrial hygienists or toxicologists on
staff or on call, as well as specialists in occupational medicine,
whose job it is to monitor and treat exposures.
Barkley emphasizes communication. "My general guidance is to
speak openly with the senior scientist of the lab. We encourage
discussion of risk, and this should be freely pursued. Labs have
often made provisions where a person would [temporarily have
someone else] carry out work with a particular agent or chemical. I
would also encourage people to draw upon the expertise of an
occupational medicine physician."
Most biomedical research organizations have a contract for
occupational medical services, says James Schmitt, medical director
for the occupational medical service at NIH, but they should be a
last resort. Scientists "should work closely with a safety
specialist. Primary prevention strategies are [handled by] the
safety specialist, who engineers out the hazard or fixes things in
a process or equipment. Occupational medicine is more secondary
prevention--early detection, or if a woman becomes ill, determine
if it's related to an exposure. The occupational medicine provider
should be complementary to the safety specialist."
Always Use Protection
Niemi also emphasizes proper use and careful choice of
protective equipment, including engineering controls such as fume
hoods, disposable gloves, and respirators. Discard disposable
gloves after one use, he says, because they really are designed for
single use. "Personal protective equipment is where a lot of people
make a mistake. They choose their own equipment and aren't
sufficiently expert to use it properly. It gives you a false sense
of security," Niemi says. Instead, consult with the safety officer
to be sure of your choices and how to use them. Finding protective
equipment that fits properly can be a challenge given the physical
changes associated with pregnancy. "You [may] have to search a bit
harder to find a proper fit. It's not impossible, it just means you
can't buy just one brand," says Niemi.
In the end, laboratory pregnancies require more diligence than
the average occupation. But your work shouldn't put a damper on the
joy. "If good laboratory practices are used and those risks are
managed well, there's no reason to think that a woman of
childbearing age would be at an increased risk," says Barkley.
Jim Kling writes
fromBellingham,Washington.