“Will my work affect my pregnancy?” Resources for anticipating and answering patients’ questions

Abstract

Authoritative information on occupational reproductive hazards is scarce and complex because exposure levels vary, multiple exposures may be present, and the reproductive toxicity of many agents remains unknown. For these reasons, women's health providers may find it challenging to effectively address workplace reproductive health issues with their patients who are pregnant, breast-feeding, or considering pregnancy. Reproductive epidemiologists at the Centers for Disease Control and Prevention National Institute for Occupational Safety and Health answered >200 public requests for occupational reproductive health information during 2009 through 2013. The most frequent occupations represented were health care (41%) and laboratory work (18%). The most common requests for exposure information concerned solvents (14%), anesthetic gases (10%), formaldehyde (7%), infectious agents in laboratories (7%) or health care settings (7%), and physical agents (14%), including ionizing radiation (6%). Information for developing workplace policies or guidelines was sought by 12% of the requestors. Occupational exposure effects on breast-feeding were an increasing concern among working women. Based on information developed in response to these requestors, information is provided for discussing workplace exposures with patients, assessing potential workplace reproductive hazards, and helping patients determine the best options for safe work in pregnancy. Appendices provide resources to address specific occupational exposures, employee groups, personal protective equipment, breast-feeding, and workplace regulations regarding work and pregnancy. These tools can help identify those most at risk of occupational reproductive hazards and improve workers' reproductive health. The information can also be used to inform research priorities and assist the development of workplace reproductive health policies.

The Perinatal Condition Around Birth and Cardiovascular Risk Factors in the Japanese General Population: The Suita Study

“…Further, birth weight, gestational week, maternal smoking during pregnancy, and passive smoking in childhood also affect future cardiovascular risks 43,44) . Although we have proved that feeding type after birth affects the future cardiovascular risks, it is suggested that lactation is associated with maternal occupation, which we could not investigate 45) . The results of this current study may be different when we consider all of these as confounding factors.…”

Reproductive toxic agents in work environments and related cases in Korea

“…In addition to the above case reports, there were more diseases caused by unknown reproductive toxicity factors that the patient or physician could not recognize. There are many factors to be considered and asked along with the individual's past medical history and underlying disease, but sometimes, these are easily overlooked in actual clinical practice [56,57]. If a patient experiences fertility problems, or is planning to conceive, those questions are essential: "What do you do for a living (including present and in the past)?"…”

Evolution of gynaecologists’ practices regarding the implementation of Swiss legislation on maternity protection at work between 2008 and 2017

“…Despite the central role that gynaecologists-obstetricians play in the protection of pregnant women in the workplace, international [23][24][25] and national literature has shown that gynaecologists-obstetricians encounter several difficulties in this task. A lack of perceived competence in assessing working conditions and pregnant women's ability to work, time constraints and a lack of cooperation from employers are some examples of these difficulties.…”