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The hazard of work in pregnancy

    The hazard of work in pregnancy

    the hazard of work in pregnancy

    Noise and vibration

    There is no evidence that noise causes any more problems in pregnancy than at any other time, apart from intensifying mental stress. Local vibration from handheld vibrating tools has been reported as causing autonomie nervous system effects, but the evidence is unsupported by any epidemiological studies, and in any case it is doubtful whether this would be more important during pregnancy than at any other time. Whole-body vibration has been said to be associated with menstrual disorders but there are no reports of its effects on pregnancy.  
    Lowfrequency (18-30 kHz) high-power ultra sound is extensively used in industry
    for cleaning of watches and machine parts. Workers exposed to this type ofultrasound have complained of headache, earache, vertigo and general discomfort , but there are no reports of effects on pregnancy. The effect of high-frequency ultrasound (100-10000 kHz) on pregnancy has been extensively investigated,
    particularly as the technique is used specifica11y in obstetries. No effect on
    chromosomes has been detected

    Thermal stress

    Many industrial jobs involve exposure to he at or cold, and there has been a great deal of investigation on the differences in re action to thermal stress among men and womens . There is more interindividual variation than intersex variation, and no reports have been made of any effects in pregnancy

    Electromagnetic spectrum

    Microwaves

    Possible effects on the fetus from the thermal effect of mierowave radiation have been reported, but there is an absence of data on depth-dose distribution in tissues. Reports of miscarriages and impaired embryo development are difficult to evaluate. A WHO Report decided that the evidence was inadequate to reach any conclusions. The authors were equally unable to reach any conclusions about the effect of high-frequency electromagnetic fields.

    lonising radiation

    With ionising radiation the situation seems clear. Stewart and her colleagues have pointed to a c1ear dose-response relationship between irradiation of the fetus and leukaemia in the first 10 years of the child's life. Apart from radiologists, many women are exposed to ionising radiations, from isotopes for thiekness gauges in cigarette factories to X-rays for non-destructive testing of Christmas puddings. X-radiography in shoe shops has been abandoned because of the risk to shop assistants. Security X-radiography at airports is done with high-voltage sets and image intensifiers, so that there is no risk. Because of the
    potential hazard, it is necessary to limit radiation exposure of any wo man known to be pregnant. The main problem is that the fetus is at its most sensitive during the early stages of pregnancy, when the woman may be unaware of the situation.

    Gravity

    As pregnancy advances, while the woman's rnind and fingers still remain nimble, her body becomes progressively less so. This is particularly important if her job involves lifting and carrying, but problems also arise even when sitting at a typewriter. It is important where there is any occupational health doctor or nurse in the factory that they collaborate with the physician in charge of the case so that suitable arrangements can be made for appropriate ergonomie adaptations of the job where this is possible. The American College of Obstetricians and Gynecologists have produced guidelines on pregnancy and work which accent this need for collaboration with the occupational health services.

    BIOLOGICAL HAZARDS

    Several infections, particularly rubella, are known to produce effects on the fetus, although few infections are associated with occupation. Two cases of chlamydial infection were reported by Beer et al. in farmers' wives who had helped their husbands with lambing. In view of possible infections, special care must be taken with pregnant hospital workers with regard to exposure to cytomegalovirus, herpes simplex, Toxoplasma, varicella and syphilis. Isolation procedures should be developed which specifically prohibit pregnant hospital
    workers from ente ring isolation areas, although this presents considerable difficulties,
    especially in the early weeks of pregnancy, when, as with radiation exposure, the effect is likely to be greatest while the woman may be still unaware of her pregnancy.

    PSYCHOSOCIAL HAZARDS

    Pregnancy is a mystical state surrounded by a whole series of taboos, many of which are likely to affect the mental health of the pregnant worker. The subject is a complex one because of its multifactorial and subjective nature and because of the great individual differences that exist. There is no good epidemiological evidence of any effect on mental health, although one study in the USA suggested that nurses, waiters, secretaries, personnel service workers and inspectors in manufacturing industries had significantly elevated rates of mental illness.
    The WHO Report (World Health Organization, 1983) advises caution in drawing any inferences from these findings.