Pregnant and breastfeeding women

The risk of giving birth prematurely or stunting the growth of the fetus can increase with folowwing physical matters:

• Night work
  Pregnant employees may only work night shifts once a week. This means that regardless of any other measures the employer takes to ensure the safety of the pregnant employee, the requirement to limit night work to once a week must be adhered to.

• Shock, vibrations and risk of violence..
  Shocks, e.g. as a result of a fall or blow directly to the pregnant woman’s stomach, can pose a danger to the pregnancy.
  Pregnant women should not be exposed to strong whole-body vibrations, e.g. when driving on uneven surfaces. Vibrations when driving in a car, bus, lorry, train or when working on planes and ships do not involve any risk.
   
• Noise and Ultra sound.
  Knowledge about significance of noise for the pregnant woman is limited, but heavy noise exposure above 85 db(A) during a working day can probably affect the fetus, partly the ears and other parts of the organism.
  
  The fetus is protected by the mother´s body when ultrasound is in air. Regardless of how powerful the ultrasound is.
  The ultrasound will pass into human tissue, when the body is in contact with solid objects or liquids that oscillate with the frequencies of the ultrasound. The ultrasound can pose a danger to both mother and child.
  The ultrasound-carrying parts of and ultrasound device must be isolated from the parts that the operator touches during work – and preferably with air.
   
• Non-ionzing radiation
  Non-ionzing radiation is a collective term for electromagnetic fields with frequencies up to 300 GHz as well as optical radiation.
   
• Extreme heat and cold.
  Working temperatures of more than 35 °C can be harmfull to the development of th fetus. Exacerbating factors must be taken into account when the pregnant woman's heat stress is assessed, such as high humidity and direct hot radiation from sunlight or ovens.
  Working in extremely cold conditions does not give rise to special measurement for pregnant woman if she is suitable dressed.
   
• Manual handling of heavy loads.
  Research suggests that pregnant women who lift loads weighing more than 10 kg more than 10 times during a working day are likely to have an increased risk of preterm birth, but lifting loads below 10 kg does not pose a risk.
   
• Prolonged standing and walking work.
  Prolonged standing and walking work is suspected of being the cause of stunted growth in the fetus.
  The employer must organize the pregnant woman´s work so that she can alternate between sitting work and standing/walking work from the beginning of the fourth month of pregnancy.
  The need for relief from work increases during pregnancy. Therefore, it will often be necessary for the pregnant woman to have opportunity to take rest breaks in a suitable resting place during the last month of pregnancy.
   
• Combined physicals loads.
  The risk of giving premature birth or stunted growth of the fetus can increase with combined physically loads, e.g. repeated heavy lifting, manual movement of people or materials, pulling and pushing or a lot of standing/walking work.
   
• High Overpressure.
  Working under high overpressure, e.g. in pressure chambers and when diving poses a particular risk for pregnant women. Pregnant women must therefore not perform this type of work.

Certain chemicals can be hazardous to the health of the pregnant woman and the fetus, as well as posing a risk to the child who is breast feed.

The employer is responsible for preparing an assessment of the risk to the pregnant woman when working with chemical substances and materials with the following Hazard phrases (H): 

• H310 Fatal in contact with skin.
• H311 Toxic in contact with skin.
• H312 Harmful in contact with skin.
• H340 May cause genetic defects.
• H341 Suspected of causing genetic defects.
• H350 May cause cancer.
• H350i May cause cance by inhalation.
• H351 Suspected of causing cancer.
• H351i Suspected of causing cancer by inhalation.
• H360 May damage fertility or the unborn child.
• H361 Suspected of damaging fertility or the unborn child.
• H362 May cause harm to breast-fed children.
• H370 Causes damage to organs.
• H371 May cause damage to organs.
• H372 Causes damage to organs through prolonged or repeated exposure
• H373 May cause damage to organs through prolonged or repeated exposure 

Substances and materials labeled with other hazard phrases may also cause hazardous effects to the unborn child or reproductive effects.

Therefore, the employer must also make an assessment of the risk to the pregnant woman when working following substances and materials:

• Carcinogenic substances and processes. 
• Endocrine disruptors (EUH380, EUH381, EUH430 and EUH431).
• Volatile substances and organic solvents.
• Pesticids. 
• Heavy metals.
• Cytostatica and other pharmaceuticals. 
• Anesthetic gasses.
• Suffocating gasses.
• Chemical substances, that is absorbed through the skin.

Involve the OHS-group when preparing the pregnancy risk assessment. If in doubt, contact the occupational medicine clinic – it is the pregnant woman that contact her doctor, who if necessary contact the occuptational medicine clinic.

The local adminstrator in Kiros can pull a list of all the chemicals in the group that are classified as hazardous to pregnant and breast feeding women.

The manager must in collaboration with the pregnant woman make a assessment for the radiation dose for the unborn child.

Pregnant women´s work must be organized in such a way that there is no risk that the radiation dose to the unborn child exceed 1mSv. In account must be taken of the risk of radiation dose as a result of unintended incidents/accidents.

If the radiation dose is less than 1 mSV the work can continue without special measurements.

If in doubt, the work risk assesment can be submitted to Danish Health Authority (Statens Institut for Strålehygiejne -SIS) for final assessment.  

The rules for each BioSafety Level must always be followed, and a thorough instruction must be given by the person responsible for instruction (supervisor/labmanager) before the work begins.

Laboratory animal may pose a danger for the fetus:
aboratory animals can carry a protozoa, toxoplasma gondii, which in humans can cause toxoplasmosis. It is recommended to consult your doctor and request a blood sample to determine antibodies against toxoplamosis. It is also possible to test the laboratory animals.  If the presence of antibody, the work can continue, otherwise the employee must be transferred to other work.

Avoid working with birds/poultry:
In addition, pregnant women should not work with birds/poultry due to the risk of Ornithosis/Psittacosis (parrot fever). Both Toxoplasmosis and Ornithosis/Psittacosis can cause birth defects.

Patient specimens:
Pay attention when workning with blood and tissue samples; all patient specimens is considered potentially infectious and treated accordingly to that.
It is recommended to get a vaccination against infectious hepatitis before starting work and before a possible pregnancy.
 

Following microorganisms can pose a risk to pregnancy or during breast feeding period:

• Rubella - (Vaccine against rubella is included in the Danish Child vaccination program)
• Toxoplasmosis.
• Varicella (chicken pox)
• Erythema infectiosum (fifth disease or slapped cheek syndrome)
• Cytomegalovirus (CMV)
• Hepatitis A
• Hepatitis B
• Ornithosis/Psittacosis (parrot fever)
• Q-fever (Coxiella burnetti)