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There are many chemicals agents and physical factors that have the potential to be a reproductive hazard to men, women, and children.[1] Exposure to many of these could occur at the workplace.[2][3][4] Some examples include heavy metals (e.g. lead), noise, work schedules, heavy lifting, smoke and byproducts of burning, infectious agents, pesticides, heat, etc. In the United States, there are over 80,000 chemicals used in the workplace, many of which are untested or inadequately tested for reproductive toxicity.[5][6][7]
History
[edit]Most notable case
[edit]- United Automobile Workers v. Johnson Controls, Inc.[8] - Johnson Controls, Inc. added a workplace policy that barred all women from employment, except for those who had medical evidence of infertility, with the purpose of protecting the women's fetuses from lead exposure. This led to a class action suit where it was established that Johnson Controls' fetal-protection policy violated Title VII of the Civil Rights Act of 1964 and the Pregnancy Discrimination Act on the basis of gender discrimination.[9][10][11]
Laws
[edit]The following laws have been important in the protection of workers, the protection of pregnant women in the workplace, and the regulation of chemicals used by industries in the United States.
- Occupational Safety and Health Act of 1970 - Created with the main objective of protecting workers by reducing hazards at their place of employment and implementing safety and health programs for employers and their employees.[12][13]
- Toxic Substances Control Act of 1976 (TSCA) - Regulates the production, use, importation and disposal of chemicals.[14] In June 22, 2016, President Obama approved a reform of the TSCA, called the Frank R. Lautenberg Chemical Safety for the 21st Century Act, which would improve the regulations of new and existing chemicals used in the country.[15][16][17][18]
- Pregnancy Discrimination Act of 1978 - An amendment of the Civil Rights Act of 1964 (Title VII), which prohibits sex discrimination on the basis of pregnancy, childbirth, or related medical conditions.[19][20][21][22]
- Americans with Disabilities Act of 1990 (ADA) and its amendment, the ADA Amendments Act of 2008 - Pregnancy is not considered an impairment because it is not the result of a physiological disorder, but a pregnancy-related impairment that limits major life activities, is not transitory or minor, or is considered as the basis for a prohibited employment would be covered under this Act.[23][24][25]
Identifying and evaluating workplace risks
[edit]There are several critical windows of vulnerability that can affect the development of the fetus, which is an important factor to take into account when looking at workplace exposures before conception and during pregnancy. Women and their fetuses have different susceptibilities to chemicals and other exposures than men or non-pregnant women.[26][27]
Types of exposures
[edit]- Chemical agents: pesticides, solvents, and formaldehyde.
- Non-chemical agents: noise, work schedule (e.g. long working hours, shiftwork, and irregular work schedules), radiation, and body positions (e.g. lifting, standing, bending).
Challenges
[edit]- Historically, most OSHA PELs (Permissible Exposure Limit) and NIOSH RELs (Recommended Exposure Limit) for existing chemicals have been determined using mostly men and have rarely included women, pregnant or non-pregnant.
- Very few of the all the chemicals used in the U.S. have been tested for reproductive toxicity.[28]
- Chemicals where there is evidence of toxicity, reproductive or other, are often substituted by similar chemicals for which there is no toxicity data.
- The full extent of the toxicological profile of a chemical is not always known due to the lack of systematic testing for toxicity.[29][30]
- Toxicity data for the chemicals that have been evaluated for toxicity is not always publicly available.[31]
Reproductive health outcomes
[edit]Workplace exposures have the potential to cause a wide array of health and reproductive problems in men and women.
- Erectile dysfunction
- Decrease of hormone levels
- Decrease in sex drive
- Changes in the amount of semen, ejaculation quality, and decrease of penis sensitivity
- Changes in the number and quality of sperm
- Infertility and subfertility
- Miscarriages
- Menstrual cycle disorders
- Stillbirths
- Birth defects
- Premature birth of offspring or too small offspring
- Sex hormone imbalance that can, in turn, cause other health problems such as some cancers, osteoporosis and heart disease, among others.
Types of occupational exposures and effects on pregnancy
[edit]Various studies have shown the potential negative effects on pregnancy by different occupational exposures of women.[36]
| Exposure | Effects observed | Examples of work with potential exposure[37] |
|---|---|---|
| Anesthetic gases[38][39] | Miscarriage[40][41] | Healthcare professionals working in operating rooms and/or recovery rooms, veterinary and animal care workers, |
| Antineoplastic (Chemotherapy) drugs[42] | Miscarriage, birth defects, and infertility[43][44][45][46] | Healthcare professionals (e.g. pharmacists and pharmacy technicians, nurses, doctors, veterinarians, and hospital operation room personnel) |
| Chemical disinfectants and sterilants | Healthcare professionals, laboratory technicians, veterinary and animal care workers, | |
| Formaldehyde | Laboratory technicians, morticians/anatomy students/medical students, beauty technicians (e.g. hair, nails) | |
| Heat | Artists (e.g. craftwork, fine arts, pottery, etc.), firefighters, restaurant and bar personnel, | |
| Heavy metals (e.g. lead, ___) | ||
| Noise | Farmworkers, greenhouse workers, musicians, | |
| Pesticides | Farmworkers, greenhouse workers, veterinary and animal care workers, | |
| Physical demands (e.g. bending, lifting, standing) | Aircrew (pilots and flight attendants), child care personnel, farmworkers, firefighters, greenhouse workers, healthcare professionals, office workers, veterinary and animal care workers, | |
| Radiation (ionizing or nonionizing) | Aircrew (pilots and flight attendants), laboratory technicians, | |
| Smoke or byproducts of burning (e.g. PAHs) | Artists (e.g. craftwork, fine arts, pottery, etc.), farmworkers, firefighters, greenhouse workers, restaurant and bar personnel, | |
| Second-hand smoke | Restaurant and bar personnel | |
| Solvents | Artists (e.g. craftwork, fine arts, pottery, etc.), laboratory technicians, beauty technicians (e.g. hair, nails) | |
| Work schedule (e.g. shift work) | Aircrew (pilots and flight attendants), child care personnel, firefighters, healthcare professionals, office workers, |
See also
[edit]External links
[edit]- NIOSH: Reproductive Health in the Workplace Topic Page
- WHO: Reproductive Health
- WHO: Occupational Health
- OSHA: Reproductive Hazards
References
[edit]- ^ National Research Council (US) Committee on Hormonally Active Agents in the Environment. Hormonally Active Agents in the Environment. Washington (DC): National Academies Press (US); 1999. Addendum, Endocrine Disruptor Screening and Testing Advisory Committee. Available from: http://www.ncbi.nlm.nih.gov/books/NBK230219/
- ^ Figa-Talamanca, I. (1 December 2006). "Occupational risk factors and reproductive health of women". Occupational Medicine. 56 (8): 521–531. doi:10.1093/occmed/kql114.
- ^ Drozdowsky, Sharon L.; Whittaker, Stephen G. "Workplace Hazards to Reproduction and Development: A Resource for Workers, Employers, Health Care Providers, and Health & Safety Personnel" (PDF). Safety and Health Assessment and Research for Prevention (SHARP) Washington State Department of Labor and Industries.
- ^ Grajewski, Barbara; Rocheleau, Carissa M.; Lawson, Christina C.; Johnson, Candice Y. (May 2016). ""Will my work affect my pregnancy?" Resources for anticipating and answering patients' questions". American Journal of Obstetrics and Gynecology. 214 (5): 597–602. doi:10.1016/j.ajog.2016.03.005.
{{cite journal}}: no-break space character in|title=at position 77 (help) - ^ National Research Council (US) Committee on Hormonally Active Agents in the Environment. Hormonally Active Agents in the Environment. Washington (DC): National Academies Press (US); 1999. Addendum, Endocrine Disruptor Screening and Testing Advisory Committee. Available from: http://www.ncbi.nlm.nih.gov/books/NBK230219/
- ^ Bennett, Deborah; Bellinger, David C.; Birnbaum, Linda S.; Bradman, Asa; Chen, Aimin; Cory-Slechta, Deborah A.; Engel, Stephanie M.; Fallin, M. Daniele; Halladay, Alycia; Hauser, Russ; Hertz-Picciotto, Irva; Kwiatkowski, Carol F.; Lanphear, Bruce P.; Marquez, Emily; Marty, Melanie; McPartland, Jennifer; Newschaffer, Craig J.; Payne-Sturges, Devon; Patisaul, Heather B.; Perera, Frederica P.; Ritz, Beate; Sass, Jennifer; Schantz, Susan L.; Webster, Thomas F.; Whyatt, Robin M.; Woodruff, Tracey J.; Zoeller, R. Thomas; Anderko, Laura; Campbell, Carla; Conry, Jeanne A.; DeNicola, Nathaniel; Gould, Robert M.; Hirtz, Deborah; Huffling, Katie; Landrigan, Philip J.; Lavin, Arthur; Miller, Mark; Mitchell, Mark A.; Rubin, Leslie; Schettler, Ted; Tran, Ho Luong; Acosta, Annie; Brody, Charlotte; Miller, Elise; Miller, Pamela; Swanson, Maureen; Witherspoon, Nsedu Obot (1 July 2016). "Project TENDR: Targeting Environmental Neuro-Developmental Risks The TENDR Consensus Statement". Environmental Health Perspectives. 124 (7). doi:10.1289/ehp358.
- ^ Grandjean, P; Landrigan, PJ (December 2006). "Developmental neurotoxicity of industrial chemicals". The Lancet. 368 (9553): 2167–2178. doi:10.1016/S0140-6736(06)69665-7.
- ^ "Automobile Workers v. Johnson Controls, Inc". 499 U.S. 187, 111 S. Ct. 1196, 113 L. Ed. 2d 158 (1991). 1991. p. 187.
- ^ Scannell, Theresa M. (Winter 1992). "Fetal Protection Policies No Longer a Bona Fide Occupational Qualification Defense? International Union, UAW v. Johnson Controls, 111 S. Ct. 1196 (1991)". Marquette Law Review. 75 (2): 8.
- ^ Mezey, Susan Gluck (2008). Tanenhaus, David S. (ed.). "UAW v. Johnson Controls, 499 U.S. 187 (1991)". 5. Detroit.: Macmillan Reference, USA: 87-88. Retrieved 30 June 2016.
{{cite journal}}: Cite journal requires|journal=(help) - ^ Shapiro, Robert A. (July 11, 1991). "Clearance of EEOC Policy Guidance on the Supreme Court Decision in International Union, United Automobile, Aerospace & Agricultural Implement Workers of America, UAW v. Johnson Controls, Inc". U.S. Department of Labor.
- ^ "OSH Act of 1970 SEC. 5. Duties". U.S. Department of Labor.
- ^ "OSH Act of 1970". U.S. Department of Labor.
- ^ "Summary of the Toxic Substances Control Act". Environmental Protection Agency (EPA).
- ^ "The Frank R. Lautenberg Chemical Safety for the 21st Century Act". Environmental Protection Agency (EPA).
- ^ "Essential Principles for Reform of Chemicals Management Legislation". Environmental Protection Agency (EPA).
- ^ "Highlights of Key Provisions in the Frank R. Lautenberg Chemical Safety for the 21st Century Act". Environmental Protection Agency (EPA).
- ^ "All Bill Information (Except Text) for S.697 - Frank R. Lautenberg Chemical Safety for the 21st Century Act". www.Congress.gov.
- ^ "The Pregnancy Discrimination Act of 1978". U.S. Equal Employment Opportunity Commission (EEOC).
- ^ "What to Expect When You're Expecting (and after the birth of your child)... at Work". U.S. Department of Labor.
- ^ "Title VII of the Civil Rights Act of 1964". U.S. Equal Employment Opportunity Commission (EEOC).
- ^ "Facts about Pregnancy Discrimination". U.S. Equal Employment Opportunity Commission (EEOC).
- ^ "Questions and Answers on the Final Rule Implementing the ADA Amendments Act of 2008. Question 23. Is pregnancy a disability under the ADAAA?". U.S. Equal Employment Opportunity Commission (EEOC).
- ^ "Demonstrating Coverage Under the ADA Amendments Act of 2008 for People with Diabetes" (PDF). American Diabetes Association.
- ^ "29 CFR Part 1630, Appendix to Part 1630 - Interpretive Guidance on Title I of the Americans With Disabilities Act. Section 1630.2(h)Physical or Mental Impairment". Legal Information Institute (LII).
- ^ Etzel, Ruth A.; Balk, Sophie J., eds. (2012). Pediatric environmental health (3rd ed.). Elk Grove Village, IL: American Academy of Pediatrics. ISBN 9781581103137.
- ^ Figa-Talamanca, I. (1 December 2006). "Occupational risk factors and reproductive health of women". Occupational Medicine. 56 (8): 521–531. doi:10.1093/occmed/kql114.
- ^ Office of Pollution Prevention and Toxics (April 1998). "Chemical Hazard Data Availability Study: What Do We Really Know About the Safety of High Production Volume Chemicals?" (PDF). Environmental Protection Agency (EPA).
{{cite journal}}: Cite journal requires|journal=(help) - ^ Grandjean, P; Landrigan, PJ (December 2006). "Developmental neurotoxicity of industrial chemicals". The Lancet. 368 (9553): 2167–2178. doi:10.1016/S0140-6736(06)69665-7.
- ^ Claudio, Luz; Kwa, Winston C.; Russell, Allison L.; Wallinga, David (April 2000). "Testing Methods for Developmental Neurotoxicity of Environmental Chemicals". Toxicology and Applied Pharmacology. 164 (1): 1–14. doi:10.1006/taap.2000.8890.
- ^ Office of Pollution Prevention and Toxics (April 1998). "Chemical Hazard Data Availability Study: What Do We Really Know About the Safety of High Production Volume Chemicals?" (PDF). Environmental Protection Agency (EPA).
{{cite journal}}: Cite journal requires|journal=(help) - ^ CDC - Reproductive Health - NIOSH Workplace Safety and Health Topic. "Workplace Hazards Can Affect Men's Reproductive Health". www.cdc.gov/niosh/topics/repro/mensWorkplace.
- ^ "CDC - Reproductive Health - What You Should Know about Work and Reproductive Health - NIOSH Workplace Safety and Health Topic". www.cdc.gov/niosh/topics/repro/general.
- ^ "CDC - Reproductive Health - What You Should Know about Work and Reproductive Health - NIOSH Workplace Safety and Health Topic". www.cdc.gov/niosh/topics/repro/general.
- ^ "CDC - Reproductive Health - Female health problems that may be caused by workplace reproductive hazards - NIOSH Workplace Safety and Health Topic". www.cdc.gov/niosh/repro/femalehealthimpact.
- ^ Figa-Talamanca, I. (2006). "Occupational risk factors and reproductive health of women". Occupational Medicine. 56 (8): 521–531. doi:10.1093/occmed/kql114.
- ^ "Reproductive Health and the Workplace: Examples of Jobs that could have Reproductive Hazards". National Institute of Occupational Safety and Health (NIOSH).
- ^ "Waste Anesthetic Gases: Occupational Hazards in Hospitals" (PDF). NIOSH.
{{cite journal}}: Cite journal requires|journal=(help) - ^ OSHA (2000). "Anesthetic Gases: Guidelines for Workplace Exposures". Washington, DC: U.S. Department of Labor, Occupational Safety and Health Administration.
{{cite journal}}: Cite journal requires|journal=(help) - ^ Boivin, JF (1997). "Risk of spontaneous abortion in women occupationally exposed to anaesthetic gases: a meta-analysis". Occup Environ Med. 54 (8): 541–548. PMID 9326157.
- ^ Guirguis, SS; Pelmear, PL; Roy, ML; Wong, L (July 1990). "Health effects associated with exposure to anaesthetic gases in Ontario hospital personnel". British journal of industrial medicine. 47 (7): 490–7. PMID 2383519.
- ^ NIOSH (2004). "Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings" (PDF). Department of Human and Health Services. Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health. 2004–165.
- ^ Valanis, BG; Vollmer, WM; Labuhn, KT; Glass, AG (August 1993). "Acute symptoms associated with antineoplastic drug handling among nurses". Cancer nursing. 16 (4): 288–95. PMID 8402605.
- ^ Selevan, SG; Lindbohm, ML; Hornung, RW; Hemminki, K (7 November 1985). "A study of occupational exposure to antineoplastic drugs and fetal loss in nurses". The New England journal of medicine. 313 (19): 1173–8. PMID 4058490.
- ^ Hemminki, K; Kyyrönen, P; Lindbohm, ML (June 1985). "Spontaneous abortions and malformations in the offspring of nurses exposed to anaesthetic gases, cytostatic drugs, and other potential hazards in hospitals, based on registered information of outcome". Journal of epidemiology and community health. 39 (2): 141–7. PMID 3925060.
- ^ Harrison, BR. "Risks of handling cytotoxic drugs". In Perry, MC (ed.). The chemotherapy source book (3 ed.). Philadelphia, PA: Lippincott, Williams, and Wilkins. p. 566-582.
[[Category: Reproductive health]]