REPRODUCTIVE HEALTH AND THE WORKPLACE

What Healthcare Professionals Should Know

Chances are that most of your patients hold at least one job. Here are simple steps you can take to help your patients stay safe at work.

Why you should discuss work with your patients

Your patients might encounter hazards in the workplace that affect their health and the health of their family. These hazards might include more obvious exposures such as chemicals or radiation, but other workplace hazards such as stress, noise, working night shifts, and standing or sitting for long periods of time also need to be considered.

Reproductive hazards matter all the time, for both men and women

• Some workplace hazards can affect fertility and sexual function for both men and women.
• Some chemicals can concentrate in semen, providing a route of exposure for sexual partners.
• When a pregnant or breastfeeding worker is exposed to hazards, her baby might be exposed too.
• Any worker (male or female) can carry harmful chemicals home on their skin, hair, clothes, and shoes. These can affect the people in their household, especially children.
• Some reproductive hazards can disrupt sex hormone production and lead to reduced general health, especially in women.

Pregnancy and work affect each other

Although most employees are able to safely perform their jobs throughout pregnancy, pregnancy can sometimes affect worker safety:

• Changes in pregnancy can increase the rate women absorb some chemicals (e.g. some metals)
• As she grows, a pregnant worker may find that personal protective equipment (like lab coats or some types of respirators) no longer fits correctly.
• Changes in a pregnant worker’s immune system, lung capacity, and even ligaments can alter her risk for injury or illness due to some workplace hazards.
• Workplace exposures can also affect the health of a pregnancy. Some chemical exposures might be riskier for a fetus than its mother, due to its rapid development and smaller relative size. For most chemicals, we don’t have good information on what levels of exposure might harm a fetus. Occupational exposure limits were intended to protect workers, and cannot necessarily be applied to a fetus.

What you can do to help your patients

1. Ask your patients about their work

   A few simple questions can tell you a lot about the hazards your patients might encounter at work.

   • Start by asking what they do, what kind of company they work for, and their work schedule.
   • Ask about their usual job tasks, types of hazards they encounter, use of personal protective equipment (e.g., gloves, respirators), and how much time they spend doing each task.
   • Prompt them to tell you if there is anything they are specifically concerned about at work.
   • Remember to ask about your patients’ work at every visit; many of your patients work more than one job or change jobs or job tasks often.

2. Identify barriers to healthy pregnancies

   Work can be an important source of stress during pregnancy. Your patients might have a job that could be hazardous to their pregnancy, but they might be worried about losing their job if they tell their employer they no longer want to perform their usual job tasks.

   • Discuss what they can do to stay safe at work.
   • Ask your patients if they will be able to take time off to attend prenatal care visits or take their baby to the doctor and how they can schedule these visits around their job. Recognize that if they work night shifts, scheduling appointments during the day could be difficult.
   • Talk to your patients about how soon after the birth they plan to return to work, and their plans for breast feeding while working.

   Learn more about staying safe at work.

   Learn more about work and breastfeeding.

3. Help your patients protect their home and family

   Workers can bring work hazards home with them. Chemicals can come home on a worker’s skin, clothes, and shoes and contaminate the car and home.

   • Ask your patients about the types of jobs held by everyone in the household. Jobs that involve contact with lead (e.g., construction, painting, home renovation, battery recycling) are some of the most common sources of car and home contamination.
   • Encourage your patients to create a healthy car and home by having workers change clothes and shower before leaving work, not bringing work clothes into the living areas of the house, and washing work clothes in separate laundry loads from the family’s clothes.

   Learn more about protecting home and family.

4. Find more information

   • If you are not familiar with the hazards of your patient’s job, seek information from colleagues or professional societies.
   • Your patients’ companies might have an occupational health physician, nurse, or safety officer whom you can talk to about your patients’ specific job tasks.
   • The NIOSH website has information about the most common workplace hazards; for more uncommon situations, you can contact us to ask specific questions.

Additional resources

• Managing patients with concerns about workplace reproductive hazards. Frazier LM, Jones TL. J Am Med Womens Assoc 55(2): 80-83, 105.
• MotherToBaby, a service of the Organization of Teratology Information Specialists.
• Occupational Exposures and Reproductive Health: Summary of the 2003 Teratology Society Meeting Symposium. Grajewski B, Coble J, Frazier L, McDiarmid M. Birth Defects Res B Dev Reprod Toxicol 2005; 74:157-163.
• Will my work affect my pregnancy? Resources for anticipating and answering patients’ questions. Grajweski BA, Rocheleau CM, Lawson CC, Johnson CY. AJOG 2016; 214(5):597-602.