Tutor Viewpoint - New and Expectant Mothers in the Workplace

Wendy Claxton BSc (Hons), Dip2.OSH, CMIOSH

Pregnancy is not an illness and any implications arising from pregnancy should be managed effectively through normal health and safety procedures. However, some employers are unsure as to what actions they need to take with respect to pregnant workers so as to ensure that they don’t place mothers or unborn children at risk. Consideration also needs to be given to employees when they return to work and if they are breastfeeding. Controls that are normally acceptable may not fully protect the new and expectant mother or their child and therefore further controls may need to be considered.

The Health and Safety Executive (HSE) have defined “new and expectant mother” as:

“An employee who is pregnant, who has given birth within the previous six months, or who is breastfeeding.

Occupational Exposure

It is widely believed that the main result of occupational exposure of pregnant women to workplace hazards is congenital abnormalities, but exposure may result in other adverse effects such as still-birth, miscarriage or reduced birth weight.

Congenital defects can be due to damage to the genetic material (DNA) of the male or female germ cells. This damage could even have been caused in previous generations, e.g. exposure to ionising radiation (X- and gamma-rays). Alternatively, congenital defects can occur due to disruption of the development of the child growing in the womb, e.g. phthalates, organochlorine pesticides or by exposure to infectious agents, such as rubella (German measles) or toxiplasmosis (parasite transmitted by animals, e.g. cats).

For most expectant mothers, the risk from infectious agents is no higher than they would be exposed to outside of the workplace. However, for some the risks are greater due to their occupation, such as those working closely with animals: vets and farm workers, or young children.

Where an employee works with hazardous substances, providing the exposure limits are adhered to, the pregnant or breastfeeding worker or her child should not be put at risk. For some substances, such as lead, a lower level of exposure is recommended for women of reproductive capacity, as opposed to male adults, so as to protect the foetus from the harmful effects of lead before a pregnancy is confirmed. In the case of lead, once their pregnancy is confirmed then the employee will normally be suspended from any work that exposes them to significant levels of lead. The Control of Lead at Work Regulations 1999 and Approved Code of Practice outlines the legal requirements and guidance for good practice.

Some substances are known to endanger the health of pregnant women and the unborn child, and are indicated by suitable risk phrases. Some examples are provided below:

• R40 - Limited evidence of carcinogenic effect.
• R46 - May cause heritable genetic damage.
• R61 - May cause harm to the unborn child.
• R63 - Possible risk of harm to the unborn child.
• R64 - May cause harm to breastfed babies.
• R68 - Possible risk of irreversible effects.

The Control of Substances Hazardous to Health Regulations 2002 requires a risk assessment to be undertaken at the place of work to determine the actual risk to health and prevent or control the risk as appropriate. Occupational Exposure Limits are set for specific substances including ones exhibiting reproductive toxicity.

Employers Guide

The HSE advise employers to take the following two-stage approach to managing the risks to new and expectant mothers.

Stage 1 - Initial Risk Assessment

One of the problems with pregnancy, as we know, is that it often goes undetected for the first four to six weeks. For this reason, it is vital that employers adequately assess their business activities for hazards and risks that may affect all women of childbearing age. Employers must then do what is reasonably practicable to control those risks. Consider the lower exposure limit for lead, for women of childbearing age, as discussed above. Generally, if an employer controls common workplace risks appropriately, this will reduce the need for any special action for new and expectant mothers.

The initial assessment must consider the following possible hazards (although the following list is not exhaustive):

• Physical Risks:

  • Movements and posture.

  • Manual handling.

  • Shocks and vibration.

  • Noise.

  • Radiation.

  • Compressed air.

  • Underground mining work.

• Biological Agents:

• Infectious diseases, e.g. toxiplasmosis, rubella and HIV.

• Chemical Agents:

• Toxic chemicals.

• Mercury.

• Antimitotic (cytotoxic) drugs.

• Pesticides.

• Carbon monoxide.

• Lead.

• Working Conditions:

• Facilities.

• Mental and physical fatigue.

• Working hours.

• Stress (including postnatal depression).

• Passive smoking.

• Temperature.

• Working alone.

• Working at height.

• Travelling.

• Violence.

All of the above are included in the Annexes to the European Directive on the health and safety of pregnant workers (92/85/EEC) and the European Commission’s guidelines.

Some of the above are also covered by specific legislation, e.g. the Ionising Radiations Regulations 1999, the Diving at Work Regulations 1997, the Workplace (Health, Safety and Welfare) Regulations 1992 and so on.

Employers must consult their employees or their representatives on the findings of the initial risk assessment. If the assessment does reveal a risk, all female employees of childbearing age must be informed if they are, or could in the future be, pregnant or breastfeeding. The employer must also advise what actions they are planning to take to ensure that new and expectant mothers are not exposed to the risks that could cause them harm.

Employers must allow employees or their representatives time to consider the proposals and allow them to give their views before the employer reaches a final decision. The employer should also stress the importance of the need for employees to give written notification of pregnancy, or that they are breastfeeding, or that they have given birth in the last six months, as early as possible.

Stage 2 - On Notification of Pregnancy, Birth or Breastfeeding

The first step for the employer is to carry out a specific risk assessment of the individual based on the initial assessment. If there is a significant risk that goes beyond the risks that the new or expectant mother may face outside of her work, the following actions must be taken to remove her from the risk:

• Action 1: Temporarily adjust her working conditions and/or hours of work.

Or if the above is not reasonable to do so, or would not avoid the risk then:

• Action 2: Offer her suitable alternative work (at the same rate of pay).

Or if that is not feasible:

• Action 3: Suspend her from work on paid leave for as long as necessary to protect her health and safety and that of her child.

The above action levels are only required to be implemented if there is a genuine concern as a result of the risk assessment process. Where there are doubts as to what the risks are, and whether they arise from work, then professional advice should be sought.

The specific risk assessment should be reviewed regularly as the risk to the mother or unborn child may vary throughout the pregnancy. Consideration should be given to impaired dexterity, agility, co-ordination and speed due to the increasing size of the individual as the pregnancy progresses.

Facilities Required for New and Expectant Mothers

The Workplace (Health, Safety and Welfare) Regulations 1992 outline the legal requirements for new and expectant mothers with respect to the workplace facilities.

The key requirement is around providing suitable resting facilities and clean drinking water. Breastfeeding mothers also require access to a private room where they can express and store milk.

Summary

The key to ensuring that new and expectant mothers can work safely and without risk to themselves or their child is through the process of risk assessment. Firstly, a generic risk assessment for all women of childbearing age should be completed and then a specific one for the individual once the employer has been informed in writing of their impending pregnancy, return to work, or breastfeeding.

Consideration must also be given to the fact that there may be aspects of the pregnancy which may affect the individual’s ability to work effectively. For example, morning sickness may mean that it is difficult for the employee to work on the early shift or they may be unable to be exposed to nauseating smells. Backache may mean that standing or manual handling is limited. Tiredness may affect the employee’s ability to work in the evening or to do overtime.

These aspects and the effect they have on an individual vary immensely and so it is vital that new and expectant mothers are treated as individuals and are risk assessed accordingly.

References

HSG122 New and Expectant Mothers at Work, HSE, 2002

Dr Chris Ide, Tomorrow’s Children, Safety and Health Practitioner, Nov 2004

Management of Health and Safety at Work Regulations 1999

The Workplace (Health, Safety and Welfare) Regulations 1992

The Control of Lead at Work Regulations 1999

The Control of Substances Hazardous to Health Regulations 2002

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