Slide 1

Alan Hall, M.D.Neal Langerman, Ph.D.

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A regular CHAS programming event which provides a forum for discussion of current topics in chemical safety.A subject is assigned to each session

ANY topic of chemical safety interest is fair game for the sessionSessions are scheduled for 90 minutes

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Fetal protection programs represent a variety of approaches to preventing harm to a developing fetus as the result of workplace impacts.

While women must clearly be protected, men must also be afforded equal protection.A rich set of case law defines the legal construct under which an employer must function.

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Reproductive toxicity is the occurrence of biologically adverse effects on the reproductive system of females or males that may result from exposure to environmental agents.Developmental toxicity is the occurrence of adverse effects on the developing organism that may result from exposure prior to conception, during prenatal development or postnatally to the time of sexual maturation.

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A teratogen is an agent or organism that produces a permanent structural or functional abnormality. Teratogens may be classified as infections, metabolic disorders, drugs, and chemicals.A mutagen is an agent or organism that produces a permanent change in the genome of the individual. The change will pass down generational lines.

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The Safe Drinking Water Act (Proposition 65) contains the most comprehensive list of reproductive toxins generally available.

See handout for the current P65 list

Results for a search of Reproductive on Elseviers new HazMat Navigator

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Advanced Chemical Safetywww.chemical-safety.comSolutions@chemical-safety.comTopic (from title page)

Topic (from title page)

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Advanced Chemical Safetywww.chemical-safety.comSolutions@chemical-safety.comTopic (from title page)

Topic (from title page)

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Fetal Toxins

Fetotoxin: has the same impact on the fetus as on the adult.Methyl ethyl ketoneTransplacental carcinogen: causes fetuses exposed during pregnancy to eventually develop cancer. DES is a specific example of this class.

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Fetal Toxins

Mutagen: alters the chromosomes of the ova or sperm.Ethidium bromideTeratogen: an agent which can cause a miscarriage or deform the developing fetus.Polychloro-dibenzo-p-dioxins

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This is only a subset of occupational/ environmental potential exposures and reproductive hazardsThere is a revision of the ATSDR Case Study in Environmental Medicine in development

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Male and Female reproduction and fetal/early childhood development are extremely complicated biological processesEnvironmental exposures (including those which may occur in Laboratories) have the potential to interfere with many aspects of these processes

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Those responsible for Safety in Laboratories must consider:

Female reproductive issues (including the eventual ability to conceive and carry a normal pregnancy)Pregnant female reproductive issues (including the ability to carry and deliver a normal infant)Male reproductive issues (including the ability to father a child and the potential for that child to be a normal infant)Issues that may, from the aspects of both parents, to lead to maximizing normal early childhood development

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Numerous chemical substances have been shown, in humans or experimental animals, to have an adverse effect on reproduction and development, such as:

Drugs/Medications (both licit and illicit)PesticidesSolventsMetalsPetrochemicalsIonizing radiationCarbon monoxide/other asphyxiantsAnd other lifestyle issues such as tobacco smoking, shift work, domestic violence, alcohol, caffeine, folic acid deficiency, etc., etc.

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Chemical exposures in Laboratories are only one aspect of the very complicated issues in human reproductionAny measures that can be adopted to decrease potential exposures to reproductive hazards in male and female laboratory workers are to be encouraged

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What is the magnitude of the problem, overall?

Approximately 12% of women in the US had difficulty conceiving a pregnancy in 2002Male and female infertility are each responsible for approximately 30% of infertile couples; the remaining cases are due to complex or unknown causesAbout 7% of couples are infertileAbout 30-50% of pregnancies may result in very early and often undetected fetal lossOnly about 15-20% of failed conceptions are clinically recognized as miscarriages

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What is the magnitude of the problem, overall?

Fetal losses (births plus fetal deaths) after 20 weeks gestation were 6.4 per 1000 in 2002; and infant deaths were 0.7% in 2003Fetal growth restriction occurs in approximately 3% of birthsPreterm deliveries were 12.5% in 2004Genetic diseases are present in 11% of birthsLow Birth Weight (LBW) incidence was 8.1% in 2004

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What is the magnitude of the problem, overall?

There are several thousand known birth defects. Major malformations are estimated to occur in about 3% of live birthsAbout 20-25% of birth defects are known to be caused by genetic factorsAbout 60-70% of birth defects are of unknown causesAbout 10% of birth defects are due to environmental conditions or exposures: about 4% are due to maternal risk factors; about 3% are due to infectious agents; about 1-2% are due to mechanical pregnancy problems< 1% are known to be due to chemicals, prescription drugs, or physical agents

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Some Issues for discussion

Do you feel adequately informed about potential reproductive toxins in your work place?Do you feel adequately protected?Do you work directly with known reproductive toxins?Has your employer discussed a Fetal Protection Program with its employees?QUESTIONS, COMMENTS, DISCUSSION

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