Reproductive and Developmental Hazards

September 21, 2015 | Healthcare Risk, Quality, & Safety Guidance

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It is estimated that 68% of working women will become pregnant at least once during their working life, and more than two-thirds of women work during their first pregnancy (Connor et al. "Reproductive Health"). Male partners of pregnant women and women who are trying to become pregnant are also likely to be working. These parents-to-be face a variety of hazards at home, in the environment, in the community, and in the workplace, many of which may affect their reproductive health or ability to produce healthy children.

Although workplace exposures may not be of scientific or medical significance in terms of reproductive or developmental risk (collectively referred to as "reproductive risks" in this article, unless otherwise specified), people sometimes worry that the workplace is the single greatest threat to their ability to parent healthy offspring (NMCPHC). Scientific, epidemiological, and toxicological data concerning the reproductive health risks is available for some chemicals, biological agents, and physical agents, but data for most is limited, and in some instances nonexistent. For example, although over 1,000 workplace chemicals have been shown to have reproductive effects on animals, most have not been studied in humans. And even this information is just a tiny proportion of the over 72 million unique chemicals registered by the American Chemical Society (ACS), with thousands of new substances added every day, most of which are not tested for reproductive health effects (NIOSH "Men's Reproductive Health").

Moreover, infertility and other reproductive disorders, as well as adverse pregnancy outcomes, are not uncommon in the general population. For example, in young, fertile women, sperm that reach the ovum only fertilize it 88% of the time, and up to half of those fertilized ova do not survive their first two weeks. In other words, the "normal" estimated probability of a resulting live birth is about 30%, and of those live births, 3% to 5% have a developmental abnormality identified at birth and another 5% to 15% have a development abnormality identified over first year of life (NMCPHC).

Usually the causes for these adverse outcomes are unknown. Poor nutrition, alcohol, smoking, prescription or illicit drug use, lack of prenatal care, age, and heredity all can have significant effects on reproductive health and fetal development. How much workplace exposures to reproductive or developmental hazards (also collectively referred to as "reproductive hazards," unless otherwise specified) contribute to these problems is not clear, and while some hazards clearly do have adverse effects, there is a great deal of uncertainty associated with the reproductive risk posed by most chemicals, biological agents, and other stressors.

The terms hazard and risk are often used interchangeably, but while they are related concepts, they have different meanings which are important for the risk manager to understand. They are...

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