“Virtually all work risk exposures have shown adverse effects on the reproductive health of the workers”


Interview with Ana María García, author of the study “Prevalence of occupational exposure to reproductive risks in Spanish pregnant”

First of all, explain briefly why did you decide to do this study?
Since 2008 our group works on the study of the relationship between work and health of people. We knew that certain conditions and exposures present in the workplace may have adversely affects on the reproductive health of workers. And the INMA Project provides valuable data on employment and working conditions in a large sample of pregnant women from different parts of Spain. This is the second scientific publication based in the INMA data (the first one, published in the Gaceta Sanitaria journal in 2009, and which present very similar results, only analyzed data from pregnant women participating in the cohort INMA of Valencia). We are sure that the descriptive analysis of this data is have a great interest and utility: in the international literature there is little information to quantify the problem of exposure to occupational risk factors in pregnant workers, an increasingly large group in our country and worldwide. In our context we have rules and regulations that try to protect the health of workers during pregnancy and lactation period, an especially sensitive stage in witch certain environmental exposures that may cause alterations in the normal course of pregnancy, and in the health and development of the newborn. This information will help us to evaluate potential associations between occupational exposures reported by women and health problems that may occur after.

What are the main occupational risks faced by pregnant women?
Most of risk exposures for occupational health have shown negative effects on the reproductive health of workers. We may have more information regarding the classic risks, like exposures to certain chemical pollutants (such as solvents or metal fumes). which can be found in relation to different materials and processes for work and not always have the appropriate preventive measures and facilities in the workplace (such as local exhaust systems, isolation of processes that generate pollutants or personal protective equipment such as masks and gloves); and exposures to biological risks (bacteria, viruses and other microorganisms) that can be especially dangerous during pregnancy. But the categories of occupational risks to which they are exposed more often working population (physical load and psychosocial risks) are likely to cause adverse effects during pregnancy. Some kinds of physical load (efforts, handling loads) have been associated with alterations of normal development of pregnancy. And some studies suggest that mental overload situations at work (stress) can have the same negative effect.

“Certain forms of load have been associated with alterations in the normal course of gestation. And some studies suggest that mental overload situations at work is also detrimental”. 

What risks can have on the development of the pregnancy?
Of course, all depends on the intensity of exposure and action of other risk factors that may act simultaneously on the pregnant woman. The exposure to pollutants and occupational risk factors described problems such low birth weight or prematurity, which are associated with difficulties in the normal development of the newborn. In some cases it can cause more serious effects such as abortions or congenital malformations, commonly associated with acute exposures to certain chemical contaminants and infectious agents that act as reproductive toxicants. Fortunately,the frequency of such problems is relatively low in our population, but research is showing that more subtle effects, such as alterations of neuroendocrine development or even chronic degenerative diseases that manifest in adulthood, may be related to environmental exposures during the gestation period.

What are the worst factors, for mother and baby, to which pregnant women are exposed in their working environment?
Basically, those which we have greater certainty of its negative effects and of the severity of these effects. Among the chemical, exposure to chemicals called reprotoxic, but also carcinogenic, mutagenic or endocrine disruptors can have particularly negative effects during pregnancy, although exposure should avoided or closely monitored, in any case, in all workers and in the general population. These categories include substances such as lead, mercury and derivatives (especially in the form of fumes or vapors that can be inhaled), pesticides and organic solvents (these ones are very volatile and present in the composition of a large number of products and materials used labor (such as paints, varnishes, cleaning products, etc..). The detrimental effects of ionizing radiation on pregnancy and exposure to such biologic agents (such as rubella or toxoplasma, which may be present in certain work environments related to the health sector) have also shown.

What are the more important differences between the different categories of workers? What are the sectors most exposed to these risks?
Overall, and concerning the different situations of known and potential risk, certainly the service sector is the most affected. These workers generally emphasizes exposure to physical load and psychosocial risks, but not only: services also include many activities with exposure to chemical pollutants (transport, cleaning, hairdressing, etc.). The exposure to a chemical risks is more worrying in industry, but workers in these sectors also experience the physical and mental overload. Some sectors, such as health, can concentrate higher prevalence of exposure to specific risks as well as biological or drug manipulation. The farm workers also have frequent exposure to different reprotoxic agents, including pesticides manipulation -or environments contaminated by these substances- and various types of physical load.

“Concerning to the different situations of known and potential risks, the services sector is the most affected. Stresses in general, exposure to physical load and psychosocial risks, but also include many activities with exposure to chemical pollutants”. 

What steps should strengthen the authorities to minimize these risks? The Spanish Prevention of Occupational Risks Low, in force since 1995, notes the companies obligation to take special measures for the protection of health in the case of pregnant women and infants. There are other specific regulations related, as the recent Royal Decree 298/2009 which includes a non-exhaustive list of agents, processes and working conditions that may have adversely affects on the health of pregnant and newborn. These regulations can be improved. Does not mention any type of psychosocial risk (stress) and does not include endocrine disruptors, very ubiquitous substances and for which we have abundant information about its dangerous effects on reproductive health. The law is also too permissive of exposure to carcinogens substances. In fact, there are many opportunities for health protection of workers in companies apart from the role that governments may have: it depends, specially, on the will and responsibility of company owners, on the activity and prevention services that all companies have contracted, and on the workers willingness and opportunities to influence over their working conditions.