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A staff member just informed us that she is pregnant.  What safety precautions do we need to take?

The first thing to remember is that the staff member didn't get pregnant just to inconvenience the practice! Although there will have to be some adjustments by both the staff member and the practice, this is a temporary situation and things will return to normal.

When developing your hospital's policy for pregnant employees, keep in mind that the Supreme Court of the United States has upheld the law that prohibits an employer from removing an employee from their hazardous job simply because the employee is pregnant and the fetus may be affected. On the other hand, The Court did reaffirm that the employee must be capable of performing the essential elements of the job in order to be protected by this ruling. In other words, it would be appropriate to transfer a pregnant worker because she can not perform the physical tasks required of the job but a transfer would not be appropriate just because she is pregnant.

It's also important to remember that there are numerous hazards pregnant women face in everyday life as well as on the job. In the past, the most common concerns have centered around exposure to radiation, waste anesthetic gasses and cats; those hazards are definitely controllable but many others warrant attention. Only a thorough understand of the "big picture" will give the leaders and the staff member the information necessary to come to a workable solution.

Here's our over-simplistic big picture, of the 5 basic hazards that a pregnant woman would face in a typical veterinary practice that may be more significant than at other times of their lives:

Injuries (including miscarriage) from strains, falls and exertion - This is the hard one. They have to understand the limitations and no matter how "busy" the place gets, they have to allow the other staff members to do the physical things like lifting, (even small dogs) and restraint (especially fractious animals). Wearing good "slip-resistant" footwear is a must. And of course, exercise care when getting in/out of the car, going up and down stairs, and even while in the "act" of sitting down in a chair or standing up from a sitting posture is important. You can't really regulate most of this stuff, but you can remind the staff member if you see them pushing the limits.

 Exposure to hazardous chemicals and drugs (especially those with mutatogenic effects such as chemotherapy drugs). I would avoid the whole chemo treatment issue, even handling patients that have undergone the procedure elsewhere. Good personal hygiene and pharmacy practices when handling medications, such as washing hands and using the pill counter instead of counting tabs in the palm of the hand are illustrations.

Exposure to anesthetic gasses, primarily during masking, patient recovery and "difficult to scavenge" procedures. I believe that if a person is following the safety rules (e.g., avoiding "hard-to-scavenge" procedures like masking, always using the scavenger hooked to the machine, checking the machine for leaks prior to use, using the proper protective equipment when handling chemicals, practicing good personal hygiene, etc) then there is really no INCREASED exposure or risk to her fetus.

If you are using ANY scavenger properly and in the case of the f/air canister, changing it regularly, you should have NO exposure to waste anesthetic gasses during the procedure. However, animals do give off some gas during recovery since they don't metabolize all of the gas they inhale while on the machine. The only way to deal with that issue is with good general ventilation in the recovery area and for you to avoid very close face-to-face contact with recovering animals.

We don't recommend using masks for protection against anesthetic gasses. And by allowing the employee to use a mask as PPE, he practice is now required to comply with the full provisions of the Respiratory Protection Standard, including logs for monthly leak checks, test fittings, cleanings, etc of the respirator. Furthermore, OSHA expects the business to use engineering  controls (fans, scavengers, etc) and procedural controls (listed in first paragraph) to alleviate the hazard BEFORE they use PPE for protection.

The best strategy is to test the employee's exposure using an exposure badge before making any decisions on exposure.  Here's a link to a suggested source for the testing badges and instructions on how to use them: http://www.safetyvet.com/images/WAGBadg.pdf

Link to more info on masks: http://www.safetyvet.com/osha/respsurg.htm

Exposure to radiation - Only during the millisecond when the button is pressed would there be a concern about exposure, so all other aspects should be fine. Wearing full gown and full hand gloves is really adequate protection. It's not unusual for women to get radiographs taken of themselves during
pregnancy when necessary, they just take precautions.  For example, the simplest thing they do is cover the belly with an apron. In most cases, the pregnant worker does not need to totally avoid the radiation area, just minimize the exposure and wear the appropriate safety devices.

Exposure to infectious or zoonotic diseases - Personal hygiene and knowledge of disease transmission routes is the best defense.

 

 

 

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