Module 3: Toxicology - Section 18: Reproductive Health Disorders in the Workplace
TOX 18.3 Reproductive Health Hazards continued

2. KNOWN HUMAN REPRODUCTIVE HAZARDS

Workplace reproductive hazards can be divided into three broad groups of agents - physical, biological and chemical.

2.1 Physical Agents:

2.2 Biological Agents:

Several biological agents can affect the unborn baby if the mother is infected during pregnancy. These may be transmitted in-utero through the placenta, during or after birth. Table 1 provides information on some of the agents:

Table 1. Biological agents that are reproductive hazards for women in the workplace
Agent Observed effects Potentially exposed workers Preventive measures
Cytomegalo-virus (CMV) Birth defects, low birth weight, developmental disorders Health care workers, workers in contact with infants and children Good hygienic practices such as handwashing
Hepatitis B virus Low birth weight Health care workers Vaccination
Human immuno-deficiency virus (HIV) Low birth weight, childhood cancer Health care workers Practice universal precautions
Human parvovirus B19 Miscarriage Health care workers, workers in contact with infants and children Good hygienic practices such as handwashing
Toxoplasmosis Miscarriage, birth defects, developmental disorders Animal care workers, veterinarians Good hygiene practices such as handwashing
Varicella-zoster virus (chicken pox) Birth defects, low birth weight Health care workers, workers in contact with infants and children Vaccination before pregnancy if no prior immunity.
Source: The Effects of Workplace Hazards on Female Reproductive Health. National Institute for Occupational Safety and Health, Publication No. 99-104, 1999 http://www.cdc.gov/niosh

2.3 Chemical hazards:

Hundreds of chemicals with known reproductive effects exist. Occupational exposure limits to these substances are most frequently based on acute health effects or cancer risk and rarely on reproductive effects. Many chemicals have not been assessed for reproductive effects.

The Registry of Toxic Effects of Chemical Substances (RTECS) published by the National Institute for Occupational Safety and Health (NIOSH), is a list of substances for which there is some information relating to possible health risk from overexposure. In 1999 there were more than 145,000 substances on the list. Of these, 6,000 substances (4%) are listed as "reproductive effectors". Of the 6,000 reproductive effectors, 1,000 (0,7% overall) have human data. These substances include general industrial and domestic chemicals, metals, solvents, agricultural chemicals (pesticides/fungicides/herbicides), disinfectants, gases, and pharmaceuticals.

The risk of chemicals with potential reproductive effects can only be determined following a risk assessment of the substance at the particular workplace. It is the responsibility of the employer to determine the potential risk and ensure that every precaution is taken to ensure that the workplace is safe and healthy, that health and safety training is done and that recommended occupational exposure limits are adhered to. Known reproductive chemical hazards include:

Exposure to hazardous chemicals of both women and men during the reproductive cycle can result in serious genetic damage, which can be passed on to children through negative effects on development of the embryo, foetus and infant. In women, exposure to dangerous chemicals can result in menstrual or gynaecological disorders, abortion or infertility, decreased foetal growth, low birth weight or poor survival, prematurity and maternal death related to pregnancy. If there is a known high risk of exposure to an infectious agent, it should be recommended that pregnant workers avoid exposure altogether.

Exposure to hazardous chemicals affects the reproductive health of men in a variety of ways. Contact with certain agents can result in decreased libido and impotence, testicular damage or infertility and spermatoxicity. Tables 2 and Table 3 list some of the reproductive hazards for which there are human evidence of adverse reproductive outcome for women and men.



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Postgraduate Diploma in Occupational Health (DOH) - Modules 3: Occupational Medicine & Toxicology (Basic) by Profs Mohamed Jeebhay and Rodney Ehrlich, Health Sciences UCT is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 2.5 South Africa License. Major contributors: Mohamed Jeebhay, Rodney Ehrlich, Jonny Myers, Leslie London, Sophie Kisting, Rajen Naidoo, Saloshni Naidoo. Source available from here. For any updates to the material, or more permissions beyond the scope of this license, please email healthoer@uct.ac.za or visit www.healthedu.uct.ac.za. Last updated Jan 2007.
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