Reproductive hazards in the workplace

The growing public concern about the presence of toxic substances in the working and living environments has increased the awareness of prospective parents on the potential reproductive damage that may occur as a result of occupational exposure. The obstetrician or gynecologist attempting to counsel a couple about reproductive damage of specific occupational exposure faces a dilemma because of conflicting factors that need to be taken into account. Those factors include lack of a well-defined relationship between exposure at the worksite and reproductive damage, lack of information or conflicting data, economic concerns, and sex discrimination issues. This review describes pathogenic mechanisms of reproductive damage produced by occupational chemical exposure and details common weaknesses and problems in the interpretation and application to clinical practice of the burgeoning literature in the subject. A listing of different chemicals and physical agents suspected of producing reproductive impairment in either membrane of the reproductive dyad is presented. In addition, the legality of the so called "fetal protection policies" is also reviewed. Despite the current scientific uncertainty, knowledgeable health professionals can help parents reach an informed decision about the reproductive risks that they are willing to take when a "zero exposure" environment cannot be guaranteed and allay unfounded fears.