[Pregnancy and smoking: the occupational physician's point of view]

It has become urgent to initiate preventive measures to avoid occupation exposure of pregnant women to smoking. Tobacco smoke is a recognized cause of respiratory cancer and a large number of workers are exposed to substances classified as cancerogenic agents. The occupational physician can provide information on risks, measure biological markers (CO in ambient air, serum markers such as CO in expired air, carboxyhemoglobin or cotinine), counsel the employer concerning elimination of the secondary smoke current or the management of toxic materials, and propose modifications of the ventilation system. The current legislation (Evin law) should be included in the house rules. In the event a non-smoking pregnant woman is exposed to passive smoking, the work post should be adapted or changed. Smoking women should be encouraged to stop smoking and provided with the necessary support to achieve cessation. The woman's individual maternity book let should include information on the risk of smoking and encourage contact with the primary care physician, the gynecologist, or the anti-smoking care center. The occupational physician should search for addictive or occupational co-exposures.