The three most common occupational exposures reported by pregnant women: an update

Many uncertainties exist in regard to counseling women with occupational exposures during pregnancy. This is due to limited knowledge of the reproductive toxicologic effects of industrial agents, lack of safety standards aimed at protecting the fetus, and limitations in assessing the extent of exposure. The approach to this subject taken by the Motherisk Program and a review of the three most common occupational exposures are presented. Epidemiologic studies and measurements of radiation do not suggest a reproductive hazard for video display terminals. Exposure to organic solvents is hard to quantitate, and information is sparse and sometimes contradictory, and therapeutic decisions are difficult to reach. To date there is no convincing evidence that working with organic solvents within safety regulations would harm a fetus, in contradistinction to detrimental fetal effects of solvent abuse. The reproductive risks of lead are well documented, fetal exposure can be assessed, and effective treatment exists, but its effects on the pregnancy have not been fully established. However, new evidence suggests that maternal levels that are much lower than the accepted adult limits may be damaging to the fetus.