Reproductive Health Guidelines

Purpose

This guideline outlines the recommendations for protecting the reproductive health of all individuals on campus from occupational exposure to chemical, biological, radioactive, and other substances that are known or suspected of being capable of posing a hazard to human reproduction. Potential reproductive and developmental hazards will be identified and appropriate exposure control measures will be implemented.

Scope and Applicability

This shall apply to all faculty, staff and students on the Knoxville campus of the University of Tennessee. This shall apply to individuals on campus who have the potential to encounter potential reproductive hazards as part of their job responsibilities, with worker health protection and OSHA regulations in mind.

Abbreviations and Definitions

Abbreviations

EHS: Environmental Health and Safety

OSHA: Occupational Safety & Health Administration

PPE: Personal Protective Equipment

SDS: Safety Data Sheets

Definitions

Reproductive Hazard: Any chemical, physical or biological agent that is capable of impacting an individual’s ability to conceive, maintain a pregnancy or results in a birth defect.

Reproductive Toxicity: Adverse effects on the health of the reproductive organs, endocrine system, or gametes (egg or sperm) from exposure to an exogenous agent. May result in effects such as: menstrual dysfunction, damage to gametes (ova or sperm) or gamete development, impaired fertility, or inability to maintain a pregnancy.

Developmental Toxicity: Adverse effects on the developing organism that may occur anytime from conception to sexual maturity.

Mutagen: physical or chemical agent that changes the genetic material, usually DNA, of an organism and thus increases the frequency of mutations above the natural background level.

Teratogen: substances that may cause birth defects via a toxic effect on an embryo or fetus.

Roles and Responsibilities

Employees and Students shall

• At your discretion (this is a voluntary act), formally declare pregnancy or other reproductive health issues to your supervisor or instructor as soon as you become aware of it, and request a review of work or classroom assignments, if needed.
• Consult with a personal physician about particular circumstances and potential hazards.
• Take care not to expose yourself to any unnecessary chemical, biological, radioactive, or hazardous physical agents.
• Report all unintended or improper exposure incidents to your supervisor or instructor.
• Follow all recommended work practices and utilize PPE and equipment provided to decrease exposure to hazards in the work area.
• Comply with all university policies and OSHA requirements and regulations to assure a safe and healthful working environment.
• Attend all required safety training and seek additional training or information if you become aware of a reproductive health issue that applies to you.
• Work with supervisor to identify possible alternate job duties or temporary reassignment within the department consistent with medical restrictions.
• Be aware that UTK endeavors to provide information regarding relevant facts and safety regarding reproductive health. However, there are circumstances and situations that may not pose a clear threat or are not specifically identified by regulatory guidance as a reproductive threat. In these cases, you, not the university, must make the ultimate decision whether to accept a risk to you or an unborn fetus.

Supervisors shall:

• Ensure that all employees attend required safety training.
• Provide employees with appropriate PPE and ensure that employees properly use PPE and other control measures.
• Temporarily assign duties, if needed, consistent with medical restrictions.
• Maintain an inventory of chemical, biological, and radiological agents used in the work area.
• Be familiar, and ensure that employees are familiar with the hazards associated with these agents – including reproductive or developmental hazards and develop operation-specific chemical hygiene plans or standard operating procedures (SOPs).

EHS, Radiation Safety and the Biosafety Office shall:

• Provide onsite hazard analysis upon request and assist in determining appropriate methods to minimize exposure to within acceptable limits. Preventative measures may involve engineering or administrative controls and personal protective equipment. Appendix A includes a sample consultation form which will facilitate the onsite analysis.
• Provide guidance, training and assistance to involved parties regarding ways to minimize exposure to reproductive health hazards in the university environment.
• Provide, or arrange for, exposure testing and monitoring, as appropriate.
• Work with other safety offices (Radiation Safety and Biosafety) to ensure that all areas have been covered.
• Develop and implement UTK’s Reproductive Health Program and update the Reproductive Guideline as needed.

Procedures

Hierarchy of controls and general protective measures

• Whenever possible eliminate the hazardous material or substitute with a less hazardous or non-hazardous alternative.
• Using effective engineering controls, such as local exhaust ventilation, fume hoods, or biosafety cabinets.
• Receive training on and use safe work practices.
• Use the following administrative controls when engineering controls are not available
  • Use job rotations to reduce exposures.
  • Transfer the employee to a job which does not involve exposure to reproductive or developmental hazards, consistent with medical restrictions. Similar considerations should be made for students who may be exposed to such hazards during classes, labs, or independent research projects.
• Wear personal protective equipment as prescribed. Examples of personal protective equipment include, but not limited to face shields, googles, gloves, and respirator protection.
• Direct questions regarding reproductive risks in the work area:
  • Chemicals: contact EHS (865-974-5084); safety@utk.edu
  • Biological Hazards: contact the Biosafety Office (865-974-1938); utbiosafety@utk.edu
  • Radiological Hazards: contact Radiation Safety (865-974-5580); radiationsafety@utk.edu

Considerations for handling hazardous chemicals

• Chemicals that may act as reproductive hazards may be found in laboratories, shops, art studios, pharmacies, medical facilities (e.g. operating rooms, patient care areas, etc.), and maintenance areas (e.g. custodial supply closets). A list of chemicals which may pose a reproductive hazard is provided in Appendix B, though this list should not be considered exhaustive.
• Chemical exposures may occur through multiple portals of entry into the body, including inhalation, ingestion, injection, and muco-cutaneous (skin & mucous membrane) absorption.
• Remember, the presence/absence of specific odors or visual contamination is not a reliable indicator for exposure. Even if there is no detectable odor or visible residue, significant exposure may be occurring.  Therefore, preventative and protective measures must be taken.
• Protective measures include:
  • Correct use of a chemical exhaust hood or other ventilation controls to limit inhalation and/or mucous membrane exposures. This is critical for agents that readily release hazardous vapors into the air. Even if the agents aren’t readily released into the air, air currents, turbulence or other disturbances can cause the agent to become airborne, leading to potential exposures. Therefore, use of a chemical exhaust hood or other local ventilation device to mix or weigh potentially toxic powders is recommended.
  • Environmental monitoring to determine the presence and relative concentration of hazardous chemicals. EHS will determine if environmental monitoring is necessary, and if so, conduct (or arrange for) monitoring. If results indicate an unacceptable risk of exposure, appropriate protective measures will be communicated.
  • Wearing PPE. Gloves, lab coats or protective smocks, and protective eyewear limit mucous membrane and skin exposures and should always be worn when handling hazardous chemicals.  Respiratory protection may also be indicated if a chemical exhaust hood or other ventilation controls aren’t available. The extent of PPE and types/makes/models are determined by the types of material, exposure potential, and relative health risk.  EHS will work with staff, supervisors, and instructors to help assess and define appropriate PPE.
  • Practicing good personal hygiene. Avoid hand-to-mouth or hand-to-face contact when working with hazardous chemicals to limit mucous membrane exposures or accidental ingestion. Always wash your hands any time you remove protective gloves, before leaving a lab/work space, and/or prior to eating or drinking. Additionally, do not store or consume food in lab/work spaces where hazardous chemicals are stored.
  • Practicing good lab hygiene. Ensure that chemical containers are thoroughly and accurately labeled, closed when not in use, and stored appropriately. Chemical wastes should be similarly labeled, closed, and stored.

Considerations for handling biological hazards

• Biological hazards include: infectious agents (bacteria, viruses, fungi, protozoa, etc.); toxins that may induce acute and/or chronic health effects (often managed as toxic chemicals); blood, tissues and body fluids from humans and animals; and diagnostic or environmental samples that may contain any of the above. Biological hazards may be found in laboratories, animal research facilities, and human/veterinary clinics and hospitals. Areas and equipment containing biological hazards are generally marked with a universal biohazard symbol along with caution/warning statements.
• Like chemicals, exposures to biohazards may be via muco-cutaneous exposure, ingestion, injection/dermal injury, or inhalation. Biological hazards are typically microscopic (not visible) and otherwise difficult to detect.
• Infection or exposure to biohazards may or may not result in disease depending on the agent, level of exposure, portal of entry, and multiple host factors. If disease occurs, the onset, severity and duration of disease may be highly variable between individuals. Appendix C lists agents known (or reasonably suspected) to cause reproductive harm, mild-to-severe fetal defects which may result in miscarriage or spontaneous abortion, and/or significant risk to pregnant women. This list should not be considered exhaustive.
• It is often difficult to tell if reproductive problems or congenital defects are caused by exposure to biological agents or some other complicating factor(s). Also, it is difficult to know what levels of exposure to infectious agents are safe for any given individual. Therefore, preventative/protective measures are necessary.
• In addition to the general protective measures for chemicals listed above:
  • Use engineering controls such as HEPA-filtered biological safety cabinets, sealed centrifuge rotors or safety cups, etc.
  • Eliminate or reduce the use of sharp devices. Whenever possible, use safety-engineered sharps devices and observe sharps safety precautions.
  • Ensure that vaccines are up-to-date, including the (inactivated) seasonal flu vaccine. Some vaccines may be contraindicated during pregnancy, so it is important to consult with a medical professional.
  • If working in a healthcare setting, avoid working with patients who are infected with the listed agents if not vaccinated or otherwise immune. Also, patients diagnosed with unusual or emerging infections should be avoided.
  • Follow the latest recommendations of the Centers for Disease Control and/or local public health agencies.
  • Enroll in the Animal Care & Use occupational health program if working with research animals, farm animals, or in the Veterinary Teaching Hospital.

Considerations for handling radiological hazards:

• Radiological hazards may be found in laboratories, medical facilities (e.g. radiology & nuclear medicine), and in some pieces of analytical equipment. Areas and equipment containing radiological sources are marked with a magenta trefoil on yellow background along with caution/warning statements.
• Radiological exposures may come from direct contact with materials or indirect exposures via proximity to areas/equipment containing or emitting ionizing radiation. Radiation cannot be seen, smelled, or otherwise sensed, so preventative/protective measures are necessary.
• In addition to the general protective measures indicated for chemicals listed above:
  • Observe the time, distance and shielding rule: minimize time around radiological materials, maximize distance between yourself and radiological materials, and use shielding equipment to block or minimize indirect exposures. Follow safe handling techniques and use of protective equipment if working with radiation sources. The Radiation Safety Office will help define these parameters.
• If you work around ionizing radiation and become pregnant, you may declare your pregnancy to your employer. A declared pregnant worker has a lower maximum occupational radiation exposure limit that decreases any potential risk to the fetus. If you would like to declare your pregnancy, you may notify your P.I. or the Radiation Safety Department. If you declare your pregnancy, please complete the Pregnancy Declaration Form (Appendix D), or go to http://radiationsafety.utk.edu/declare-pregnancy/ and submit the form to the Radiation Safety Office. For further information about pregnancy declaration, please read the Guidance Document from the State of Tennessee: http://radiationsafety.utdev4.wpengine.com/wp-content/uploads/sites/20/2013/04/State_Pregnancy.pdf

Recordkeeping

EHS will maintain any monitoring records and chemical inventories for a minimum of 30 years. Any medical records will be maintained for at least 30 years.

All health and monitoring records shall be treated as confidential.

Training

EHS provides general lab safety training (which includes hazard communication). The Biosafety and Radiation Safety Offices also provide hazard-specific training for students, staff and faculty. In addition, supervisors should provide on-the-job training and communicate any potential reproductive hazards to employees. Employees must have access to SDSs and other agent-specific information as required by regulations and/or institutional policies/procedures.

References

OSHA: 29 CFR 1910

Disclaimer

The information provided in this procedure is designed for educational use only and is not a substitute for specific training or experience.

The University of Tennessee Knoxville and the authors of this procedure assume no liability for any individual’s use of or reliance upon any material contained or referenced herein. The material contained in this procedure may not be the most current.

This material may be freely distributed for nonprofit educational use. However, if included in publications, written or electronic, attributions must be made to the author. Commercial use of this material is prohibited without express written permission from the author.