Safe working while pregnant

RE: Safe working while pregnant

Clover — Wed, 01 Jun 2016 01:43:49 GMT

Is A fluosorber "adequate scavenging"? No pumps just passive. We have a nurse planning a baby at the moment and trying to find information about iso risks.

RE: Safe working while pregnant

Julian Earl — Tue, 24 May 2016 08:30:14 GMT

Congratulations and hope all goes well. I think that apart from the radiographic risks, the main hazard is probably zoonosis, specifically Toxoplasmosis from kittens. So either get someone else to do the cat/kitten work and don't handle anything without gloves. Ask colleagues to help, that is what they are there for!? Best wishes.

RE: Safe working while pregnant

Clare Tapsfield-Wright — Fri, 29 Apr 2016 18:14:15 GMT

[quote user="J G Wray"]

[quote user="Gillian Mostyn"]child-bearing age [/quote]

I think the term is "child bearing potential", because the menopause is no longer a barrier to having children. How times have changed.

[/quote]yes come next year the male vets will be having them too no doubt

RE: Safe working while pregnant

J G Wray — Fri, 29 Apr 2016 12:15:08 GMT

[quote user="Gillian Mostyn"]child-bearing age [/quote]

I think the term is "child bearing potential", because the menopause is no longer a barrier to having children. How times have changed.

RE: Safe working while pregnant

Wren — Fri, 29 Apr 2016 12:05:17 GMT

[quote user="Gillian Mostyn"]

[quote user="robloxley"]Can you state the source of this 'rule'; I cannot find it in IRR 1999, the HSE ACOP or HSE guidance indg334[/quote]

Hmmm...I could have sworn that this is part of our local rules but you're right it doesn't seem to be a general rule.

[/quote]

I'm pleased about that! I was scratching my head wondering how it would apply to ambulatory equine practice, where we're pretty much in contact with the machine the whole time, including while the exposures are taken.

RE: Safe working while pregnant

Gillian Mostyn — Fri, 29 Apr 2016 11:59:21 GMT

[quote user="J G Wray"]the workplace should have safe working such that no change is required for the special circumstance which is "expectant mother" [/quote]

That phrase could only be uttered by somebody who has never been an 'expectant mother' in the 3rd trimester! Try strapping a 4 stone beachball onto the front of your abdomen, have somebody repeatedly punch you in the bladder/diaphragm/ribs, and only be able to eat three mouthfuls in one go before feeling full, and then tell me that your current daily routine wouldn't be disrupted!

Flippancy aside, I do know what you mean though. I would guess that 3/4 of staff in the veterinary environment are women of child-bearing age so (aside from the obvious necessity of looking after all staff of both genders and all ages), you should be working on the assumption that any one of them could be pregnant at any given time.

RE: Safe working while pregnant

Iain Richards — Fri, 29 Apr 2016 08:43:09 GMT

"If I had told her she would have to carry on lambing sheep against her wishes then I think I would be in a very much worse position if she aborted due to toxo!"

Michael, I'm ashamed of you. No transmission of toxo from sheep........

Iain

More likley from pink lamb or old cat poo in the garden

RE: Safe working while pregnant

J G Wray — Fri, 29 Apr 2016 07:34:36 GMT

[quote user="Michael Woodhouse"]Life is a risk. I could be killed driving my car tomorrow. I would not be very happy if any of my farmers had a 8% (never mind 20%) abortion rate![/quote]

Well, we've got one Yawk-shuh-mun so I raise another. Bob Partridge has always been completely coherent on this subject. His view is that the workplace should have safe working such that no change is required for the special circumstance which is "expectant mother" - note use of language.

Safe working is not a matter of choice . As an employer or colleague it is your responsibility to see that policy is followed. If it is not, then, as an employer, you are caught on the hook of insufficient supervision and enforcement - even in Yawk-shuh.

RE: Safe working while pregnant

Gillian Mostyn — Fri, 29 Apr 2016 07:29:05 GMT

[quote user="robloxley"]Can you state the source of this 'rule'; I cannot find it in IRR 1999, the HSE ACOP or HSE guidance indg334[/quote]

Hmmm...I could have sworn that this is part of our local rules but you're right it doesn't seem to be a general rule.

RE: Safe working while pregnant

Michael Woodhouse — Fri, 29 Apr 2016 00:55:41 GMT

[quote user="robloxley"]As an employer can you absolve yourself of your duty of care to your employee like this??[/quote]

We discussed the sheep issue. Conveniently she got pregnant as lambing was practically over. We discussed risks and advice not to be near periparturient sheep. She was happy if a late season lambing came in OOH doing it with suitable PPE.

As far as I'm concerned we looked at the risks and put a sensible plan in place. As I said earlier - not doing on call for months on end is not possible in our practice. She was happy with that arrangement, and therefore so was I. If I had told her she would have to carry on lambing sheep against her wishes then I think I would be in a very much worse position if she aborted due to toxo!

[quote user="robloxley"]All the more reason to take steps to prevent it??[/quote]

Is there any evidence we can prevent the risk? Do we have figures for the diagnosed abortions caused by enzo and toxo? I can find the data from sheep quite easily submitted to the AHVLA.

I'd be much happier putting more stringent measures in place if we knew what we were trying to achieve. The last thing I want to do is put anyone in a position where they (or their fetus) undergoes harm. Obviously. We still can't wrap them up in cotton wool just because they chose to have a baby.

Life is a risk. I could be killed driving my car tomorrow. I would not be very happy if any of my farmers had a 8% (never mind 20%) abortion rate!

RE: Safe working while pregnant

Rob Loxley — Fri, 29 Apr 2016 00:41:45 GMT

[quote user="Michael Woodhouse"]I would leave such things to the individual's decision[/quote]

As an employer can you absolve yourself of your duty of care to your employee like this??

[quote user="Michael Woodhouse"]Miscarriage in early pregnancy is common[/quote]

All the more reason to take steps to prevent it??

RE: Safe working while pregnant

Rob Loxley — Fri, 29 Apr 2016 00:35:56 GMT

[quote user="Gillian Mostyn"]This is not just practice policy but a general use of ionising radiation rule - same as applies to under 18s. You must not be in the room when the power is on to the machine. Ever. [/quote]

Can you state the source of this 'rule'; I cannot find it in IRR 1999, the HSE ACOP or HSE guidance indg334?

For guidance on xrays in pregnancy you want to read http://www.hse.gov.uk/pubns/indg334.pdf including:
Examples of precautions that can be taken ■ If you work with diagnostic X-rays, you should keep as far away as practicable from the patient and the X-ray tube while it is on, preferably behind the protective screen. If you have to be outside the protective screen during exposures, you must wear a lead apron that is comfortable to wear, fastened properly at the sides and covers your abdomen comfortably. Your employer will need to check that such protective measures do not create other risks such as back problems. Although it is not a legal requirement, it may be possible to wear an active dose monitor for additional reassurance. ■ If you have to be inside the X-ray room itself and can move further away from the exposure, this could halve your radiation dose
etc.

RE: Safe working while pregnant

Gillian Mostyn — Thu, 28 Apr 2016 22:47:49 GMT

It doesn't compare at all to the sadness of a miscarriage, but my daughter was born with a large and permanent facial birthmark. I spent a very long time wondering if I could have done anything at all to cause it. Eventually my logical brain won and I came to terms with the fact that 'it was just one of those things'. Even though we are all scientists, when our own children are involved it is impossible to be objective.

RE: Safe working while pregnant

Michael Woodhouse — Thu, 28 Apr 2016 22:40:31 GMT

[quote user="savet"]benefit of having a husband that is not so biologically minded!!![/quote]

He managed to get you knocked up............

RE: Safe working while pregnant

Gillian Mostyn — Thu, 28 Apr 2016 22:39:18 GMT

Apparently:

Standing As pregnancy progresses into later states, the curve in the lower back increases, which means the back muscles must work harder to help the woman maintain her balance. As a result, after standing for an extended period, the woman may experience lower back pain. Some studies have shown that prolonged standing is a serious pregnancy risk factor. A study of members of the Assn. of Women's Health, Obstetric and Neonatal Nurses found that those who worked more than 36 hours per week, more than 10 hours per day or who stood for more than four to six hours per day had an increased rate of pre-term deliveries (Gabbel).

Female physicians have an increased risk of premature labor compared to the general population. Some research suggests that this risk may be the result of long workhours and excessive standing

RE: Safe working while pregnant

savet — Thu, 28 Apr 2016 22:35:45 GMT

Thank you for the input everyone, it is definitely reassuring to know theres nothing way out there that I need to change.

Just to respond to a couple of points

- re- lifting anything bigger than a cocker spaniel, I wouldn't say I would never lift anything bigger than that, but generally we work to an unwritten 'anything over 20kg you should share the load', mainly because why not prevent/reduce the risk of back injuries etc. if possible? That goes for all staff, not just pregnant ones! Of course there are cases where you can't avoid it...

- re- clearing out my own cat litter tray, I did use the excuse of pregnancy for avoiding this one but mainly because I could get away with it, rather than because I wouldn't clean it out benefit of having a husband that is not so biologically minded!!!

I definitely agree with Gillians post - there is no way that I will ever know whether work related factors contributed to my miscarriage (and deep down I don't really think it did) but if I know I've done everything I can to make sure it was not my fault then I can't ask more of myself. It was such a horrible thing to go through and one of the lowest points of my life so far that I don't want to do anything to increase my risk of going through it again as far as possible. On the other hand, I have a job that I enjoy and am getting paid to do and want to be as reasonable as possible throughout.

Thank you for the help and also for the kind words of sympathy. It is great to have an environment such as this to share these things with.

RE: Safe working while pregnant

Clare Tapsfield-Wright — Thu, 28 Apr 2016 22:32:57 GMT

My sympathy for your loss and I can understand your concern even though it is highly unlikely that anything at work caused it but of course you want to be as sure as you can be.

The fact is that in a practice employing women any one of those of childbearing age could potentially be pregnant so the health and safety aspect has to cover all those employees. We monitored levels of gases in the op room and prep room for everyone's benefit and they always came back very low. We discouraged heavy lifting for the sake of everyones backs. It probably varies in risk with individuals depending on their physical status but I would agree that once you have a child there seems to be no option but to lift squirming unco operative weights from time to time. Anyone who has wrestled a toddler into a car seat at a weird angle has probably been at more risk than lifting a cooperative border collie.

No one should be exposed to X-rays full stop and we should all be less blasé about handling drugs. I wince when I think how Nuvan Top was blasted around in the eighties. The main thing is to feel confident enough not to do anything you feel to be potentially risky however busy you are and for the rest of the team to look out for you. Listen to your body , trust your instincts and rest when you can or feel you need to.

We had individuals who did everything and had to be restrained from overdoing it and others who refused even to bend down to open a washing machine door or lift a cat basket.

Wishing you all the best

RE: Safe working while pregnant

Gillian Mostyn — Thu, 28 Apr 2016 22:27:32 GMT

[quote user="Michael Woodhouse"]Does anyone know of a vet who suffered an abortion as a result of work related issues? I'm sure we all know people who lost babies [/quote]

I know what you are getting at Michael, and you're absolutely right- most miscarriages (to be honest I would avoid the word abortion in ladies) would probably happen regardless of the lifestyle of the mum. Unfortunately these aren't just foetuses, they are much wanted and loved babies. Mum needs to be able to come to terms with the loss, which includes being able to think that nothing they did, or did not do, caused it.

[quote user="Michael Woodhouse"] Lots of farm vets continue to calve cows, do caesarians, return prolpases until the 3rd trimester.[/quote]

I'm sure they do. But do you think they should? Blunt trauma to the abdomen is a significant cause of maternal and foetal death and injury. I personally think that the risk from a cow kick etc is too high - but I guess that's a decision to be taken by the employee.

RE: Safe working while pregnant

Anthony Todd — Thu, 28 Apr 2016 22:17:44 GMT

What's the status of anaesthetic gas monitors now?

Some years ago the monitor used was, frankly, stupid.

Have things improved?

RE: Safe working while pregnant

Michael Woodhouse — Thu, 28 Apr 2016 22:05:08 GMT

Toxo is not immediately infective in faeces, so pregnant women can still clean out litter trays - they just have to do it daily.

It's your cat - you're not getting out of that.....

RE: Safe working while pregnant

Gillian Mostyn — Thu, 28 Apr 2016 22:02:12 GMT

[quote user="Nicola M"]I was advised by one gp not to handle cats from a toxoplasmosis risk[/quote]

Yes - me too!

I was tested (because I assumed I would already be positive, meaning I wouldn't have to worry) but it turned out I was negative. Apparently gardeners and people who work outdoors are far more likely to be positive though. My Dad, as a builder, handled cat shit with ungloved hands far more frequently than me (lumpy sand - always a guarantee once the sand delivery had been on the floor a few days....you'd find the lumps in the mortar...')!!!

RE: Safe working while pregnant

Nicola Cole — Thu, 28 Apr 2016 21:56:29 GMT

Sorry to hear about your loss.

A lot of what you do/don't do will depend on your individual practice, and also your take on things. It's very difficult not to worry about things happening (especially if you've had previous problems) but the vast likelihood is that very little of what you do at work will influence a pregnancy. A lot of employers (I would suspect) would be open to reasonable requests.

So if you're happy with the current set up with your practice in terms of safety then from a small animal point of view there's not much that I think a pregnant employee can't do.

I avoided injectable chemotherapy and injectable hormones/antagonists, certainly i would have avoided prostaglandins if I did any large animal work. I personally would avoid having animals on masks for GAs. If they've got a well fitting et tube, appropriate scavenging etc, avoid being in the room after the vaporiser filled etc then risk is minimal. If you generally walk into the prep room/theatre and it stinks of iso then that is obviously a problem (but that is a problem whether pregnant or not, obviously can have a much bigger impact if pregnant but it shouldn't be happening on a regular basis full stop).

Radiographs-obviously manual restraint should be very rare for any employee and certainly shouldn't be done if pregnant.

I was advised by one gp not to handle cats from a toxoplasmosis risk-in my mind the risk was tiny, I just handled then as normal then washed my hands afterwards and I've certainly never heard anyone else advising not handling cats.

Im not sure if you do large animal work as well? If you do then my one concern would be lambings and toxo-to be honest I'm not sure what I would have done about that but as I'm just small animal it wasn't an issue.

RE: Safe working while pregnant

Michael Woodhouse — Thu, 28 Apr 2016 20:39:22 GMT

How much testing goes on in women who abort?

TBH - I think you are going way over the top not lifting anything bigger than a cocker spaniel. Lots of farm vets continue to calve cows, do caesarians, return prolpases until the 3rd trimester.

I think the biggest risks would be things like prostaglandins, aglepristone, corticosteroids. We have a policy of wearing gloves when handling tablets, but It's not always followed.

Obviously extra care with boisterous or dangerous animals.

Sheep are an interesting risk and hard to quantify. I know a number of female vets who were pregnant during lambing season and actively handing lambs and sheep with no problems (sometimes not knowing they were pregnant, sometimes knowing). None of them suffered harm. We wear gloves for all contact so that has to reduce the risks. I would leave such things to the individual's decision.

Does anyone know of a vet who suffered an abortion as a result of work related issues? I'm sure we all know people who lost babies (and I suspect know a lot more people who have lost a baby and not told us about it). From Google:

Miscarriage in early pregnancy is common. Studies show that about 8 to 20 percent of women who know they are pregnant have a miscarriage some time before 20 weeks of pregnancy; 80 percent of these occur in the first 12 weeks

RE: Safe working while pregnant

Gillian Mostyn — Thu, 28 Apr 2016 18:22:13 GMT

[quote user="savet"]I had a miscarriage back in January and hope to try again soon, but following from my miscarriage, I have been racking my brains wondering if there is anything I could have avoided during my pregnancy that would have prevented the miscarriage, [/quote]

So sorry to hear this - my sympathies. As far as prevention, it is extremely unlikely that you did anything at all to precipitate the miscarriage, but I can understand your caution.

[quote user="savet"]and our practice policy is that no pregnant workers enter the room if the x-ray is on at all, [/quote]

This is not just practice policy but a general use of ionising radiation rule - same as applies to under 18s. You must not be in the room when the power is on to the machine. Ever. I worked around this, as do my staff, by doing everything possible before then stepping out while the nurse/vet turns on the machine and does final beam placement and taking the picture. As long as the power is immediately turned back off, you can step back in. Unless you are alone doing radiography (??) there should be no need for this rule to be a problem.

[quote user="savet"]In terms of iso, our policy is that pregnant staff cannot enter the prep room if iso masking is occuring but that as soon as it is switched off then it is fine to go as normal. Does this seem appropriate? We currently don't have any rules regarding recovery kennels, but following from comments on the other thread then maybe we should consider this?[/quote]

Ideally, pregnant ladies should be avoiding inhalation of anaesthetic gases at all. If one of my staff insisted on this, I would comply - but no staff actually request this - I guess noone wants to spend all day consulting/cleaning/filing! Sensible precautions can be taken though:

- all ET tubes cuffed and checked for leakage

-no masking

-adequate scavenging

-Leave animal connected to machine on oxygen for some time( maybe 5 mins or so) after the procedure finishes to ensure as much of the gases are removed as poss.

- avoiding spending any more time than necessary in the kennel room.

[quote user="savet"]In terms of heavy lifting, I guess as a rough guide that I set in my own mind, I am quite happy to lift animals that equate to the size of a toddler (as I figure if I already had children and then had a second then this is what I'd have to do at home), and in reality this equates to about cocker spaniel size and therefore anything much bigger than this then I would likely ask for help lifting regardless of pregnancy status! [/quote]

I think it is difficult to have absolutes with handling issues. Certainly a pregnant lady shouldn't be lifting heavy animals. But neither should they be wrestling on the floor with a wriggly spaniel or being pulled along by a boistrous lab. I'm also reluctant to let them handle aggressive cats, as cat bites and scratches could be a problem, esp if meds are then needed. In an ideal world, we should be able to employ teamwork and cooperation to make everyone safe - but i do realise that in some practices, hard and fast rules are needed to ensure compliance.

Good luck with everything!

RE: Safe working while pregnant

Marie Kubiak — Thu, 28 Apr 2016 17:57:56 GMT

Hi,

I had a similar scenario - contracted pneumonia following avian flu and miscarried, I then refused to see any birds during my following pregnancy due to flu/psittacosis risks.

I was happy doing gas GAs with a tight fitting mask but not those where iso was wafting round the room and after vaporisers were refilled I didn't reenter the room for 15mins.

We all exit the xray room during exposure as routine so needed no change and I was happy to be in the room between exposures.

Marie