••• Chapter 63^ Reproductive Toxicology^637
❍ Is working as a medical resident harmful during pregnancy?
Overall, residency training has not been shown to cause spontaneous abortion, preterm birth, or low birth weight.
However, when women worked >100 hours/week, preterm birth rate was slightly increased. Mild preeclampsia that
was not associated with adverse pregnancy outcome was also increased in women residents.
❍ Should pregnant anesthetists and nurses be allowed to administer anesthetic agents?
Yes. Provided there is adequate ventilation and a functioning gas scavenger system in the operating room so that
any possible fumes or vapors are quickly dissipated to the outside environment.
❍ What are the major reproductive hazards facing pregnant health-care worker?
Working with antineoplastic and carcinogenic drugs in improperly ventilated areas has been associated with
increased risk of pregnancy loss and congenital anomalies. Anesthetic agents may increase the risk of pregnancy
loss, but do not appear to increase malformation rates. Infectious diseases such as hepatitis and HIV pose a risk to
workers and their fetuses. Chemical sterilants widely used in operating rooms, pharmacies, and laboratories may
have reproductive toxicity. Lastly, the stress on residents imposed by long working hours may increase the risk of
preterm delivery and preeclampsia.
❍ To which toxins are a ceramic artist or a painter exposed?
Ceramics artists and painters may be exposed to lead and other heavy metals. Kilns emit toxic gases including CO.
In general, you won’t know what her exposures are at work or at home if you don’t ask!
❍ In which occupation do workers face the greatest risk of job-related violence?
In a 1996 report, OSHA stated that more assaults occur against health-care workers and social workers than in any
other industry. Pregnancy does not offer any protection against violence.
❍ What is the primary problem facing women who become pregnant while living at high altitude (>1600 m)?
IUGR. The average birth weight decreases by 100 g per 100 m of elevation for term pregnancies. Smoking appears
to exacerbate the effects of high altitude on fetal growth. As far as traveling, it seems probable that a 2-week visit to
moderate altitude (<3000 m) is unlikely to affect the final birth weight of a baby.