Document RjexDzNZL6pyz1RJ94R15O4rz

July 22, 1975 cc: J. M. Quinn TO; SUBJECT: J. M. DeVoe XCD Mfg. DAB-G Baton Rouge North Vinyl Chloride Standard Engineering Requirements The Safety and Health Standards for employees subject to exposure to vinyl chloride was published by OSHA in the Federal Register on October 4, 1974, and are reproduced and attached including marginal notes which appeared as corrections in the Federal Register of December 4, 1974. These regulations went into effect on April 1, 1975, not January 1, 1975 by or^er of the court. Paragraph 1910.93q(f) outlines the method of compliance and is reproduced below: ) "(f) Methods of compliance. Employee exposures to vinyl chloride shall be controlled to at or below the permissable exposure limit provided in paragraph (c) of this section by engineering, work practice and personal protective controls as follows: (1) Feasible engineering and work practice controls shall immediately be used to reduce exposures to at or below the permissible exposure limit. (2) Wherever feasible engineering and work practice controls which can be instituted immediately are not sufficient to reduce exposures to at or below the per missible exposure limit, they shall nonetheless be used and shall be supplemented by respiratory protection in accordance with paragraph (g) of this section. A program shall be established and implemented to reduce exposures to at or below the permissible exposure limit, or to the greatest extent feasible, solely by means of engineering and work practice controls, as soon as feasible. (3) Written plans for such a program shall be developed and furnished upon request for examination and copying to authorized representatives of the Assistant Secretary and the Director. Such plans shall be updated at least every six months. ORlGii't'-w w. C. KOCH w. c. Koch Manager Occupational Health & WCK/smm Product Safety ASI 00022730 Attachment C L'O' S i\~ H ""-.-/-t'. c <7~ tr^n /.v y/ THF ^ A,NCVTj NOVKMBFR 29, 1975 'W tcfv. AS'EN'CFPHU-VS AND APINA BIFIDA IS OHIO VfATI AND IS PUWAVM |.F HOSPITAL, OHIO Year 19^0 I9"l I9'2 t9'3 19*,4 19701974 AnenceyhiJc* Spna bifida Pamvi!le Stale PainwiHc Stile So. of No. of No. of No. of cases Raie* cava Kate cava Rate caw Rate 0 00 26 5 0 3 31 2 5* hi 1 10 3 31 73 3 309 44 8-5 3 2 35-6 24 9 33'! 6-3 54 0 0 0 4" 2 24*9 46 9-6 9.2 0 00 22 4J 1 15 1 29 6*0 6 14] 144 5-7 9 21-2 224 8-9 Ter 10 000 total white births. the discrimination of vector of means can be tested for signifi cance. A high discrimination between the malformation group and its matched controls appeared within the first 10 of the 24 variables see accompanying figure . Even with 8 variables a significant discrimination of both groups at l'J level was found. The discrimination of both groups was also possible without the two factors "abortions/stillbirths in mothers family" and "hours of daily work". So, even in a sample with factors each not discriminating significantly between both groups, the linear discrtminance Analysis makes it possible to discriminate between the malforPnation group and the matched controls. This might mean that the malformations in our sample can be explained as caused bv the combination of many minor factors extrinsic and intrin sic). Instiiut fur Humngeneiik. Ktmikum dee Johsnn Wolfgang. ntvmatJt. Frankfurt am Main. Federal Republic cfGermany.- J. Kt FISFBRtCHT K.-H. Dicfshardt CONGENITAL .MALFORMATIONS AND VINYL CHLORIDE Sta,--In March, 1975, a significantly increased rate of central-nervous-system fc.s.s.t malformations was reported in 3 Ohio communities where polyvinyl chloride t r.v.c. polymeris ation plants are located;' the increase was not uniform and appeared more prominent in the Painesviile area. "ITiere are two r.v.c. plants in Painesviile, one of which began operation in 1949 and the other in 1967. The birth-delect rates were computed from binh-cenificate data for 1970-73 and were compared with simitar data for the entire State of Ohio. This study suggested a relationship between the higher rates of c.s.s. malformations and the increased risk of exposure to vinyl chloride in these communities. By analysing data collected through the Center for Disease Control's hospital-based birth defects monitoring programme (b.d.m.p. V we examined this relationship. Two hospitals parti cipating in the b.d.m.i*. are located in cities with polymerisa tion plants: one is in Pennsylvania, the other in Patncsville. Ohio, c.s.s.-malfortr.ation rates for white infants born in these Ihvo hospitals in 1970-74 were compared with the rates for white infants in each State. No increase was seen in the `Penn sylvania hospital, but an increase, primarily in anencephaly and spina bifida, was noted in the Painesviile hospital for the total lime 1970-74 (see table-). 1. Infante. P. in Proceedings of the Conference on (.Vcupjlional C.arnni'peneM, at the Neve York Academy of Science. 25 March. 19*5, \r Yorts in the press . 2. Center for Disease Control. Congenital Malformations Surveillance Annua! Summars 1974. Atlanta. 1975. The b.d.m.p. hospital data for Painesviile were compared with birth-certificate data from the Ohio department of health, and 1 additional case not included in the k.d.m.p, report was added, bringing the total to 15. 30 controls, the first normal 1 white infant born before and after each case, were, selected from the hospital birth registry. Medical records lor,cases and controls were reviewed to confirm the diagnosis and to obtain.,;,. among other data, the parent^' occupation and residence at the time of the infant's birth. In addition, parents of 14 of the affected children were interviewed abouit previouss occupatioonnss;,- . and residences. v- The study revealed that none of the interviewed parents of ... V ' ' 7, A affected infants had ev:-eerr.worked at either of thef,-two; r.v.c.-polymerisation plants in Painesviile <1- set(:of.;pars records show that of their infants' births. None of lived within 2 miles of the lw,pian*.';cT^\fcfe^ significance , was used,! in comparing The::distahces;;'Ti^;;^ :V:: ' 7' residence and scork-place of motherland plants, for cases and controls. Comparisons.were .iriade|;at;'y ;'; distances of 1 to 10 mites. in 1-mile increments;);A(signifii:anilyii;^ larger proportion of control mothers tha.ii .including housewives',within a 10-mile,radius'of.thei'pA'.c., . plant, at the 95'J confidence level.i.This. J occurrence among multiple^ Vinyl chloride is a known carcinogen.*. "artdyconcerh'ijjiiwi;^^ arisen over its possible lerawf^ic-effeCTi2.ji^i*^ i*'., from recent studies which have shown s a; an increase(i'muta-ii ' genicitv in bacterial in chromosomes Department of gested that Although the' follow-up study moderate increase in c.n.s. malformations(iiti no association was found with....... -.........-- -..r------- --- - . , v.; i Canetr and Binh Defects DWm Kureau of fcpdemiok'jD, Center for lWavc Control# Atlanta, Georgia 30J33.l'.SwC 'V';!lARRvb}:EDMOSl>S^F'7 '' " .' . 7:HfnryFalk . ; , ;y,,v. \v LATE CO.MPLICATIONS OF TUBALLIGATION Sir,--Unlike Mr Darwish and Dr SaafanyNoy; 15, p. 975 >, . we are uncertain as to the *tiology-`of theilate '.s^uelar.-of. female sterilisation, which they refer to as menstrual irregu- : ; tarity. but in our study it will be noted we looked specifically at menorrhagia and dysmenorrhera. It seems unlikely that a pxv- '. chosomatic. cause could be present when two. different, tecl. . 3. Ce9nt.e1r9t'o4r,pDiv*e9*.*** Control. .Morbiditv snd Mn*r'tahiv,W\ peM7'v.*`vKrfWi. /Feb- , 4. Rannup. l\. Jehamvon. A* Ramel. C.# VTachroeFter. C` A. AmN**. 19*4. 194. ' 5.FunevCravioto, F . Latakrrt. B.. Lmdsicn, J. Lancet. 19*?. i. 4?9. CO t' CM CM o o o 00 < THE EFFECTS OF MATERNALLY INHALED VINYL CHLORID/qN EMBRYONAL AND FETAL DEVELOPMENT IN Micfe, RATS AND RABBITS BY: J.A. John, B.A. Schwetz, B.K.J. Leong, F.A, Smith K.D. Nitschke, H.D. Haberstroh, F.J. Murray M.F. Balmer and P.J. Gehring REVIEWED BY: P. J. Gehring December 19, 1975 Toxicology Research Laboratory Health and Environmental Research Dow Chemical U.S.A. Midland, Michigan 48640 Vk-'j<0' - : V lYFl-Fht : - |Vv;;t:i;yV;Vv';:c,:irH "'J'' ' ;`'v\ `'y1;';! , *. - , \-,, , V' This study was funded by the companies supporting the vinyl chloride : projects being administered by the Manufacturing Chemists Association, Washington, D.C. ' - ,,, 1 Ir :>- The results of these studies indicate that exposure of pregnant mice, rats or rabbits to vinyl chloride by inhalation at con centrations sufficiently high to cause maternal toxicity was not teratogenic in any of the three species. A significant increase in the percent resorptions was observed among; mice exposed to 500 ppm vinyl chloride, but not among rats or rabbits exposed to 50o ppm or 2500 ppm vinyl chloride. Ingestion of 15% ethanol in the drinking water enhanced some of the .effects of inhaled vinyl chloride. ASI 00022732 4 --**-* i i. criteria for a recommended standard . . . . OCCUPATIONAL EXPOSURE TO BENZENE 'v v ' 1-c: . 1 L; L'A : ' `\.e \ u,- '/',, 1 '`"V, ; - , f, ' \ , ',v U.s. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE. Public Health Service Center for Disease Control, National Institute for Occupational Safety and Health 1974 ASI 0022733 It is concluded from study of the rclcvcnt reports that an increased susceptibility to benzene of pregnant women or their offspring has not been demonstrated. The risk of exposure of pregnant women to benzene at levels below 100 ppm has not been defined. The literature contains statements such as that of Cassan and Baron [60] in 1956 that a pregnant woman must be removed not only from the work station but from the room where work with a benzene exposure risk is performed. Their statement is based (in part) on the measurement of RBC between 4.0 and 4.25 million in two pregnant women following their removal to another part of the room from the work station where they used a benzene varnish on electrical equipment. There are special requirements placed on the hemopoietic system of women in general, and especially during pregnancy. Although no definite hypersusceptibility to benzene vapor has been shown in women, pregnant women, or their offspring, it may be prudent to avoid exposing pregnant women to benzene. In the study by Smith, [16] the ages were quite evenly distributed, between 17 and 52 years. Susceptibility to benzene poisoning was about equally marked between young and old, so youth was not considered, to be a predisposing factor in benzene poisoning. 1 . In view of the borderline hematological changes which occur in both . -. ,i ' roan and animals from exposures to benzene and of the consequences .which result from overexposure, it is considered that a conservative limit roust be recommended. Therefore, in order to provide protection of workers to the effects of benzene poisoning over a working lifetime^ it is recommended that an environmental limit for benzene of 10 ppm as a time-weighted average for up to a 10-hour workday, 40-hour workweek be adopted. In addition, in order to preclude acute effects from benzene, it is considered AS I 00022734 73 He|.iiiMlctS 11oin Ji>h buluty A liujlih fvi.iijcigiiit! April 1075 Vol. T No. 4 II .> l h :| i. nil ii' 1mI I .i; ii Occupational Safoly and Health Administration urn strong, I am invincible. 1 am Marret!, a University of Wisconsin soci woman,"' sang Helen Reddy in a ologist, oilers some explanations. "Today ong dial lias bet omc almost an there ate few of (lie obvious abuses'' to the women's movement, 'the women workers that often were the rallying , a forceful rallying cry, but the points for both reformers and researchers in is that women are not invincible. And previous decades." she says. "Perhaps even men. "f lic human body, of either more problematic is the fact that concern indeed fall prey to the various as- for wuiwit'.v occupational health seems"in-~ c workplace. aditionaily, working women have been into ``women's jobs" because consistent with the current thrust toward equality.'' In the old days there were abuses aplenty. `weakei sex." 'this reasoning Shock''d by stories of deplorable working ' too:.Wf;.4: 5~Vv;Vkv"t:\1a1 handy excuse for job discrimination, is many women have known all along. lurked behind conditions. Congress in HU'S funded a study of the problems of working women. At about. the same time, an investigation of phos phorous match factories revealed serious force of law behind poisoning among the industry's 2,M() wank jobs," they share full range of safety again the question women react differ: 1 y to job stresses and toxic substances? beiously, there's one very basic difference between the sexes: women have babies. And mcc (his fact of nature isn't likely to change, iy consideration of the occupational health vi of v omcii also must include the health of the neat genc ation. these issues come to the lore as women enter the labor foi cq^feivet -inet casing num- ers. about half of whom were women and children. The phosphorous poisoning caused degeneration of the bones., especially, the jawp producing a horrible deformity known as "phossv jaw." A few years later, in 1912, :l54 ;wpmcn am! girls died in a ftfc at New York City s Triangle Shirtwaist Factory, a building that had no tire escapes^: Snell tragedies led many slates to'pass so- called "protective legislation"- to spare the "weaker sex" from long boms, hazardous jobs, and unsanitary conditions.- As w^jmm cmt- nver inhs vacated by men during ^^pd "'j*`lt**^'**t Obv* ious! v' , tlici c's one veiv bask diff-erence 7:'.between the sexes: women have babies. And : met this fact of nature isn't likely to change, vk-g>TCY any consideration of the occupational health -CVY*'*. ,,f v-oincn also must include the health of the nc,-.t. generation. 1 Itese issues come to the lore as women enter (he labor force in cvcj -incieasing num bers. Women today account for about 40 percent of the nation's workers--compared to 20 percent in 1920. Fifty yeats ago the continued. Occupational health pioneers average woman worker was single. Today like Di. Alice Hamilton, believing that site's mat ried--and in the child-bearing age women were mote susceptible to such -haz 1 ange. ards as lead, uras'd passage of special laws Yet, Ibete is an appalling lack of scien- to protect women in the workplace. ii he inlormntion about the occupational I iiem in 1920--the-same year women got health of women and especially about the the vote--Congress created a Women's dfccts of job hazards on the fetus. Conse Bureau within the Department of Labor to quently, none of osua's standards contain promote employment opportunities for wom `pccial provisions for women, pregnant oi en and to look out for the special needs of nun-pregnant, and criteria documents on women workers. ivconimeuded standards t:ansmilted to oianx by the National Institute for Occupational Safety and health (kiosiiI barely touch (he subject of special hazards lor women. The whole issue, of course, is further clouded by another (homy question: In a time when women ate just beginning to When Rosie the Riveter and hs'r cohorts moved into the factories during World War 11, the ll.S. Army decided to sponsor a study of women's capability to pet form certain jobs and of "the lelalionship of employment to the Health of women." The resulting re port, ItVmeu In Industry: Ihcir Health and enjoy (lieir newly-won tights to equal em I-1flicinicy by Dr. Anna Baetjer of Johns ployment at equal pay, how do we assuie Hopkins University, concluded that "there them safety and health at wink while pm- is not reliable evidence to support the gen tecting them from farther job disci iniina1 ion? erally accepted view that women are more susceptible than men to occupational dis A long v/ay, batty? eases." She added: "There is, therefore, at present no icason why normal women should For about the past 50 years, the job safety be resiiieted any more than men from work and health problems of women have ranked ing at jobs which involve the use of toxic at the bottom of the research list. Cora chemical substances. Under all circtim- ' i?'.,1 ;wa ssem, c s'.,mes i! ..' XjH'N'l ` L'-. shouto l ept ! ee ".v `""l tm per l!k] v.jim, ! iowever. Ilia t because e; dee pie, vichphea! c It.mges dm: I dm mg j>jv J\ , P 11 e i e is c:; ; y reason to bell we lie,'i p;e^ur! women mtg bt be a.d- womb. a!' -ped h\ c,\ ' N 'J [ C * t ' {.'oneentra- Ian's o 1 to \jc MJ'vstiinc cs which wo utd usual, , , r p. !.' r ; di iv, ;i! women " h lie repoit ; P;,; ;p of i.ainuN .V.amiards f,.. a: CJ;: c of v ; i *'h a n p \, v.. h 1 c: i ;:;;; a;: 'led against png,a ee v. w;,:cn Ivi Mil C ypphCki to such j ( , ; j i i ; x. VlVCi'C, ;\>r. ::n';;w\a !e, carbon ' ' id'ede;' s ; s , ,, , , , hi jsi]:;d hi i h'lh, siiii i epics-ms li'.i '! ot \ nut is known ebon! iiow immOi !.!! cmpbwm.m; aliccls women, pieg- mm; w : I';, .r w !-i j:i the 'AVI' ended, men we:: !w!, m 'in: b:cd>: :cs. and women '.veil! duck m die dome Women's occupational s;:; e r , ,t ,, r l t ^ x aOn w i'A I' i u.eie , ,,, f 1 to M ' ' 0 11 !" ;d .'m tirlb'B as loo x on A'nh r N If ! ` ..' i'i It 'V: '`^k' s' earn and 'do die;: ea " ] " I ' S - s C . ; \ i: i'JIO ' .I00: `'0 became ad: in n :eut W o;;ip, ' l' )}, B at sine e l: ic pass 0!' of dm ('em ipationa! Sale ty an d 1 i end ii Ao f in ! 97b, eoneein ado: It WO! lie i 1 WOI k, M S has icvived as pan of i de mo '' c towa: d protecting a!! wot'ket s fiou ; |oh ll-Irnods, Alt cntioii 1k>s focused, espc C i a I! y on pi egu:ml \\'omon ns news of bin! i defee'Is iand ca, new among children of modlie: s .\ ho took certain drugs during mvg nancy hit the fnout paces. America's best kept secret One sociologist Inis celled the working women, and especially the woiking mollier, "one of Amei ice's best kepi secrets." Despite their glowing numbers in the work force, women have received scant elleniion in epidemiologic Mudies. "A review of the pasi five yceis of journals which publish occupational licallh studies gives the sub jective imp:cssioii ihel the woman worker is mn peit of the work force that is being dcscnbed," sn\s Dr. Vilme Hunt, tin cpideiniologist fiom i'enn Stele l hii\ cisilv. She cues as a typical example a paper that dclmcd die study population as 31,203 male cmp'ovccs of a patlienlar plant and added tinii "m older to simplifv dcsien, the 5,2b] female employees were excluded from the st iidy." in one of the few studies that did include info, ami ion about employment dining piegn.uuc;,-- a health inter, icw smvey conducted to the National Center lor Health Sialisti oiiiinj' I hoj-A3- .women weie not asM what jobs they held l heir husbands' o cupabons were, however, carefully noted! I'enn State sociologist Dr ildna Rapha points out dial investigation of women woik experience is dillicuit because worm often want to forget the unpleasant and. u rewarding jobs ducy held before martin;.: Data colicctimi b, further hindered hceau many mail ictl women have varied work hi tones that include moving bom job to jo repeated entries and exits from the lab. foice, am! both part-time and full-time ci ploy meat. To some decree, the lack of reseat eh is direct result of so few women in imlustri. jobs. As Dr. C. Cram Wright, president < the American Occupational Medical ,\ss< ciaiiun fanM-M, points out, "It's only set recent!: drat lawn and the encouragement i women's groups have resulted in more won en---and more pregnant women----'working i industry. Because of tire Itrek of information, man of the stereotypes about women worker rest on shaky foundations. Dr. David We: man of the Harvard! School of Public 1 leall suggests that common beliefs--women ar too weak to do heavy work, women canm tolerate temperature extiemes as well a men. women ate moie susceptible to lost subsiances---are mostly well cultivate myths. Studies show that on the avorag women's absolute strength is about two thirds that of men. However, Wcgmai points out, other studies reveal more dtlfer enees in strength between working and mm working women than between working worn cn and working men. And although tin temperature regulation mechanism apparent !y is different in the two sexes. women ca: regulate their body temperature equally a well as men. Therefore, Wegmnn urges cm ploycis to set criteria on work strength am endurance for specific joins and then to hire individuals, regardless of sex, who can meet those criteria. Wegman points join that caih judgments about women's greater susceptibility m certain substances bflen were based more on opinion than on proven fact. For example, a study showing ihtjit women wcic more sus ceptible to hen/ciu' was eounteibalanced by a study suggesting that men were more sus ceptible, although1 in neither case were exposure levels refiorted. In fact, it is dif ficult In dispute Afina Baetjcr's conclusion AS I 00022737 'tlial non-pregnant women are no less tolerant fef toxic substances than men. W Even some beliefs about the effect of woik on pregnant women are not supported by solid evidence, Wegman contends. While some studies suggest that working kite into a first pregnancy may increase the chances of premature birth, other studies show no effect. Most authorities agree that working during pregnancy rarely create;, complica tions. although some common-sense pre cautions--against fatigue and heavy lifting, for example--are necessary. When it comes to the effects oT job ex posures on the developing embryo, Vilma Hunt believes that researchers have ignored an important population-at-risk--the thou sands of children who were present in work places during (heir mothers' pregnancy. According to the National Ccnlei fot Health Statistics survey, almost onc-thiui of. the women who gave birth during 1 b63 were employed at some time during pregnancy. Sixty percent of the women having their first child and 22 percent of those who had had previous children worked while preg nant. Yet, says lUmi, "If we :wb the <|iics*ion. `[s the offspring of the working mother at higher risk than that oT the 11011-working mother?' we still do not have an answer to apply to the United States in the year 1975." Three categories of hazards Obviously, the specific hazards women workers face are ns varied as the jobs (hey hold. But Clara Schiffcr. a program analyst in the Department of Health. Education, and Welfare, suggests dial job safety and health problems of women can be divided into (luce groups: those associated with the sex-stereo typed jobs many women hold; those dial are. common to both women and men workers; and those that relate only to women's re productive ability. "Women's jobs" exist in boil; blue-collar and white-collar employment. Clothing fac tories and textile mills, for example, have tiaditionally employed many women--often in jobs that can iiardlj be called "protected." The Amalgamated Clothing Workets of America (aM.-cioi, a majority of whose |nemhcrs ate women, recently funded a "nc-year investigation by Nio.Mt of hazards in the clothing industry. Industrial hygienist Dr. Peter J. Nord concent!ated his survey on the men's apparel industry, which em ploys some 400,000 workers---about 85 per cent of them women. Although most of these *'ot'i'T ry | i(fI ; vul.c who operate some ;>i:i of sew:ue ri.srhm'.. Nord found dim the me . xposed ,<i a sl'-lliug v,i; iei\ ol hn/;mi\: < 11. iwd to fabri'-s. vniiotr. m.; v.ob lob, v,mi\, and ; pi ;;; rui|ie-iyr\; oil mis':; fro in oil:, used lo h'biijaU' flt's-no; in.g.h mms-' le\c!s fiom macliiuiwv; triehloioeili'.leue, a 'olvcui used to dissolve plastic Ivsliug. bneoK; such chemicals as chl'M`'aprcnc an-.l -'jri.'i'c tint are used to spray the edg ' <d oVah to prove.tit raveling. and Ii.r and dusi ( 'j'-tti should see me in the bd. one woman told Noul. "I "nave so much dir t on me dial the bath water buns ibc co!m of die fabric 1 woiked wilh that day."} Noid found |hai most riudung manufae- furers have no idea what eiiemicak they're using, "dcloic a emmeid is complcdd. as many as |() dill'iuent ehemi'-a!;. may be put . . ''/Spy-. , : ,. S ^ on (lie lafuir to make it perm men! picas ;.Wsisyd; ' and llaine, p'tard.mt." itc save "du! app:w',l msy/" plaids are so Ini down the line firm the ' Cg'/o'd. y chemical plants lieu make diese products / . ,s ;..y and the textile indls din! a;gdy then; no one in the elothiug Indus! r. iculiv knows,1 'd'i-dy.Vydb;;'j'd' llieii biolog'ea' herp;. N- hud and i loro.than it50.v/oiac,!i in humidhy ip c'ndo'ig pi oils cm, emsc die ' a lii'y^t.Ngiwyutj;'^jt:d::;7,s-V,;d chemicals applied to fgbre;. to (-xidi/e and 'dan-jlp Shirtwaist rectmy release such mhsimteex a- I'promi'd-diy.l^ isord iio.es PCI oeci.naownw is common among pri Dusl and rtangefous machin.ji/ are common hazards in many "women's jobs" in *"> textile Industry AS I 00022739 oaf tini-lies -m e.lnth. hu! i>r' one lias yet studied tfic cMcut o! this j>ri'I>K'ut in the cleibfig in-lustrs. IK believes lliat puliiMmaiy function tests also arc needed to determine iT respiratory disease, results from inlialifij! dusts an-l fibers fiom chemi cally treated talnic. Some attempts to control hazards in clothing plants aie almost laughable. A common sight m storage areas. Nor! reports, is a leij; of charcoal briquets hanging from the ceiling to chemically control formalde hyde. In an elfort to control fumes, one manufacture r installed a hood vent near a spot dry ci-'aninp operation. but ther exhaust liibc s-mph looped imtler the woil: table- -- anti cmled! 'n another plant, buttonhole ami bar lac1, machines vane lilted with plastic, .-livid:; to protect the seamstresses from ib.in-' bi.'ken nosIKs. Ih-wcvci. the plastic was td such poor quality lliul the women '.'"t headaches fiom trying to see through 't to r.iii-le their work. I heir solu tion: icinoic tiv guaids. In some parts, of Appalachia, many women who wnk must ciioose among the textile and clothing mills that have Hocked to the region. Work ini: conditions in some of those factories are dcseiibcd in a recent book, nitihilly Women, by Kathy Kalin. One woman employed in a north Cicorgi carpel mill tells what it's like to work in th pervasive dust: `Thci",s no place in th mill to move away from the dusl. They pc ait hoses in there to move the dust, but just made more dust for us to breathe of: Now they stopped that cause it was makin our eyes po bad." And because of the oftc brutal pace in the mills, some of Hie womc have a drug culture all their own. `Til! can be pot just by snapping your fingers, says (lie carpet mill worker. "The womc have to use them lots of times cause of th rotating shift and getting used to it. Sec they have to keep up their production. S they use the pills to speed them up whe they don't feci so good." In some lines of work, "women's jobs" ar not only lower-paying and less prestigiou but also potentially more hazardous. I some clothing plants, for example, men hav the higher-paying job of cutter while womei operate the machines. In her - survey o women's jobs in the District, of Columbia Clara Schiller found that in laundries met usually arc employed to run the washin, machines, but women are hired do do th pressing--and consequently : to. experience heat stress. .y 'y/. ,\.;.v You can always be a nurse, stewardess bor the woman who has aspired to a pro Icssion, and who ciuildialTord the training there have been juiy 'mimber of "appropriate' jobs--nurse, lalxiratiiry technician. airliiu stewardess, teacher, be;iutieiah.;TiKlay wc'ri finding out that these jobs aren't as safe at they look. 1 In ministering to the sick, nurses (am other hospital workers, many of whom arc women) tire exposed to drugs, germicides, x-rays, and radioactive .materials used for diagnosis and treatment:^suffer,back strains frotn Ii11iiig: and risk ilifcctjon from, needle punctures and exposure to contagious dis eases. A recent study indicates that nurses, possibly because they arc on their feet for long periods, arc more susceptible to blood dots in their legs. Perhaps even more troublesome are findings of 'more"spontane ous abortions and clefectiyej,offspring among nurses exposed to anesthetic gases in operat ing looms. A Canadian research group also found a higher incidence ; of birth defects among the children of nurses who cared for infants with infectious diseases : and con genital defects.. An estimated 125,00(1 women in the United Stales work in laboratories, where they arc exposed to radiation, drugs, and qch chemicals as mercury llial have caused a mage to the fetus among experimental agimals. Even supposedly "safe'' occupa* tions, such as teaching or day eaic work, can expose women to rubella and other viruses that could damage the fetus if dis ease is contracted in the early stages of preg nancy. A recent niosii study of beauticians and cosmetology students throughout Utah showed a high incidence of lung problems, possibly caused by inhaling large amounts of hair spray. When it comes to "women's jobs," what could be more glamorous than jetting about in tbe "friendly skies" on the "wings of man"? Yet, stewardesses are making itknown that behind their smiles lurk a variety of health problems that they attribute di rectly to their work. " The average tenure of a (light attendant used to be a year and a half, but now it's more than six years," says Del Mott, a stewardess for 1U years and currently director of safety for the Associa tion of Flight Attendants. "We have some cople who have flown for 15 or 20 years, tad I think the jet age is finally catching up with us." She is trying to get funding for a comprehensive study of the health prob lems that afflict women flight attendants-- kidney ailments, menstrual disorders, alco holism, and a mysterious nerve condition that resembles multiple sclerosis. Mott suspects that ncivousness and perhaps other problems may be caused by the constant roar of jet engines, as well as by ultrasonic sound and possibly even subsonic noise (or "infrasound") that causes body vibration. Then there is the constant fatigue. Mott points out that flight attendants arc not cov ered by the same flight time-duty time regu lations that govern pilots, so it is not in conceivable for an attendant to work up to 20 or 30 hours without adequate rest time. Safely hazards in the air include galley equipment that isn't properly secured and attendants' jump seats that come unfastened from the wall. And with the newer, bigger planes come new hazards. "The DC-lO's, for example, lly at a three- to five-degree angle with the nose up," Mott explains, "so ur flight attendants are experiencing severe eg and back pains from constantly walking uphill or downhill." A perpetual woriy is possible radiation leakage from radioactive materials carried in (lie cargo compartments of commercial airliners. Last summer the Atomic Energy ('ommi .sion (recently icplaecd by the Nu clear Regulatory Commission and (lie Encigy Research and Development Ad ministration), the Department of Transpor tation. and aiilinc employees cooperated in a study to determine how much radiation flight attendants are exposed to, both from cosmic and natural sources and from radio active materials. For eight weeks some 200 attendents wore small dosimeter badges that measured low-level radiation, 'flic results of the study are expected to be available ibis spring. TssW I &. m Del Mott points out that one study isn't enough. "We have enough reports of safely and health problems that it's time to sit down with researchers and ask them to substantiate our own informal findings," she says. Equal jobs, equal hazards In the last decade, many of the barriers to equal employment for women have come tum Flight attendants have their own problem:: at .70.000 , feet: equipment that comes unfastened from waits ,,anrl, noise levels so high in ' some galleys that "we don't talk, we shout." bling down, "flic biggest breakthrough was passage of the 1964 Civil Rights Act, Title VII of which prohibits discrimination based on sex, as well as on race, color, religion, and national origin. The Equal Employment; Opportunity Commission (i-i-or). wliich cn-, forces Title VII, has issued "Uuidclincs;oii j'v' 'k-j Discrimination Because of Sex."A These ;|ar,; hiring based on stereotypes of;thejj'sexes:! prohibit classification and advertising ofjobs; by "male" and "female'' categories; anti, specify that "protective" stale laws prohibit ing or limiting employment of women in certain occupations, during certain hours, or for certain periods before and after childbirth are superseded In Title VII. The law cleat ly gives women the right to be considered for jobs on an equal basis with men. But it also gives them ilic dubious right to share a whole host of occupational hazards. As women move into the construct lion trades and into a wider range of indus-j; ttial jobs, they too must contend with as ,'Vf ;V'v bestos. silica, carbon monoxide.'lead, and other common health hazards--as well as with new chemicals about which even less is known. ; John Zalusky, research director for the Allied Industrial Workers International, Union and a member of the ad hoc commit tee on lead hazards convened by the ALL-, cio's Industrial Union Department, describes what is happening in one midwestern plant: "The plant lias two parts. One makes dec- , ironic equipment, and the other makes lead AS I 00022740 n.-jdin11on Unai: , ar'i an nriI*-'pvnn>!y n( etniniicals may pose health risks lor hrnalr lab employ'-1--i--and their unborn children. Murage batteries for automobil w. 'I here al ready are a lot of women 01111110)0(1 in the clectionies pari where' they can he exposed to lead in soldering fumes, l!ul because' of the equal employment opportunity laws, the company also is trying to move women into the higher paying jobs, which happen to be in the battery manufacturing section. This noans that even more women will be ex posed to lead." Lead is one of the substances that, according to some of the scientific liieiaturc, causes abortions and stillbirths among women exposed to it during preg nane)-. liquidity is a mixed blessing for other women woikers like Juanita Mims, a mem ber of the United Furniture Workets Union and an oigani/.er of the Baltimore chapter of the Coalition of Labor Union Women. '1 he plant where she works now employs mostly women to manufacture curtain rods and dtapery hardware. The workers arc ex posed to dangerous machinery, oil-slick (1 nire, and oil mists from machine lubri cants, and they risk back strains from lifting heavy metal. "The department where 1 work used to be mostly men, but with equal employment opportunity, our union fought for the light of women to have any job they wanted and could do," Mims explains. nane)'. I here was also a (it) percent to two fold ineiease in birth delects among children born to women who worked in operating moms. Yet, only about 21 percent of the nation's hospitals arc now equipped with devices for removing waste anesthetic gases from the operating rooms. There arc other indications of growing recognition of pregnant women as an oc cupational ginup. In its recommended stan dard tor occupational exposure to vinyl chloride, niosii notified osiia that "in view of the preliminary results of animal toxicol ogy studies, it is recommended that no wom an who is pregnant or who expects to be come pregnant should be employed directly in vinyl chloride monomer operations." The recommendation was based on findings by an Italian scientist. Dr. Ccsurc Maltoni. that pregnant rats exposed to vinyl chloride gave birth to offspring alllicled with angiosar coma, the rare liver cancer that has killed a repot ted 32 vinyl chloride workers world wide. No special provisions for pregnant women were written into osiia's final stan dard 011 vinyl chloride because osiia experts did not believe the scientific evidence of a hazard was strong enough for such provi sions to withstand the stilf court challenges they would inevitably face. Tim pregnant worker Unlike earlier niosii criteria documents, the recent document on benzene also devotes '1 he r.coc guidelines also assure specific .specific attention to the potential hazatds for rights for the pregnant woman. Employers pregnant workers: "Although no definite cannot exclude from employment any ap bypcrsusccptibiliiy to benzene vapor lias plicants or employees because they tire liesn shown in women, pregnant women, or piegnant. Fuilhcr. disabilities caused by or their oilspring, it may be prudent to avoid associated with picguancy, miscarriage, exposing pregnant women to benzene." allottiun, and childbirth must be considered temporary disabilities and treated tis such under any health insurance or sick leave plan available to all employees. Perhaps more troubling, though, are some findings from a new field of occupational health icscarch known as behavioral toxi cology---the investigation of subtle changes It is a significant victory for women that in the functioning of the brain and nervous child-hearing can no longer be used as an system pioduced by long-term, low-level ex excuse for discrimination in the workplace. posures to certain substances. Dr. Joan But the abolition of "protection" for the Spvker of the University of Virginia Medical pregnant worker makes it even more ciucial School points out that the placenta is a to learn more about the third category of limited barrier at best and that molecules juh hn/aids- -those that dirccll) alleel the of almost all substances can cross the pla female tepioduelive system. One stud)' that centa by simple dill'usiou or by some type has caused quite a stir is a survey of operat of active transport system. Therefore, nearly ing loom personnel conducted by niosh and every chemical entering the pregnant woman the Amei ican Society of Anesthesiologists --by ingestion, inhalation, or skin absorp 1 he stud) showed that the risk of spon tion--ultimately will be found in the fetus. taneous abortion was 1.3 to 2 limes higher 'Iernlogcns--those substances that can cause among, women who worked in operating abnormalities in offspring--mav have a rooms dm me die first three months of preg special allinity for developing brain centers nancy or during the year preceding preg and produce effects that show' up as bc- ASI 00022741 havinrul problems, sometimes not until latci in life. To determine if there ore subtle mul long^inge effects from picmitnl exposme to ;i euroloxic stibM'.mcc, Spvke: injected healthy pregnant mice with methyl mcicmy. (All forms of mercury, v,Inch is widely used in industry, me capable of converting natmal!y into methyl mcicmy.) When the young were born, she selected for study 372 that appeared normal Close study of these "nor mal" mice throughout their thice-year life spans produced some da;thug results, [he test mice, for examp'e, did not expirnc as normal mice did and could rah seem to petceive the edge of their territory, although there w as no sign of changes in their brains. Spyker found, however, that these early indications of trouble were indeed foiewarninns of later developments: neuromuscular and learning, deficits, infections, posture problems and other stiuclural abnoimalities, defective immune systems, general debilita tion. and early aging. This evidence, Spykci concludes, suggests "dial evaluation ol subtle and long-icim consequences of pre natal exposure is essential foi a thorough assessment of the impact of occupational a/ards on human health." /hat is being done? Taking action on women's occupational hazards within the bouiuiaiics of the law represents a dilemma for labor, industiy, and the government agencies responsible for setting workplace standards. Women themselves tire bringing the issue to the fore. This year's annual meeting of the prestigious .American Association for the Advancement of Science feat mad a ses sion on the occupational health status of women. And women wotkeis are banding together to lobby for impmved conditions. The Association of i light Attendants and the more militant Stewardesses for Wom en's Rights tire lighting safety and health problems at 20.000 feet. The newly-orga nized National Union of Hospital and Health limployees, representing some 70,000 hos pital workers, is trying, to control hepatitis exposures among lab technicians who handle blood plasma, in impiovc housekeeping in the labs, and to look into such potential new Iha/.auis as using microwave ovens to heat wispiiai food. Another gioup that plans to focus on the saletv ami health of female woikcrs is the Coalition of l.abot Union Women, which since its founding convention in March 1974 inn; ehartcicd 32 ' hapten; will' ?,n0() to 3,(100 members nabo'i'wiie. However, many ''./.men on the it b still don't realize the potential humids they face. Pearl ,'lpnullef n| the lutlmi ! Ku-urlmeiii's Women's biucau reports 11ki` most of the letters the 'hm-mi recC'/w, '-till icflecl con cern about diiei imiu.ition an employer try ing tt> prevent a pieman! v,u>i;i.ut hum doing, a job she feds she can do. lor example. To try to aleM women to 'aunt' of il:e problems. Andrea lirieko ol Raloh Nadu's Health Research Group i. wiiiiue a nnmphlel for women workei; lh;,l > u|l lie mn'lab'c late" tltis spring. Inlo'mepou abut" ordering copies can be obtained hum the Health Re search Gioup. ,`ll)t)() p Street NW. Wash ington, DC. 2h On the government In ml Nun.it ean point In its am:-.1 liexta '.nab-, ip tvainmgs about viuvl chloride and benzene, ;m(| io study of eosinelnlonise; `I he Insliiule is pursuing tilt' vinyl eltloiide issue ItiNher by couperaling with the Ohio i)ep:utiuen: ol Health in a studv til umgeniial ahnnri.aihlie.s <;mong residents in the 'leiuitv of vitwl chloride polv inei i/abon pi.mis. niosii aho is con ducting a massive study of employee safety and lieahh piopiums in the nation's hospital' --an clloil that will lesult in seven >eporjs Sometimes Hie snlutisn is ns bod os the pnohlcim, ftiDse aeomcUs ssr>s cic1 lienrJoclic: f;c'ii ctwiCnq to son liiiouuh plastic s'tic Ida demined to niotect ttiem from llyinri. biolion needier;. AS I 00022742 , ;:! /'nn.ii' 'id ;u`iinn i1 v am 'Mo y,n<lri.i ;sm! piowo'e the health of thiee r,''I'o11 1 osoi'.i! voi I>i'rs." Dr Jo.eph \\';'|,oii'-'. diieciri of '/tostt's i ^i: situ i>| buhl Sliiiii'". and ' linicel tn\ , r--poiT. that Mi', division lias a ip. eyed 11 ic DV0V0 substances on niosm's "focio Substances List and found that I}! I of '!io:11 Move shown teratogenic or nmla- p-fuc idr'o'iiosoniO'aHci in;:) clfccls in atii- even minis'edne In ;i' nick ono ho fi izavlcvp lo car l '-aMi. QaO''-sirni".-. b.ooo clue.. and iiiDcucl! dior.'i^-.o; 01^ nrme ol Mir pK.'I'loma riur-.er, wee. !' < -0 >'. nni'-l vo|\ on m:uikI -r `i'I i1 ` i -'la in so: i: i 11/'. ivw '.I a in 1 :n < D And i;:,t . ronooiii/os that unhiding sp'orni pio- vision', iii dan.D is liomui !o iai'-o 11 a: question ..if v umon's lights 'o equal job pi,menu nl. Hut. vo. x lbs Donald I.assiloi, 'M!,'/, i'f o i;11 a'-sisiai.l bn occuonl lonal ). :i1;i. "if thete is auv snlislanli.il ovulonci' i]i: ! dio'o '!lo MHviliij hazards for women of child i'oa'ini: age... `dial thov should not bo ompo-.i. ! to a sulv.ianoo or dial thoir exposure dintiii' !io sno;'iail_v i onlrnllrd - this would p(. ^ruhii in'o standards. If iiifonnalion c.; [() mtcntiou. aland teratogenic , , ,, '. cliC' Is o * u.ish.ia vs o,c already nave smn- i|ai'.i- t r of oaos wo don''----'c woo'd VA WD r>. h'OiS . 1 '-ii%;\y>i .'V.V'd' gf Is , i 1 |y ,, TV f>`i s ,,,%\X-'r`v-wf As d-' 'J J'1 '-V.A.b C] AX, -> Vr V-L ."i.roz * \ \ . Ik * , _ , D-'*v I1 :. >w >.:<.)/ i a rvi J > *i * f f v*. '*Us* - ,,, , "fmmkM B* V Cj Ti ih I f J Vif vo V V. V ?}* .zo>td5.A.; 1_V U. J. '?< 'vrK-insM-j-ida'Df d'lVpvlVfAy '{V- v, > r.a:fi,V `5 'v d J) /: V-;-' ` 'i-D Mlo > , ;'i vv'.NI '".`-Vo/ . -ov:, .:.f. ti;,:' . "iV: , rVv-t 'j1 id-" H f//>''i, atdoniatioallv asf; niosii lo evaluate it, al* ihoiiph niosii. as a research agency, would bo much more likely lo he aware of such inlormation before osiia would." l.assiter points uni dial dsiia is in die position ol Iryini; lo eonirol things dial have never been eonlmllcd before. "Tint's wny wc'rc in the com is all die time. The effects of certain suhsiances on fertile or pregnant women is jns| one nspccl of a field that in general we know very little about." All of this naturally leaves industry in a quandary. As more women move into indusliial jobs once held only by men. larger companies can be expected to take a closer look at hazards to women. Uxxon. for ex ample. plans to start a research program on the elfecls of hcn/.vne on women. "Our lecommendaiion probably will lie dial wom en of child-bearing age should not be ex posed to benzene until the facts arc in." says Dr. Norbcrt Roberts. Exxon's medical di rector. "If we don't take such .action, we may lie in trouble scientifically; and if we do, we may be in trouble legally. Hut we'd rather face the t;t;oc titan a deformed baby." Concern about potentially hazardous oc cupational exposures lias already led to some recommendations that women activists consider drastic. For example, the Environ mental Health Committee of the Lead In dustries /Sssncialion. [nc.. recently recom mended against employing "fertile, gravid |pregnant |, or Inctaling females in the lead industries until such time as adequate in formation has been developed regarding the elfect of lead. . . In a similar case, the National Council on Radiation Protection recommended that in onlcr to minimize exposure to the fetus or cmbiyo. occupational radiation expostne 1 inti is should be reduced for all fertile wom en, Concerned about the impact of such limitations on women's employment oppor tunities and about dig invasion of privacy involved in determinini: if a woman is preg nant or fertile, the Nuclear Regulatory Com mission (nuc) lias talfcn a more cautious appioacli. In proposed amendments lo its regulations, which appeared in die Federal Ucxister January 3. dnj nut did not propose setting dillerent exposure limits for men and women. Instead the regulations would re quire all Niic licensee^ to instruct workers exposed to radiation 'about the biological risks to embryos and fjetuscs, ways lo mini mize exposures, and the functions and pur poses of protective devices. i I I AS I 00022743 New excuses for [liocriniiiiot^on? Otic who f'c.'us a (torn.! against employing women of child-bum mg age in ccilaiii jobs is Dr. Jeanne Siellimm. hcallh mu! safely specialist for the Oil. Chemical, and Aiomic Workers Union (or-WO. She objects to the recommendation of the t.cad 1 ncl ust rics Association because no safe level of lean exposuic lias been clearly csianhshcd for cither men or women. She notes that while [he association seeks to pnlccl women and their unborn cliiUhen fiom lire '.wear',Is of lead, a smvey ol n< aw membeis has shown that a sizable number ol woikcrs m the lead industries already have toxic levels of lend in their bodies. "'Selectin': out certain p.toups in the labot force is the easy way," she maintains "It's a cop-out to exclude just women of child-beat ing age from cer tain jobs while pc; milting older women or men to do those jobs " Aside from the argument lhat cxcluxionaiy policies xiolalc the Coil Riylits Act, Stollman adds, such firaciiccs woultl 11;1 ve an adveise economic impact on women wink ers. She points oul tliat 2.2 pciccni of all z\mcrican household1- am headed by wom en. More than half of these women words and are the sole `-oinee of income IVu ihc family. At least 20 percent of tie: jobs they hold may have potential lode exposures. The solution, as she sees it, is to improve working conditions for all workers, "I con sider it morally reprehensible to be more concerned about the fetus ;han about adult workers," she says. Noting that, human reproduction depends on two sexes, everyone from Mari' Hilton, 'act at home'.' t)i did the occupational ex posin',,- ale.'ct spcrmalogenesis'.' 1 lie scien tists i e emu me it1 led ! 11; h e t investigation Meanwhile, the old question remains: what io do until the data come :n? Most audio: hies agree lhat it's only common sense to keen pregnant women away from suspect matcnals. Bui Harvard's David Wegman cautions that it's simplistic to regard all fer tile women as pregnant or about to become so. "Unfortunately, it's olien assumed that a woman in Ihc child-beating years (15 to 4 5) is pregnant unless proven otherwise," he says. Women workers should be encouraged to report ptegnancics early, because the most dutigcipus time Tor the developing fetus is chinin': the lust three months. Ideally, the pregnant emph'xee should then be trans ferred to an area where she will not be expired to potentially toxic chemicals. "We're gelling to the point where wc arc considering individual needs more." says m w's Clara Schiller, "I don't think special consideration for piegmmt workers when necessary negates women's rights. After all, industry would not put a man who has just had a heart aback into highly physical work or expect a lightweight man to lift heavy objects." t hifpi Innately, few workplaces seem In have such transfer policies yet. According to niosii'-. smvey. less than 15 percent o" the nation's hospitals--which one might think would be especi.illv concerned with employee health--have any kind of policy for transferring pregnant workers to areas where they would less likely receive dangerous exposures. deputy director of the Women's Human, to the Health Research OIrnup'x Andrea Ilricko Suio cute would like to see reseaiel; about die effects (,'leaily, industiy. labor, and government of job exposures on the reptoduclive systems must tecognizc the growing importance of of both women and men. Pointing to some women in (he nation's labor force. There is studies indicating that wiukplacc exposures a crying need lor more information about of fathers may be linked to bjiih defects in women as an occupational group and espe their children. Hricho maintains tint "our cially about the leiatogenic and mutagenic current emphasis on the ha/mds of chemical effects of new substances being introduced exposures for child-bearing ape women mav into ihc workplace every year, lint the sure be one-sided." 'I he Ntostt anesthesia study, erne, as many sue it, is adequate protection for example, revealed a 25 pci cent increase in the incidence of binh detects among children bom to wives of male operating room peisonnel. A Canadian study tiiat [raced the occupations of fathets of chihhcu who died from cancer before the age of five showed that a signi'ic.mt nmnbci of the men held mbs m winch ihev weie exposed to lor all woikets. When all woiking men and women ate assmed of a safe and healthful woikplaee. as the Occupational Safely and I lealih Act was designed to accomplish, theie will mi longer he a need for special cniicein---or a special magazine article--on the occupational safety and health hazards faced by women woikets. hwlmcurhons. Did the tatheis expose their M.\, I chnuirm i\ u<mh into nhltii of Jnn S.VM TY & young children to hydioc.u buns lhumph eon- I It Air! U , AS I 00022744 The intent of this paper is to relate current thougtit in proper perspective to the mountin'; concern for the pregnant woman in industry. Embryo toxicology may demonstrate a need for lowered standards of exposure for the woman worker during a pregnancy. Lastly, a plan is offered to obtain data for comparison of female work populations which may or may not be exposed to certain, primarily airborne, contaminants. The pregnant woman in industry WILLIAM D. KUNTZ, M.D., M P.H. 4702 Summer Lane, fjay Town, Texas 77521 Introduction Currently, 4 3 percent of 100 million females in the United Stales arc in the labor force.' As suming 63U are in the childbearing aces of 10-44 scars and a fertility rate of 74 births per 1000 women, there is a possibility of 2 million pregnancies occunmg to those women em ployed per year. All pregnancies among work ing women are hardly at risk in terms of occu pational exposures, but the potential numbers demand appropriate consideration when wom en of childbearing age are gainfully employed. Of still lurther interest, rate of miscarriage and stillbiilhs. estimated at about 15 percent, is not included in the above calculations. Major consequences of certain types of exposures include mutagenesis, miscarriage (abortion), stillbirth, prematurity, tciatogenesis and carcinogenesis. A` early as 1931. McCord, writing on oc cupational health, listed lead, 'x-ray, alcohol, and meremy as "race poisons."-' Karls in this decade, speaking as President of the American College of Obstetricians and GynccologRts in regards to the cnviionmcnt of the pregnant worker and her fetus. Dr. K. P. Russell pointed our Working as a physician two years in the Department of Obstetrics and Gvnccology at the University of Michigan Medical Center, lo cated only a half-hour drive from the highly industrialized metropolitan Oct roil, I saw no significant reflection of industrial exposure upon the reproduction capabilities of the fe male worker. Obvious factors relating to in frequency of association include insufficient exposure, unreliability of patients' histories and frank failure of patients to perceive and report delayed menstruation early in pregnancy (at least twelve percent of menstrual cycles arc prcdictivcly inegular in reproduclivc-agc wom en). Oilier factors precluding discovery relate to voluntary termination early in pregnancy and the diagnosis of most malformations some interval after birth, l.ast but not least is the reasonable tendency for a person to go to the closest medical center for emergency services; in the ease of the university setting described, distance is a factor. Thus, if the setting is not justly appropriate, it may be difficult to see an oven cause-and-cffect relation on the homeo static condition of the female worker and her offspring. Deleterious contaminants "the ohstetne.il axiom ili.it we aie ahvs\x A partial list of substances, known or highly dealing uilh m ti iinlo iUu.iR r.ilher ih.m one suspect for their potential to adversely affect is well known, hut not alwaxs appreciated. the embryo or Ictus, include: l;or it R not the pregnant worker alone with AU'ohnl wins h we should lv concerned, hut also the Atuluir he,dtli of the unborn. '! o he well-hoinc AiM'Did lllMA'Ill" should he a Iumc light of exeiy Ictus.''1 ( n.sulhiU- For more mfomution about .luthor, see paj;e 4**6 . . . Mtzilnl Mcri/iify S'H'i'liiur NiifjU's, Nilnto, :iml oilier of Mnhi'ntoj'lohiiitmia Industrial Wpimc Assutnobon Journ.iJ AS I 00022745 423 ( .irl'on XJi'm C'.ii't.nt I urjii.iMi'IiwK' }ft*\nclilfr<Tmir win. nr S11!fi.!c ,ipi! Oihvr t iiU'.ci of I end Mercury s. it r< -1a i:/< nc I'lu-n.-l us 111 'I s s h I* *I l U I k i! H , I'l , L Ml 11 S K.t.h i!h*M (lom/ni,1) ^ fit'n hi i n 'I I'lHcMC '1 t-rpcmmc Yms 1 Chloride' X>!rrc . Tio.sc boldfaced aic curicntly exempt from United States occupational standards. Broad catcgoiies include some general medical preparations, several narcotics (c.g., heroin and methadone), the anticanccr chemo therapeutic agents ami certain infectious agents. Women in ccitain piofessions, musing for example, rank stiipiisingly high in terms of po tential CNpOMtir. Exposures of possible sig nificance include thorn' to ethyl chloride, ethyl ether, isopropyl alcohol, nitrous oxide, tri chloroethylene, halothanc. ultraviolet and ion izing radiation, and infectious disease. In several countries, tin increased inci dence of .spontaneous abut lion among pregnant operating loom peisonnel, led to an index of suspicion and fm iher obsci vat ion.1 'The results of a recent am! carefully pbmned nationwide survey have, to quote n recent AOMA Report, ". , . suggested a possible cause-effect relation ship between exposme to (trace) anesthetic gases and higher than normal occurrences of spontaneous abortion among operating room female personnel ami higher than normal inci dence of congenital abnormalities of their off spring."6 These results, in-part summarized in the following paragraph, provided the final im petus for sufficient concern and development of criteria documentation. Among nurses directly involved in the ad ministration of anesthesia, the age and smok ing standardized spontaneous abortion rate per 100 pregnancies was 17.0 versus 14.4 for un exposed members of the same professional group, for an increased incidence of IS per cent,7 Even more striking was the comparison involving standardized congenital abnormality rates among their offspring; 9.6 versus 5.9 per cent. for an increased incidence of 65 percent. These data do mu include the far more com mon skin abnormalities. Easily, the standard ized congenita! abnormality rate among olfspring of unexposed wives of exposed males was S.2 versus 5.7 pci cent, for an increased in cidence of 122 percent. Halothanc (2-bromo2-ehlom-1:1:1 -n il ban oeth.me) and nitious ox ide are highly suspect ctiolouical I'uclois. ami the unscavenged opcrntinc room concentrations arc frequently in the range of 10 and 600 ppm. it is concluded that personnel avoid work in such mens tit least during the first trimester of pregnancy. Research with laboratoiy animals has demonstrated that certain exposures early in pregnancy tire followed by miscarriage, later exposures by teratogcncsis and still later ex posures by malignant degeneration.,'n Thus, lethality appears most related to the earliest of exposures. Sample approach The difficulty and unreliability in the extrapo lation from laboratoiy animal research to hu man interpretation is no secret. If the present trend in increased employment of the female worker is to be continued, a better understand ing of undesirable consequences, however small they currently seem, and their rate of occur rence will assist in determining if there is need for change in the working environment. Cur rent legal restrictions all but forbid maternal research. Discovery is left to the analysis of accidents and exposures to currently accepted threshold limit levels. To furnish control or base line data, a simple health statistical survey (assisted or self check-off) of appropriate prenatal history might be considered in selected population groups. The nature and extent of exposures and out come of till previous pregnancies should be incoiporalcd in the employee's overall health record. Introduction of the health survey might be accomplished with the general preemploymem health evaluation, and follow'-up pro vided with additional pregnancies. A sample procedure-questionnaire is illus trated; the method attempts to incorporate simplicity and flexibility. Summary Occupational exposures involving primarily aiiborne contaminants may affect the course of pregnancy, the development of the embryo and fetus, or both. The contaminants are found in industry in the chemical trades. A chief danger period in any pregnanes occur?, during organogenesis (principally the first trimester); lower standards of exposure or temporaly retirement from potentially hazard ous situations should be considered for protec tion of the developing embryo. AS I 00022746 424 July. ilH Health S t, a L ist leal. Survey Serial Number (Starting with 1) TO: Female LmpJoyces Please return one s_ur_ve\|_ forn for_cach prevl qus jiregnarcy to the Medical Department. These forms are a part of your medical re.cord. We are concerned with your health and well-being, and the health and well-being of any future pregnancy. Whether or not you are planning a pregnancy, we want you to have the very bent care and environment in which to work. Your understanding and cooperation, In spending a feu tiorents In answering the questions, may help and allow for better planning of individual health programs. We appreciate your concern. Please request a new survey form as soon as a current or future pregnancy is discovered. It should be returned to the Medical Department following the end or termination of any pregnancy during your employment with (Company) ____ _____________________________* These health surveys are voluntary; their value depends on your efforts to return the forms. (Check or Write in the Most Appropriate Answer) 1. Was this your 1st__ , 2nd_, 3rd_, 4th__, 5th___, 6th___ pregnancy? State your 3ge at the end of the pregnancy: _____ . 2. Were you working out of the home during the first half of the pregnancy? , last half __both halves __ 3. Were you exposed to 0__, 1 , 2_, 3_ _ chemical (s) during the pregnancy? i r f * I 4. If the name(s) of the chemical s (s) Pa re known: or can be determined, please list each on the lines below. State if the chemical was a "solid," "liquid," or "gas." Also, state what disturbed you most (the most unpleasant effect upon you): for example, "breaking out or itching of the skin," "burning or itching of the eyes, nose, or throat," "feeling nauseous or like you wanted to vomit," "feeling of lightheadedness or dizziness," "cough or difficulty breathing," "tiredness, restlessness, or physical exhaustion," etc. Chemical Gas-Liquid-Solid Most Disturbing llffoct____ Position (Job Title) 5. Could you smell any of the chemical(s) after you went home from work: Yes No____ . If so, please circle the name(s) of the chonical(s) (above) which you could smell at homo. 6. Did the most disturbing effect keep you from going to work? Yes __ No____ . If so, please circle the disturbing effect(s) which prevented you from going to work. 7. State the number of months you were pregnant; _____ ; the birtli weight (if known) ; and whether the baby was born alive___not alive, not known. 8. Was there a birtli defect present? Yes __ No . If so, please name it, or the part involved: __________ ____________ __ _____ '__________________ 9. Did the pregnancy end accidentally, in miscarriage? Yes____ No _____ . 10. Did you have Rubella or an infectious disease during the pregnancy? Yes ____ No____ . If so, name or describe it: _______ __ 11. Did you take medication during the pregnancy? Yes____ No _____ . If so, state its name or what it was used for: _ __________________________ _________________ . 12. Did you use tobacco during the pregnancy? Yes __ No ____ . The return of this form, irrespective of how you anwer the questions, has absolutely no effect on insurance benefits. Keel free to stop by the Medical Department at any time you have questions. Thank you for your Inleiesl. AS I 00022747 Substances potentially deleterious to hu man pregnancy are listed and reference is made to a recent nationwide study relating the pos sible effects of exposure to trace anesthetic gases among operating room female personnel and their offspring. '1 he study illustrates the im pact of a survey on the cause for new criteria docu ments. Lastly, a sample procedure-questionnaire \v;ts designed to facilitate the collection of pre natal history in female work populations. References 1. Maxcy-Hoscnsu: Preventive Methane tnnl Pub lic Health. 10th ltd. (edited by I\ M. Siulucll) p. 957. Applelon-Ccntui y-Ciofts, New Yoik (1973). 2. McCoitD, C. P.: Indus!tied Hygiene jar Engineers tttiil Mtrtiigert. Jiaiper ;md Hrotlieis I'uhlisheis. New York and l.otulon (1931). 3. Klim, F. It.; Ihirty-Two Million Women at Work --I tow Different me They? J. Oeettp. Med. 15:12'-) (1973). 4. Coititm. T, II.: Anesthetics as n Cause of Ahoition. Paid. Uteri!. 23:866 (1972). 5. Count.it, T. 1!,; inhalation Anesthesia: An Oc cupational Hazard. Hospital Practice p. 81, No vember, 1974, 6. AOMA Report: NIOSH Developing Criteria Document on Anesthetic Gases. Amciican Occu pational Medical Association, p. 3. December. 1974. 7. Ad Hoc Committee on the iiffect of Tiucc Anes thetics on the Health of Operating Room Person nel; A Nationa! Study. Ancsrliesiologv ///32I-340 (1974). 8. Naism kov, N.: Transplacental Carcinogenesis (edited by R. Tomatis. U. Mohr, W. Davis), In ternational Agency for Rcscaich on Cancer Sci entific Publication, No. 4. 1973. Accepted february 5, 1976 i t \ I i review volunteers fJccausc the American Industrial Hygiene As- sociation JOURNAL is a refereed scientific journal, every article published is first evalu ated and determined to be a contribution to the literature by a qualified reviewer. Ac curacy, merit, timeliness and quality of pres entation all tire considered. The volume of manuscripts offered for consideration is growing steadily. The JOUR NAL'S board of editorial advisors employs a group of referees who tire assigned manuscripts for review on the basis of their particular professional specialties and their ability to serve. Additional volunteer referees are sought, in a wide variety of specialty areas. General ists also arc invited to serve. If you would care to contribute your time and expertise to the betterment of the JOURNAL, please write to Robert S. Lee. Lditor, American Industrial Hygiene Association JOURNAL, 06 S. Miller ltd.. Akron, Oil -1-1313, Ucfctcc/rcvicweis will be recognized by being listed on a special page to be published regularly in AI1IAJ. The individuals' names and affiliations will appear. \ AS I 00022748 ( 426 July. 1976 \ \ i I