High expectations

Ensuring pregnant staff and new mothers are comfortable and
safe in the workplace is an important part of an OH practitioner’s job, but
what should a risk assessment cover?  By
Alison Persson

The OH nurse should be proactive in risk assessment of a pregnant employee
or new mother and ensure the employer is aware of legislation and how to
implement it. This should involve: the development of a policy to cover the
expectant worker or new mother; identification of workplace risks; action to
ensure the pregnant worker or new mother is not at risk; support for the member
of staff concerned and liaison with the employee’s midwife.

The manager can undertake risk assessments without the aid of the OH team,
either arranging action or sending copies to the OH department for review.
Alternatively the manager can delegate responsibility for risk assessment and
action to the OH practitioner.

Current legislation

Before undertaking risk assessments OH nurses need an adequate knowledge of
current legislation. The European directive on pregnant workers has been
incorporated into the Management of Health and Safety at Work Regulations
19991. The legislation requires employers to ensure the health and safety of the
pregnant worker and new mother at work.

The employer must undertake a risk assessment for general risks but also for
particular risks that apply when an employee is pregnant, recently given birth
or is breast-feeding. Alternative work activities or work location may be
required. Only as a last option should an employee be sent home on full pay.

A European directive1 provides the clarification of definitions. The terms
"new" and "expectant mother" refer to an employee who is
pregnant, who has given birth in the last six months or who is breast feeding.

Given birth is defined as delivery of a living child or a stillborn birth
after 24 weeks, employers’ responsibilities only begin once an employee has
notified the employer in writing that she is either pregnant, has given birth
in past six months or is breast-feeding.

Risk assessment

The OH nurse needs to have identified and to be aware of the specific risks
that apply to the pregnant worker or new mother in their work environment. The
risks may vary between groups of workers or particular work locations. It may
be sufficient to have a generic assessment form, or if risks vary considerably
between jobs or work locations, to design relevant forms.

As for any employee consultation, obtain basic personal details. Then, as
appropriate, record the current stage of the employee’s pregnancy, when the
baby was born and if breast-feeding and make a list of the employee’s work
activities. This information is used in assessing the employee’s individual

Assess whether the employee’s work activities and work location allow her to
take regular meal breaks and have access to a rest room. Tiredness in the first
and third trimester can be a problem eased by regular breaks. Is drinking water
and access to toilet facilities sufficient? This could be problem if the
pregnant worker is a driver, for example, and out "on the road" all

Alison Persson is a freelance occupational health consultant, RGN,OHND,
BSc (Hons), Cer Management


1 The Management of Health and Safety at Work Regulations, 1999. Statutory
Instrument 1999 no. 3242.

Further reading

Gabbe S and Turner L, Reproductive Hazards of the American Lifestyle: Work
During Pregnancy (1997). Am J Obstetrics & Gynaecology, April, p826-32
Salvage J; Rogers R; Cowell R

Nurses and Children at Risk (1998) Nursing Times, 28 Oct, p34-5

Rossiter A, New and Expectant Mothers: How the Law Protects their Health and
Safety at Work.

Maternal & Child-Health (1996), Jul./Aug. 21(7). p174-6.

Williams N Hazards to Pregnant Women at Work. (1996). Modern-Midwife, Mar,

Risks assessment: action plan

Manual handling

Job examples: any job involving lifting and handling of loads.

Risk effect: musculoskeletal damage may occur to pregnant worker due
to hormones causing softening of the ligaments. It may be impossible for the
pregnant worker to undertake manual handling activities safely due to changing
shape. A new mother who has had a caesarean will not be fit to lift for at
least three months.

Action: a joint assessment with the employee will determine if she needs
alternative work such as partial or full exclusion from manual handling activities.
Individual assessment needs to take into account findings of Manual Handling
Assessments. You need to consider how she is coping, previous obstetric
history, actual level of manual handling activity, symptoms such as backache,
and change in shape.


Job examples: construction worker, car mechanic, work on assembly

Risk effect: raised blood pressure may result from ongoing exposure
to noise. 

Action: no action is likely to be required if noise assessments, as
required by the Noise at Work Regulations, 1989, have been completed and
measures taken to ensure employees are not exposed to more that 85 decibels
without suitable ear protection.

Ionising radiation

Risk effect: foetal deformities can result from the pregnant worker
inhaling or absorbing radioactive liquids or dusts.

Job examples: radiographer, laboratory technician.

Action: need to ensure that the statutory dose levels for pregnant
and breast-feeding women is not exceeded. 
Should be discussed with the radiation safety officer or health
physicist, as ability to work will depend on the type of radiation and how it
is used etc.

Non-ionising electromagnetic radiation

Job examples: manufacturing of sonar equipment, anyone who uses
display screen equipment.

Risk effect: extreme over-exposure of radio frequency radiation could
harm the foetus by raising body temperature. There is no evidence from the
National Radiological Protection Board that working with display screen
equipment is hazardous to pregnant worker or foetus.

Action: no need to change work because exposure for all staff for
electric and magnetic fields should be within the safe limits set by the
National Radiological Protection Board. No need to move a pregnant worker away
from display screen equipment.

Extremes of temperature

Job examples:  working in a
cold store or working near furnaces.

Risk effect: a pregnant worker is more likely to faint in a very hot
environment and injure herself. A lactating mother will tend to experience
problems with breast-feeding due to dehydration. In extreme cold conditions,
they may not be able to wear protective thermal clothing.

Action: alternative work will need to be found for the pregnant
worker and breast-feeding mother.


Job examples: cleaners and laboratory workers

Risk effect: certain chemicals are known as hazards, which may affect
the foetus.

Action: preventative measures should already be in place under the
COSHH regulations 1995 and these should have included tetrogenic considerations
as well as the pregnant worker. Reassessment should be undertaken to ensure
these are adequate.


Job examples: laboratory workers and care workers.

Risk effect: certain infections are known to cause foetal damage.

Action: Microorganisms are regarded as substances and therefore come
under the COSHH regulations (see above).

Further reading

Hepper PG and Shahidullah S (1994) Noise and the Foetus, A Critical Review
of the Literature, HSE Guide for Employers

New and Expectant Mothers at Work: A Guide for Employers, published by The
Health and Safety Executive HS (G122). HSE Books on 01787 881165

HSC Advisory Committee on Dangerous Pathogens (1997) Infection Risks to New
and Expectant Mothers in the Workplace: A

Kenen RH, McLeish J and May D Pregnancy at Work: Health and Safety for the
Working Woman, Pluto Press. ISBN 0 7453 1286 1.



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