Table 3.

Physical hazards present in veterinary workplaces and recommendations for mitigation of risks to female reproductive health identified in the literature.

Hazard	Reproductive risk	Best practices to mitigate risk
Radiography	Risks depend on stage of embryonic or fetal development and level of radiation exposure. Outcomes range from death of the embryo to congenital malformations and mental retardation88	Occupational exposure limit for ionizing radiation to the fetus is 5 mSv (0.5 rem) cumulative during pregnancy, with a 0.5 mSv limit for each month of pregnancy89 Keep radiation exposure as low as reasonably achievable or as low as reasonably practicable90–93 Avoid radiographic evaluation unless it is justified90 Perform yearly safety verification of gloves and aprons, and check the tube device for leakage93 Increase distance of the individual performing radiography from the radiation source, reduce the duration and amount of exposure, and use protective barriers between the individual and the source23 Perform radiography only in controlled areas90; wear radioprotective clothing (eg, lead aprons, thyroid shields, glasses, and gloves) and use personal dosimetry badges worn on the trunk under the lead gown23,28,90,94,95; gloves and thyroid shields should have a minimum lead equivalent of 0.5 mm90 Prohibit manual restraint of animals by pregnant women during radiography90 Use tube stands or a pole with a cassette holder, rather than holding with hands, for radiography of large animals90–92 Emphasize the importance of adequate radiation protection and knowledge in schools of veterinary medicine and professional associations96 Include written policies in a practice infection control plan requiring staff members to notify hospital leadership of pregnancy as soon as the staff member becomes aware of it97 Fully inform female veterinary personnel of the risks from ionizing radiation29,44 Work with employers to reduce exposures during pregnancy and lactation23,49,90
Standing at work	Preterm delivery98–100 and low birth weight101	Pregnant personnel should not stand > 6 h/d98 Limit standing and walking at work, especially standing in 1 position, to 4 to 5 hours during the second and third trimesters99,101
Long working hours	Preterm delivery21,98	Limit work to < 42–45 h/wk21,98
Physically demanding work, including lifting	Preterm delivery, maternal hypertension,100 and low birth weight102	Reduce or eliminate physically demanding work from job duties of pregnant personnel100,103 Consult MacDonald et al (2013)102 for specific guidelines for occupational lifting during pregnancy; guidelines are given for infrequent lifting, repetitive short-duration lifting, and repetitive long-duration lifting in multiple body positions at < 20 wk of gestation and ≥ 20 wk of gestation. Reductions in recommended weight limits may need to be made for veterinary personnel, considering the unpredictability of sudden animal movement or pushing and pulling of animals during lifting that may influence recommended weight limits102 Minimize or eliminate demanding levels of physical work for women with previous complications of pregnancy that are likely to recur, such as low birth weight of infants and premature labor23
Shift and night work	Preterm delivery100	Limit shift or night work100
Needle sticks	Spontaneous abortion104	Establish a needle-stick prevention program7,8 Provide information and training on needle-stick prevention and establish written infection control policies that include needle-stick prevention72,105 Practice standard precautions when using anthelmintic, euthanasia, and anesthetic agents104 Avoid recapping needles or use a 1-handed scooping technique to recap37,72,106 Perform worksite analyses for tasks causing needle sticks106