1. Development of a Reproductive and Developmental Health Protection Program Why and How? Esther Luckhardt Stanford University EH&S www.stanford.edu/dept/EHS

2. Introduction Objectives Why develop the program? How did we develop the program? Program specifics Case Studies Lessons Learned

3. Objectives Protect the reproductive health of all employees and students from occupational exposures to substances (chemical, biological, radiological or physical) known or suspected of being capable of posing a hazard to human reproduction Identify potential reproductive and developmental hazards and implement appropriate exposure control measures

4. Definitions Reproductive Toxicity - Adverse effects on the health of the reproductive organs, endocrine system, or gametes (egg or sperm) from exposure to an exogenous agent Developmental Toxicity – Adverse effects on the developing organism that may occur anytime from conception to sexual maturity

5. Why? No general OSHA standards governing reproductive hazards - limited Cal/OSHA standards - Radiation dose limit established by CA Dept. of Health Services General Duty Clause Short term exposures during a critical period can result in long-term health effects Established controls that are adequate for the general working population may not be so for a pregnant individual and her unborn child

6. How? Conducted a benchmark study with other universities Collaborated with professionals in Health Physics, Biosafety, and Chemistry. Consulted with an Occupational Medicine Physician and Stanford Risk Management Reviewed program with campus Legal Department and Human Resources

7. Program Awareness Information included in Laboratory Safety and Hazard Communication Trainings Many contact us in their first trimester

8. Program Specifics Confidential conference with concerned individual Have individual fill out Reproductive and Developmental Health Hazard Questionnaire 1 Conduct an evaluation of individual’s work and worksite Speak with individual’s supervisor Provide recommendations 1 Adopted from: “Reproductive Hazards of the Workplace,” Frazier, Linda and Hage, Martin. 1998

11. Evaluation of Work and Worksite Review responses to questionnaire (including use of chemical, biological and/or radiological agents, PPE use, and ergonomic issues) Review work practices, SOPs, engineering controls, and adjacent operation(s) for potential exposure(s) Review level and adequacy of training Consult with Occupational Health Physician as needed (EH&S and/or employee or student) Provide recommendations, encourage individual to share report with physician

12. Scope of recommendations EH&S’s role is to evaluate and recommend exposure controls It is the role of the physician to determine if work modification is required If necessary, Stanford University Human Resources department will be involved

13. Anti-Discrimination Policy No employee removed from exposure will suffer any loss of earnings. While the transfer of certain employees may be necessary in some cases, it will only be considered where substitution, additional engineering controls and safer work practices are technologically unfeasible or ineffective in reducing exposure to desired levels.

14. Case Study 1 – Work Modification Lab researcher worked with over 40 chemicals EH&S recommended a combination of engineering, PPE and administrative controls (i.e., assigning other employees to work with Cryostat machine, conduct dark room work) to minimize exposures Department felt it could not implement recommendations, so rotated employee out during remainder of pregnancy

15. Case Study 2 – Apprehensive Physician Employee shared our report/recommendations with OB/GYN OB/GYN contacted EH&S and was upset that the responsibility was placed on herself Made arrangements for both the OB/GYN and the employee to speak with an Occupational Health Physician Ultimate decision still the responsibility of the OB/GYN

16. Case Study 3 – Busy Graduate Student Student’s perception of work responsibilities differed from her official responsibilities Her actual exposures should have been less than her reported exposures Conferred with Supervisor to determine job duties

17. Lessons Learned Every case is different Importance of coordinating with employee’s Supervisor Stress program awareness – early inquiry by employee/student is best