The mysterious miscarriage nightmare - reproductive hazards in the workplace - includes related information on miscarriage cases at USA Today

The mysterious miscarriage nightmare

Are you doing all you can to eliminate reproductive hazards in the work place?

In one year, 11 pregnant women who worked in USA Today's newsrooms in Arlington, Va., miscarried. Was this just a tragic coincidence or was there a sad but scientific explanation?

During that year, employees had worked in the midst of construction. Walls were knocked down and carpets ripped out. Dust and fumes were released.

The newspaper's employees and executives wondered if the construction had released airborne toxins that could trigger these miscarriages.

Another concern: Each of these pregnant women frequently used computers. It has been suspected, but not definitively proven, that video display terminals increase the risk of miscarriage.

"We were prepared to replace anything in the employees' work space that was found to be a problem," says Sheila Gibbons, director of public affairs for USA Today. "Had we run into toxic carpeting, for example, we would have removed it."

Not easily traced

But the problem wasn't so easily traced. An outside consultant hired by the newspaper ran a battery of tests on the air and the materials used in the remodeling. Results turned up negative. Radiation from the computers was also ruled out.

One possible cause was discovered: There were high levels of lead in the drinking water, 3.5 times the federally recommended level. Lead is a known reproductive toxin to both men and women. But tests of blood-lead levels in employees came out below normal.

Today, the cause of the cluster of miscarriages among USA Today employees remains a mystery.

In factories and offices across the country, there is heightened concern over reproductive hazards in the work place. Evidence is mounting that these hazards are found in a wide variety of jobs in which millions of people work. Fear, too, is escalating because no one can say for certain what these hazards are.

Employers have no choice but to develop policies that deal with reproductive hazards. If they don't, they open the gate for continued tragedies--as well as for increased lawsuits, high absenteeism, and rapid turnover.

What dangers are lurking in your work place? What can be done to protect the health of your employees and their unborn children? How can the proper policy be designed?

The hazards

Facts and figures about work-site reproductive hazards are scare. Neither federal regulators nor scientists have a through handle on such dangers. But what is apparent is that these perils represent significant health threats.

Reproductive hazards are the sixth leading cause of injuries and illnesses in the work place, according to the National Institute for Occupational Safety and Health. In 1985, more than six million workers were exposed to eight substances--including commonly used chemicals such as cadmium and formaldehyde--known or suspected to threaten reproductive health, NIOSH reported.

That figure includes only those workers exposed to dangerous chemicals. Another nine million workers came into contact with radio-frequency or microwave radiation, another suspected health threat, according to 1985 NIOSH figures. And if further research conclusively links computers to reproductive problems, another 14 million workers of childbearing age would be at risk as well, says 9to5, the National Association of Working Women.

OSHA regulations

Despite growing evidence that a variety of substances threaten the reproductive health of workers, the U.S. Occupational Safety and Health Administration regulates only four on the basis of being a reproductive hazard: lead, ionizing radiation, the pesticide dibromochoro propane, and ethylene oxide, a gas used to sterilize medical instruments.

These regulations only scratch the surface; they barely address the range of reproductive hazards in the work place. With little guidance from the federal government, employers are left to design a policy on their own.

Unfortunately, many employers are doing less than they should, experts say. In the most exhaustive review of reproductive hazards to date, the congressional Office of Technology Assessment said in 1985 that "industry needs to develop greater sensitivity to and education on the reproductive hazards issues."

In 1988, a study of 198 chemical and electronics firms in Massachusetts that was done by the state's Department of Health found that 63 companies were unaware that their employees were exposed to one or more known or suspected reproductive hazards--glycol ethers, ionizing radiation, lead, and mercury.

One response

Even when such substances are identified in the work place, many employers don't know how to react. Often, responses are panic-driven, unplanned, and carelessly thought-out, with little notice of their long-term implications.

Eleven years ago, American Cyanamid Co. removed all women of childbearing age from jobs with high exposure to lead at its Willow Island, W. Va., plant. Because of this policy, five women underwent surgical sterilization, which the company said would ensure that they would not lose their jobs or be transferred to lower-paying positions. On behalf of the women, the Oil, Chemical and Atomic Workers International Union filed suit.

Then-U.S. Appeals Court Judge Robert Bork ruled in 1984 that Cyanamid's policy didn't violate the 1970 Occupational Safety and Health Act. But, bombarded with negative publicity, the company settled with the five women for a reported total of $200,000.

It's highly unlikely that any company would set a policy today that encourages its workers to be sterilized. Employers have learned that much from American Cyanamid's experience. But some companies are taking steps that labor unions, women's rights groups, and other experts say are far from the best.

Excluding women

Among employers, the most common response is to restrict women from working with substances that are hazardous to their reproductive health.

In the survey of Massachusetts companies, nearly 20 percent limited the contact women have with reproductive hazards.

However, none of the companies limited the exposure of men to these hazards, even though the substances used threatened their reproductive health as well.

Employers with policies that restrict only women could face a sex discrimination lawsuit. This is true even if employers allow women of childbearing age to transfer out of restricted jobs with no loss of pay, seniority, or benefits.

Since 1982, Johnson Controls, Inc., of Milwaukee, Wis., has banned all women of childbearing age from areas of its car-battery manufacturing plant where workers are exposed to high levels of lead.

This so-called fetal protection policy is intended to protect the health of the unborn children of female workers, company officials say.

UAW disagrees

But the United Auto Workers union doesn't see it that way. The union sued Johnson Controls and claims that the company's policy violates Title VII of the 1964 Civil Rights Act's ban on sex bias. The union argues that because lead poses a danger to men as well as women, the exclusion of only women cannot be justified. Johnson Controls should be required to remove the lead risk to all workers, who have a right to a "safe and healthful workplace" under the Occupational Safety and Health Act, the UAW maintains.

The U.S. District Court for Eastern Wisconsin upheld the company's policy, finding a "considerable body" of expert opinion that the risk controlled by the policy is "substantially confined to women." The U.S. Court of Appeals for the 7th Circuit recently upheld the lower court's decision saying the policy was permissible. Four of 11 judges dissented, however.

Other companies, though, have lost lawsuits against them that were related to their fetal protection policies.

Ten years ago, Children's Hospital of Birmingham, Ala., placed an X-ray technician on unpaid maternity leave after she informed the hospital that she was pregnant. Such a step was necessary, hospital officials said, because fetuses shouldn't be exposed to any radiation and the hospital didn't place employees with temporary disabilities in alternative jobs.

In 1988, however, the Equal Employment Opportunity Commission ruled that there was reasonable cause to believe that the hospital committed illegal sex discrimination. "It is the commission's view that the hospital failed to show by independent, objective evidence and by the opinion of qualified experts that any exposure of a pregnant woman to radiation, however small, is harmful to the fetus," the EEOC argued.

Steps to take

Dealing with reproductive hazards can be a legal, ethical, and human resource challenge, as the Johnson Controls and Children's Hospital cases show. But it is important that companies develop special policies to address these hazards, say experts.

"Many corporate officers believe there is no need to specifically mention reproductive hazards and that the very mention of this subject will create problems from employees and their representatives, who will demand additional information about work-place exposures," observes Marcus Bond, M.D., an occupational health physician in Golden, Colo. But since employees will learn about reproductive hazards from television and newspapers anyway, employers can't ignore this issue, he explains.

Policy options

Given the legal and personnel constraints, how can a company design a policy that allows women and men to work in their chosen jobs, yet still protects them from unsafe substances?

First employers should make every effort to control exposure to hazard--especially in jobs where many women, perhaps three or more, already work, recommends Bond.

Women of childbearing age shouldn't be assigned to jobs where exposures cannot be reduced to safe levels for them, he adds. In all cases, employees who are exposed to potential reproductive hazards should be told about them, Bond argues.

"I don't say that this policy will please everyone," he says. "I've offered it as a realistic statement."

Objections

As expected, women's rights groups and labor unions object to Bond's guidelines as well as to other policies that are based on the exclusion of women from certain jobs.

"Bond proceeds from an assumption that I don't [share], which is that there are large numbers of chemicals out there that affect women's reproduction, but not men's," says Joan Bertin, an attorney with the Women's Rights Project of the American Civil Liberties Union in New York City. "The scientific evidence does not support this claim, and in light of that, I have real problems accepting these policies, which are virtually always used on women."

The way fetal protection policies have evolved, she adds, they are used too often and too easily to exclude women, partly because women haven't been considered as essential to the work force as have men.

Issue not clear-cut

Union representatives say that the issue of reproductive hazards is not clear-cut.

"A lot of reproductive hazards policies developed by companies are discriminatory, and we challenge them," says Richard Uhlar, health and safety representative for the Chemical Workers union. "Our workers see these policies and ask us whether the affected areas are safe. In some cases, there's nothing left to do, so the person must be removed [from the job]. Here we may have a conflict between what we advice our local people to do and the ACLU's position."

The federal government has stepped in to help employers design the proper policy. The EEOC's position is that employers can't exclude women from jobs unless: * the weight of scientific evidence shows the reproductive hazard is substantial; * the hazard has been shown to only affect women; * there is no feasible, less-discriminatory alternative available.

The EEOC cautions that "the same impulse that has led some employers to exaggerate the risks of employing handicapped workers can also lead to exaggeration of risks to offspring."

Effective programs are based on good and up-to-date information about the risks and hazards. Above all, open communication with employees is the most critical element in any program, say experts.

USA Today knows this lesson well. "We listened very carefully to what our employees were asking us," says the newspaper's Gibbons. "You really do need to respond [to them] every step of the way."

A great stride

Although some companies still are slow to move when it comes to reproductive hazards, others are taking steps to protect their workers. And that is a great stride forward, say experts.

"Some reproductive hazards issues, including discrimination against women and the idea of male reproductive hazards, weren't even thought about five or 10 years ago," says Richard Boggs, vice president of Organization Resources Counselors, Inc., a Washington, D.C., consulting group that specializes in occupational health and safety.

In the past, "you got the sense that some companies were trying to just keep women off the production lines. But now I think companies see [reproductive hazards] as a bigger problem and that they must find a way of addressing them other than saying: `You might get pregnant, so you can't work here.'"

Michael Rose is senior editor at Prentice-Hall's Law & Business.

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