Most women work during pregnancy and many return to work while breastfeeding. In general, this may not pose a risk to the health of the future mother or child.
However, there are jobs where chemicals or other hazards can affect a woman’s ability to give birth to healthy children or harm the health of a pregnant woman and her unborn child.
Pregnancy causes major physiological and psychological changes in a woman’s body. A woman’s hormonal balance is very sensitive and interrupting it can cause complications that may lead to miscarriage. Ionising radiation, chemicals, smoking, certain viruses and alcohol are examples of risk factors that can damage reproductive health.
Women’s health problems are considered mental and physical illnesses or damages to health, as well as possible adverse effects on pregnancy, the foetus, the new-born or the woman who has recently given birth.
Pursuant to subsection 1 (1) the Government of the Republic regulation “Occupational health and safety requirements for work performed by pregnant women and women who are breastfeeding”, an employer shall ensure that women who are pregnant or breastfeeding (hereinafter female workers) have a safe working environment. If a female worker has submitted a medical certificate regarding her condition, the employer shall identify any factors that pose a risk to her health at the workplace. The problem is that the employee may not be aware of the pregnancy in the initial stage of pregnancy (30–45 days) and therefore the health of the foetus or employee may be damaged due to ignorance.
Pursuant to subsection 13 (4) of the Occupational Health and Safety Act, an employer shall conduct a risk analysis of the working environment and evaluate the health risks, as well as inform employees of the existing risk factors and their possible adverse effects on health. Raising awareness of employees on safe work and maintaining a healthy life, systematic internal control of the working environment and risk management create preconditions for preventing potential damage to the health of all employees, including potential mothers.
Even if the risk assessment indicates that the possibility of damage to health caused by a risk factor in the workplace is unlikely, the employer should still inform the female worker of this risk. The employer should also explain further measures that are planned to protect the health of pregnant women, women who have recently given birth and women who are breastfeeding.
Risk assessment is not a one-off activity in the company, but the basis for systematic internal control and supervision that is especially important for pregnant employees. Different risks can affect a woman and her foetus in different stages of pregnancy and harm the mother and child even after birth. The working conditions of exposed employees who are pregnant or breastfeeding should be approached individually. The risk assessment should be repeated if there have been any changes in the working conditions, equipment or chemicals used.
A doctor’s advice to the woman and recommendations to the employer, and, if necessary, a written decision to change the working conditions or organisation of work of a female worker should be based on the specific working environment. Information regarding women’s health is strictly confidential. The employer may not disclose information about a woman’s pregnancy unless the latter agrees to it.
Although the risks may not change, the risk factor may have a different effect on the foetus in different stages of pregnancy and also during long-term breastfeeding. Some chemical compounds, such as lead, organic solvents and pesticides, are absorbed into the mother’s breast milk and thus harm the child.
If necessary, the employer shall take the following measures:
- Temporarily ease working conditions or transfer the female worker to lighter work or another job.
- Transfer to daytime or night-time work, change her organisation of work, including shortening her working day and enabling her to take suitable rest periods.
Risk awareness is a rather complex and specific task where the level of knowledge and involvement of employees play a major role. The company should focus on activities related to the prevention of adverse effects on the entire workforce, i.e. reduce the impact of risk factors affecting the reproductive organs of both women and men.
Working during pregnancy
A woman may continue to work during pregnancy if the requirements and limitations provided in the 11/06/2009 regulation No. 95 of the Government of the Republic, “Occupational health and safety requirements for work performed by pregnant women and women who are breastfeeding”, are met. At the request of the employer the employee shall submit a certificate confirming pregnancy issued by a doctor or midwife.
Employees who are pregnant or breastfeeding shall be allowed the use of a relaxation room where there is the possibility to lie down.
If the employer becomes aware that an employee is pregnant or breastfeeding, he or she shall re-examine the risk analysis of the work performed by the pregnant or breastfeeding employee and assess risks based on the employee’s health condition.
If an employer becomes aware that an employee is pregnant or breastfeeding, he or she shall assess the risks to the female worker’s health posed by any agents, work or production processes in terms of their nature, level and duration, as well as any possible effect they may have on the outcome of the pregnancy or the health of the child being breastfed. After conducting a risk assessment, the employer shall inform the female worker of the results of the risk assessment and the measures to be taken to ensure she has a safe working environment. The employer shall also conduct a risk analysis of the work of female workers who are entitled to maternity leave but who are not breastfeeding.
The risk assessment should identify all risks that an employee is exposed to in their work and provide an adequate assessment to the risks so as not to underestimate them. If the risk assessment is not carried out thoroughly and substantively and some risk factors are not identified or the impact of the risk factor is underestimated as a result, the consequences could be dire. If the employer cannot adequately assess the extent of a health risk or safety of the work performed in the course of the risk assessment or if any questions regarding it arise, he or she should consult the employee and also doctor or midwife, if necessary. He or she can also get additional information from an occupational health doctor.
The employer shall assess whether the pregnant or breastfeeding employee (hereinafter female worker) may come into contact with work or risk factors that would prevent the female worker from working. If a female worker is exposed to the work or the risk factors listed below, she may refuse to perform the work. Only pregnant women who have concluded an employment contract and have health insurance can be transferred to lighter work if they have a certificate for sick leave due to their state of health. For this purpose, a doctor or midwife will issue a certificate for sick leave to the pregnant woman on the grounds of “Providing work appropriate to the condition or transferring to a lighter work”.
When assessing the health risks posed to a female worker, the employer is required above all to take account of the following work:
- work involving a risk of falling from a height;
- underground work.
If the risk assessment identifies a risk or if the female worker is performing work that is not permitted, the employer shall temporarily provide the female worker with work appropriate to her health condition in consultation with the female worker and, where necessary, with a doctor or midwife.
Work which is not permitted for pregnant women:
- if there is a risk of contracting rubella, unless the pregnant woman is proved to be adequately protected against rubella through immunity;
- if there is a risk of contracting toxoplasmosis, unless the pregnant woman is proven to be adequately protected against toxoplasmosis through immunity;
- in conditions of high air pressure;
- with lead or lead compounds;
- underground work.
Work which is not permitted for women who are breastfeeding
- with lead or lead compounds;
- underground work.
When assessing the health risks posed to a female worker, the employer is required above all to take account of the following physical risk factors:
- shocks, vibrations and the tools that cause them;
- harmful radiation;
- constant high or low air temperature.
When assessing the health risks that a female worker is exposed to, the employer shall in particular take into account the biological risk factor of risk groups 2, 3 and 4 provided in the Government of the Republic Regulation No. 144 of 5 May 2000 The Occupational Health and Safety Requirements for Working Environment Affected by Biological Hazards if it is known that these hazards or the measures taken to treat the damage to health caused by them pose a risk to the health of the pregnant woman or the foetus, and if they are not mentioned below.
if there is a risk of contracting rubella, unless the pregnant woman is proven to be adequately protected against rubella through immunity (rubella is an acute virus that presents itself as a rash and is caused by the rubella virus which mainly affects children); Rubella is a dangerous disease for pregnant women. The earlier in the pregnancy a woman contracts the virus, the more severe the damage is to the foetus. If the infection occurs within the first 11 weeks of pregnancy, 90% of foetuses develop congenital rubella syndrome. The child who is born is underweight and may have a heart condition, deafness and various eye problems such as congenital cataracts, microphthalmia (abnormally small eyes);
if there is a risk of contracting toxoplasmosis, unless the pregnant woman is proven to be adequately protected against toxoplasmosis through immunity (a person may contact toxoplasmosis through contact with a surface, hands, or objects that are contaminated with cat faeces); Toxoplasmosis can also be contracted by eating raw or rare pork, mutton or beef).
When assessing the health risks posed to a female worker, the employer is required above all to take account of the following physiological risk factors:
- manual handling of loads (weighing 5 kg and more). Pursuant to subsection 3 (9) of Regulation 26 of the Minister of Social Affairs of 27 February 2001 The Occupational Health and Safety Requirements for Manual Handling of Loads, pregnant women and women who have given birth up to three months prior are not permitted to manually handle loads.
- constraining postures or movements that cause physical tiredness or over-exertion, including constant work in a standing or seated position, a rapid work tempo or other similar factors.
When assessing the health risks posed to a female worker, the employer is required above all to take account of the following psychological risk factors:
- work causing mental exhaustion, including highly focused work;
- isolated work;
- monotonous work.
When assessing the health risks posed to a female worker, the employer is required to take account of the processes giving rise to a carcinogenic hazard referred to in Section 2 of Government of the Republic Regulation No. 308 of 15 December 2005 on occupational health and safety requirements for the handling of carcinogenic and mutagenic chemicals, and of the substances or mixtures released during those processes.
When assessing the health risks posed to a female worker, the employer is required above all to take account of the following chemical agents:
- substances and mixtures in respect of which, under Regulation (EC) No. 1272/2008 of the European Parliament and of the Council on classification, labelling and packaging of substances and mixtures, amending and repealing Directives 67/548/EEC and 1999/45/EC, and amending Regulation (EC) No. 1907/2006 (OJ L 353, 31.12.2008, p. 1–1355), one or more hazard statements correspond to the criteria for one or more of the following hazard classes and hazard categories:
- cell mutagenicity, category 1A, 1B or 2 (H340, H341);
- carcinogenicity, category 1A, 1B or 2 (H350, H350i, H351);
- reproductive toxicity, category 1A, 1B or 2 or the additional category for effects on or via lactation (H360, H360D, H360FD, H360Fd, H360Df, H361, H361d, H361fd, H362);
- specific target organ toxicity after single exposure, category 1 or 2 (H370, H371).
If an employee who is pregnant or breastfeeding is exposed to hazardous chemicals, information provided in section 2 (“Hazards Identification”) of the safety data sheet of the hazardous chemicals used shall be compared to the list provided above. If any hazard statement of the chemicals used matches with a hazard statement provided above, the employee who is pregnant or breastfeeding may not continue working.
For example, the safety data sheet of a hazardous chemical may include H370 Causes damage to organs.
An example of such a chemical is methanol, which is used in the chemical, timber, pharmaceutical, petroleum, gas, and microbiological industry, as fuel and raw material in the production of biodiesel as a water-treatment chemical, and elsewhere.
If in section 2 of the safety data sheet the company does not contain hazard statements (e.g. H370) but contains R-phrases (e.g. R10) and S-phrases (e.g. S2), then request a new safety data sheet with hazard statements from the chemical supplier.
- mercury or its compounds;
- substances that slow cell division, for example cytostatic medicines, in particular in the event of interaction with ionising radiation; Cytostatic
- medicines are medicinal products that may be mutagenic, carcinogenic, teratogenic or cause reproductive disorders;
- carbon monoxide;
- organic solvents (e.g., acetone);
- chemicals that have a harmful effect on health through the skin.
If an employee who is pregnant or breastfeeding uses a hazardous chemical in her work that is not listed above, the employer shall evaluate the properties of the substance used in the course of a risk analysis to exclude safety and health risk. Safety data sheets of chemicals and limits set on chemical hazards can be used to find the baseline from which exposure to these agents poses a risk to health. The maximum limits have been provided in the annex to Government of the Republic Regulation No. 105 of 20 March 2001 on occupational health and safety requirements on hazardous chemicals and materials containing them and the maximum limits for working environment hazards.
If an employee and/or employer has doubts as to whether a female worker may be exposed to a certain chemical, they can contact a doctor or midwife, show them the safety data sheet of the chemical, and ask whether the employee may be exposed to this specific chemical in her work. They may also ask the opinion of an occupational health doctor.
Work processes that cause a carcinogenic hazard are as follows:
- production of auramine (CAS 492-80-8);
- work processes where an employee may be exposed to polycyclic aromatic hydrocarbons contained in coal soot, tar or pitch;
- soldering, welding or other heat treatment of materials containing copper and nickel where dust, smoke or aerosol of these metals is produced;
- strongly acidic processes of isopropyl alcohol production;
- work processes where an employee may be exposed to dust from the processing of hardwood, such as beech or oak;
- work processes where an employee may be exposed to respirable crystalline silica dust;
- other work processes where employees are at risk of being exposed to carcinogens or mutagens.
Transfer to lighter work and easing working conditions
The following employees can demand work appropriate to their health condition:
- pregnant women;
- employees who have the right to maternity leave. If a woman who has the right to maternity leave by law does not take this leave, she is still entitled to request work appropriate to her health condition based on a doctor’s prescription.
The employee shall submit to the employer a certificate from a doctor or midwife indicating the restrictions on work due to his or her state of health and, where possible, proposals regarding duties and working conditions corresponding to his or her state of health. A doctor’s or midwife’s certificate is mandatory for the employer.
For example, a doctor or midwife may not permit a pregnant woman to handle loads or work in a constraining posture or at night.
If the employer cannot provide the employee with work corresponding to his or her state of health, the employee may temporarily refuse to perform the duties. Only pregnant women who have concluded an employment contract and have health insurance can be transferred to lighter work if they have a certificate for sick leave due to their state of health. For this purpose, a doctor or midwife will issue a certificate for sick leave to the pregnant woman on the grounds of “Providing work appropriate to the condition or transferring to a lighter work”. A doctor will issue a new certificate of incapacity for work to a pregnant woman every 30 calendar days until the beginning of maternity leave. The first day of the certificate for sick leave is not reimbursed; the EHIF pays sickness benefit from the 2nd day onwards. The benefit rate is 70% of a person’s average income per one calendar day in the previous calendar year.
If the employer has lighter work available that he or she can offer to the employee, the employee will temporarily be provided lighter work. The EHIF reimburses the difference between the wages of a person performing light work compared to their average income per calendar day of the previous calendar year. The benefit rate is 100% and the benefit is paid from the first day.
Time off for prenatal examination
Pursuant to § 10 (4) of the Occupational Health and Safety Act, an employer is required to grant a pregnant employee time off, to be included in the working time, at the time indicated in a decision made by a doctor or a midwife for prenatal examination.
Also, pursuant to § 38 of the Employment Contracts Act, an employer shall pay an employee average wages for a reasonable period when the employee cannot perform work due to a reason arising from the employee, but not caused intentionally or due to severe negligence or if the employee cannot be expected to perform work for another reason not attributable to the employee.
A reasonable period that is evaluated on a case-by-case basis is important for this provision. Reasonableness is evaluated based on subsection 7 (1) of the Law of Obligations Act, pursuant to which reasonableness is to be judged by what persons acting in good faith would ordinarily consider to be reasonable in the same situation. If the employee is prevented from working for longer than a reasonable period, not giving him or her time off and not paying wages is justified. It shall be a short-term obstacle that will enable the employee to resume work soon.
Extra time off for breastfeeding
A breastfeeding mother is entitled to additional breaks for breastfeeding until the child is 1.5 years old. An additional break shall be granted every three hours for a period of no less than 30 minutes each time. The duration of the breastfeeding break for two or more children who are less than one and a half years old shall be no less than one hour.
Breaks for feeding a child are included in the working time and average wages calculated based on subsection 29 (8) of the Employment Contracts Act are paid for them from the state budget through the budget of the Ministry of Social Affairs, unless the mother receives parental benefit for raising the child.
The purpose of the extra break is to give the mother the opportunity to breastfeed. The additional break is for breastfeeding the child at the child’s home or another suitable place if it is not possible to feed the child at the workplace. Depending on the purpose of the breaks, the mother may also use the breaks to collect breast milk.