Pregnancy Risk
Assessments
Vanessa Davies
Head of Occupational Health
Hywel Dda NHS Trust
Carmarthen
RCN UK
Safety Representative Conference
October 2011
Personal history
Head of OH for Hywel Dda Health Board
 Joint Chair of Welsh NHS OH Forum for 6
years
 Twelve years OH experience both in and
outside of NHS
 Awarded by RCN Best OH Nurse 2006

How do you become a
occupational health nurse?
Usually by accident……
Qualifications…
Minimum: Registered Nurse (Adults)
 Occupational Health qualification, i.e.
Diploma or Degree in OH, ideally Specialist
Practitioner qualification
 Masters for nurse managers

Essential – A sense of humour
together with lots of life skills
& experience!
What is Occupational Health…..
DEFINITION:
Occupational Health is the promotion
and maintenance of the highest degree
of physical, mental and social wellbeing of workers in all occupations by
preventing departures from health,
controlling risks and the adaptation of
work to people, and people to their
jobs.
(ILO/WHO 1950)
That is the accepted definition,
what do we do?
We are advisors … on just
about everything that relates
to people and their jobs.
What ever job that may be…
And that includes any
employee who becomes
pregnant!
Initially….
Lets confirm the obvious…..
Pregnancy, just had a baby or breastfeeding
are not illnesses!!
It is a perfectly normal event, however…….
The legal
responsibility for
health and safety
rests primarily with
the employer……
Pregnancy risk assessment
Aims of today's workshop:
To provide a brief overview of pertinent
legislation
 Provide an opportunity to explore the
issues relevant to you?
 Conclude by identifying a framework for
PRA

Pregnancy risk assessment
First thing…. Lets start by:
Form groups & in 5 – 10 minutes:

Identify the present practice in relation to
pregnancy risk assessment in your
organisation

Identify what works?

Identify what are the
problems?
Relevant legislation
/Directives
 Equality
Act 2010
 European Directive
 Management of Health and
Safety at Work Regulations
Health and Safety at Work
etc Act 1999
 Control of Substances
Hazardous to Health
regulations
 Employment rights Act 1996
To whom do the regulations apply?
“Any woman who is, or in the future
could be, a new or expectant mother”
Which is women of child bearing age
who are or in the future could be
pregnant, have given birth within
the previous six months, or are
breastfeeding” (HSE, 2004)
Given birth:
is defined in MHSW Regs as ‘delivered a
living child or, after 24 weeks of
pregnancy, a stillborn child’
Equality Act 2010
Pregnancy and maternity
discrimination: work cases
Section 19(5) identifies:
A person discriminates against a woman if in the protected
period in relation to a pregnancy of hers, A treats her
unfavourably:
(A)
(B)
(C)
(D)
Because of the pregnancy, or
Because of illness suffered by her as a result of it
Because she is on compulsory maternity leave
Is seeking or has exercised the right to ordinary or
additional maternity leave
Management of Health and
Safety at Work Regulations
1999
These require an assessment of risk:
Where there are persons in an undertaking which include women
of child bearing age and
The work is of a kind which could involve risk by reason of her
condition, to the health and safety of a new or expectant
mother, or to that of her baby, from any processes or working
conditions, or physical, biological or chemical agents…… to
encourage improvements in the safety and health at work of
pregnant workers and workers that have recently given birth
or are breastfeeding.. (Management of Health and Safety @
work, 1999)
Management of Health and Safety at
Work Regulations 1999
by regulation 3 (1)
an “assessment of such risk”
Which is part of routine occupational
health surveillance……
What does that mean……
“Identification and assessment of the risks
from health hazards in the workplace.
Which involves surveillance of the factors
in the working environment and working
practices which may affect the workers’
health. It also requires a systematic
approach to the analysis of occupational
accidents and occupational diseases” ILO
1985
health surveillance is….
What do you need to do?
A competent person is
required to undertake
a risk assessment!
In most organisations
that is not the OH
nurse or the H&S
manager, however
most managers are
always a little
apprehensive of
undertaking the
assessment!
Stage one- initial assessment
NO
Are there any
hazards present?
Inform
employee of
outcome
Yes
Assess risks, reduce
or remove if
possible
This is a good place to
start……… HSE’s guidance
Specific risk assessment
NO
Has a risk
been
identified
YES
Monitor
and
review
Adjust conditions
/hours
Action 3
Suspend her from work on
paid leave for as long as
necessary to protect her
or/+ child
Yes
Can the risk
be removed
Remove the
risk
No
Action 1
Can the mothers
hours/conditions of work be
adjusted
Yes
No
No
Action 2
Can she be
given suitable
alternative work
yes
Give
suitable
alternative
work on
same terms
and
conditions
On notification of pregnancy…
The range of
potential hazards
& risks to
health is truly
awesome
in a NHS environment…..
There are the
obvious….
Health surveillance…
And the not so obvious……








Chemicals use and
storage
Workload, demands
and stress
Working relationships
Environmental risks
Manual handling of
people and objects
Aggression and
violence
Radiology
Infection control
issues…..
Epidemiological evidence, we know some
products have been found to be potentially
hazardous to health and that their use needs to
monitored
 Annual health surveillance programmes to look
at respiratory sensitizers‘ and other hazards
 Health issues identified during day to day
collaboration between different agencies in the
Health Board i.e. Health and safety manager,
infection control department, the staff or a
manager raises a concern

How are the hazards identified….
The European directive lists the
following hazards
Physical risks





Movements & postures
Manual handling
Shocks and vibrations
Noise
Radiation
Working conditions





Chemical agents
Toxic
 Mercury
 Cytotoxic drugs

Biological agents



Infection



Facilities
Mental/physical fatigue
Stress (inc postnatal
depression)
Temperature
Working with visual display
units
Working alone
Travelling
Violence
Working and PPE
nutrition
Please form groups and for about 10 minutes
consider the following scenarios!
For the pregnant, newly delivered or breast
feeding woman:
There are the responsibilities
of the:
 Employer

employee
How are they managed….
To notify the employer that
she is: pregnant, newly
delivered or
breastfeeding
Or
Advise further if she
continues to breastfeed
beyond six months
May need to provide
certificate from midwife
or general practitioner
Employee

To ensure that appropriate and

health assessment during her
current policies related to staff health
pregnancy
and safety are formulated and
implemented



Re-evaluate any risk assessments if
there are any changes
Competent person to undertake the
risk assessment to identify hazards
The employee should be offered a

When an employee is breastfeeding,
ideally in collaboration with the
the employer should ensure she has
employee
access to appropriate facilities and be
protected from identified hazards
To implement any adjustments to
address any identified hazards

If in doubt then contact your
occupational health service
Employer responsibilities:
Employer : Management of health
and safety regulations 1999
If following risk assessment,
these hazards cannot be
avoided, the employer will
need to:
Alter working conditions or
hours of work, if not
 Identify and offer suitable
alternative work, if not then
the employee is to be
suspended on full paid leave
from work!

Breastfeeding

Provide appropriate rest
areas for pregnant
employees

Recommended to provide
an appropriate
environment for mothers
to express and store milk
Night work
any new or expectant
mother who works at night,
who has a medical certificate
stating that night work could
affect her health and safety:

Offer suitable alternative
daytime work or

Suspend her from work, on
paid leave as long as is
necessary to protect her
health and safety
If the risk arises from work!
Special considerations…..
The Management of Health &
Safety at Work Regulations 1992
and 1999 specify these
responsibilities:
All employers have a statutory responsibility
under Section 2 (1) of the Health and Safety
at Work Act (1974) 1 to create as safe an
environment as is reasonably possible.
The relevant legislation requires:
 Safe environment for pregnant employees
 Ensured
by a risk assessment undertaken by
competent person
 If
suitable adjustments or an alternative role
cannot be identified, suspend on full pay
 Documented
and evaluated as needed by
responsible manager
Summary …
Any questions….?


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HSE (1992) Management of health and safety at work,
management of health and safety regulations 1999
Approved code of practice and guidance, HSE
HSE (2002) New and Expectant mothers at work. HSE
Lubick, N (2011) Advising parents in the face of scientific
uncertainty: An Environmental Health Dilemma.
Environmental Science and Technology, Nature and Earth
HSE: Biological agents: Managing the risks in laboratories
and healthcare premises: The advisory Committee on
dangerous pathogens
References