New and Expectant Mothers Policy and Risk Assessment Procedure

Version 2.0 March 2020

New and Expectant Mothers Policy and Risk Assessment

Procedure

Target Audience

Who Should Read This Policy

All Trust Staff

New and Expectant Mothers Policy and Risk Assessment Procedure


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Ref. Contents Page

1.0 Introduction 4

2.0 Purpose 4

3.0 Objectives 4

4.0 Process 5

5.0 Procedures connected to this Policy 8

6.0 Links to Relevant Legislation 8

6.1 Links to Relevant National Standards 8

6.2 Links to other Key Policies 8

6.3 References 8

7.0 Roles and Responsibilities for this Policy 9

8.0 Training 10

9.0 Equality Impact Assessment 10

10.0 Data Protection and Freedom of Information 10

11.0 Monitoring this Policy is Working in Practice 11

Appendices 1.0 Draft Letter to inform Line Manager of Pregnancy 12

2.0 Risk Assessment for New and Expectant Mothers 13

3.0 Guidance for completion of Assessment Form 17

4.0 Flow chart for managers when notified of pregnancy 22



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Explanation of terms used in this policy New and Expectant Mothers - For the purpose of this policy “new and expectant mothers” are defined as

an employee who:

• Is pregnant • Has given birth within the previous six months or

• Is breastfeeding Given Birth

Delivered a living child or, after 24 weeks of pregnancy, a stillborn child.

Child Bearing Age

A woman who is capable of having children.

Hazards - For the purpose of this policy, hazards to new and expectant mothers will be regarded as any physical, biological, chemical processes and psychological impact that may affect the safety of a new or

expectant mother.

MHSWR – Management of Health and Safety at Work Regulations 1999

HSAWA – Health and Safety at Work Act 1974

WHSWR – The Workplace (Health And Safety at Work) Regulations 1992

VDUs – Visual Display Units

DSE – Display Screen Equipment



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1.0 Introduction Pregnancy should be regarded as part of everyday life and therefore is not equated with ill-health. However, on occasion the workplace conditions and/or process may pose a hazard to the expectant, new or nursing mother and this may be compounded by pregnancy related health conditions. Those risks which may impact on any new or expectant mother may also impact on women of child bearing age and must be adequately reflected in the local workplace risk assessment. Regulation 16 of the Management of Health & Safety at Work Regulations 1999 (MHSW); states a requirement for risk assessment and adequate control of those risks where:- a. the persons working in an undertaking include women of child bearing age; and b. 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 process or working conditions or physical, biological or chemical agents. Black Country Partnership NHS Foundation Trust (hereafter known as the Trust) recognises that women of child bearing age or pregnant or new mothers employed by the Trust may be affected by hazards in the workplace which may not affect other employees. The provision of the Sex Discrimination Act 1975 requires women to be employed on equal terms with men. However, where there are legitimate health and safety issues, which result in discrimination against women, then health and safety legislation is recognised as taking priority and overrides sexual discrimination. The Equality Act 2010 provides protection to pregnant women and those on maternity leave against discrimination. Depending on the circumstances, this can include failing to carry out a risk assessment under MHSW regarding a pregnant worker. 2.0 Purpose This policy applies to all women of child bearing age working within the Trust and others who may be affected by the undertaking of the Trust. Where staff are working in environments that are controlled by other organisations or work away from a fixed environment or from home, the Trust will strive to maintain these principles as far as is practicable.

3.0 Objectives Risk assessments undertaken in line with the Trust Health & Safety Policy shall have particular regard to the persons exposed to the risks. Risk assessments shall be reviewed or undertaken when the worker advises their line manager that they are pregnant or may be pregnant. Assessments shall be reviewed as appropriate during pregnancy and on return to work



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3.1 Equality and Diversity This policy when implemented should reflect anti-discriminatory practice. Any services, interventions or actions must take into account any needs arising from age, disability, including sensory impairments, gender reassignment, pregnancy and maternity, race, religion or belief, sex and sexual orientation. This would also include any needs around language or general communication. 3.1.1 The Trust has a duty of care for the health & safety of all employees whilst at work, under section 2 of the Health & Safety at Work Act 1974 (HASWA) and this duty is further described within the Management of Health and Safety at Work Regulations 1999 (MHSWR).

4.0 Process

Employers are required to carry out a risk assessment and evaluation of all of the significant hazards which may be faced by new or expected mothers within the work place. 4.1 A risk assessment must be completed by the line manager as soon as they are informed of the pregnancy, using the risk assessment form as detailed in Appendix 2. Pregnancy is not a static condition and as the pregnancy develops it will be necessary to review the original assessment in the light of changing circumstances. The worker herself should be made aware of the need to report to her line manager any difficulties she may be experiencing or special requirements, e.g. periodic rest periods. 4.1.1 Responsibilities of the employee It is important that the new or expectant mother informs her employer about any advice they have had from their doctor or midwife (e.g. pregnancy-related medical conditions such as high blood pressure, a history of miscarriages etc.) as that could affect the risk assessment. The Trust will use this information to review the risk assessment and if necessary to adjust the new or expectant mothers working conditions accordingly. 4.1.2 Risk assessments for new or expectant mothers must be undertaken in high risk areas including but not limited to the following in-patient areas:

Learning Disability Units

Forensic Units

Psychiatric Intensive Care Units This list above is not exhaustive and each individual must be assessed to identify the risks at their location(s) Some processes, working conditions or physical, biological and chemical agents may pose a risk to a new or expectant mother and these risks will vary depending on the person’s health, and at different stages of pregnancy. Some of the more common risks might be:

lifting/carrying heavy loads;

standing or sitting still for long lengths of time;

exposure to lead;

exposure to toxic chemicals;

work-related stress;



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workstations and posture;

exposure to radioactive material;

threat of violence in the workplace;

long working hours;

excessively noisy workplaces.

Exposure to infectious diseases (further information can be found at www.hse.gov.uk/pubns/books/infection-mothers.htm)

The list of common risks above is not exhaustive. Given the changing nature of pregnancy and the post-natal period the risks identified to new and expectant mothers will vary during the different stages of the pregnancy. The assessment must take this into account and be reviewed accordingly. The initial assessment must take place as soon as the member of staff informs their manager that they are pregnant and then the suggested dates for review are:- Documented reviews:

Review 1 – between 14 – 26 weeks

Review 2 – after 27 weeks

Return to work review Good practice guidance suggests reviews of the following: (not necessarily documented)

Monthly until 32 weeks

Fortnightly at 32-36 weeks

Weekly from 36 weeks Where risks are identified then employers must take action to remove, reduce or control the risk. If the risk cannot be removed, employers must:

Action 1 Temporarily adjust her working conditions and/or hours of work; or if that is not possible

Action 2 Offer her suitable alternative work following an appropriate assessment of that environment (at the same rate of pay) if available; or if that is not feasible

Action 3 Suspend the new or expectant mother from work on paid leave for as long as necessary to protect their health and safety and that of their child.

Night Workers: The Management of Health and Safety at Work Regulations 1999 (MHSWR) also state that where a new or expectant mother works nights and provides a medical certificate from her GP or Midwife which says that working nights will affect the health of the woman, then the employer must suspend her from work, on full pay, for as long as necessary. However, the Employment Rights Act 1996 provides that where appropriate, suitable alternative work should be offered, on the same terms and conditions, before any suspension from work. Night workers have a right to transfer to day shifts if their doctor advised it on health and safety grounds. Suitable Room/Rest Facilities

http://www.hse.gov.uk/pubns/books/infection-mothers.htm



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4.2 The Workplace (Health & Safety at Work Regulations 1992) requires employers to provide a suitable room/ rest facilities for workers who are pregnant or breastfeeding. The facilities should be suitably located (e.g. near to toilets) and where necessary should provide appropriate facilities for the new or expectant mother to lie down.

For new mothers returning to work who wish to express milk, Managers will ensure that adequate and appropriate accommodation is provided and suitable time is factored into the working day to enable the preparation for and expressing of milk to be undertaken. Suitable refrigeration facilities will be provided to enable effective storage of expressed milk; these arrangements are to be made on an individual basis and in conjunction with Estates and Facilities. 4.3 A risk assessment must be completed, using the risk assessment form as detailed in Appendix 2 by the line manager as soon as informed of the pregnancy. Guidance notes to support completion of the risk assessment are detailed in Appendix 3. There is also further guidance to managers in Appendix 4 following notification of a pregnancy. 4.4 If the risks to new or expectant mothers identified by the risk assessment cannot be controlled, the Trust is obliged under Health and Safety legislation, where it is reasonable to do so, to alter the hours or working conditions of pregnant workers, if doing so would avoid the risks. Expectant mothers may also request that working hours be reduced. Alternative work/duties/Redeployment 4.5 Where altering the hours of work or working conditions are not reasonable or would not avoid the risk, the new or expectant mother has the right to be offered suitable alternative work. This has to be with no detriment in terms and conditions, where this is available within the Trust’s undertaking. 4.5.1 If suitable alternative work is not available then the Trust must suspend with pay the new or expectant mother for as long as necessary to avoid the risk. 4.5.2 The Trust is not obliged to take the actions above until the new or expectant mother has provided written notification that she is pregnant or that she has given birth within the previous 6 months, or is breast-feeding. Due to the hazards present in some of the working environments with in the Trust, the assessment may identify the need for re-deployment or suspension from work on full pay to protect the health and safety of the mother and her child on the grounds of the Trusts duty of care to the employee 4.5.3 The risk assessment identifying the hazards, significant risks, control measures, monitoring and review arrangements must be formally recorded using the Trust’s Risk Assessment form for New and Expectant Mothers. A copy must be maintained by the line manager and retained in the employee’s personal file. A copy of the risk assessment should be provided to the employee to ensure compliance with the decisions/actions.



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4.6 The Trust is also exempt from maintaining any of the actions detailed above, including the suspension from night work, where the woman has not provided the written notification of her pregnancy or has failed to produce a certificate signed by a registered medical practitioner or midwife within a reasonable time of being requested to do so by her employer. The above exemption also applies where the Trust knows the woman is no longer pregnant, etc., or cannot establish whether she remains so.

5.0 Procedures connected to this Policy There are currently no procedures linked with this policy. 6.0 Links to Relevant Legislation

The Employment Rights Act 1996

Health and Safety at Work Act 1974

Management of Health and Safety at Work Act 1999

The Workplace (Health & Safety at Work Regulations) 1992

The Equality Act 2010

6.1 Links to Relevant National Standards

Care Quality Commission(CQC)

NHS Litigation Authority (NHSLA)

National Institute for Health & Clinical Excellence (NICE)..

6.2 Links to other Key Policies

Human Resources Department – Maternity Leave Handbook for Employees

Risk Management Policy

6.3 References

Human Resources Department – Maternity Leave Handbook for Employees

The Management of Health & Safety at Work Regulations 1999

New & Expectant Mothers who Work – INDG 373

Maternity Rights – a Guide for Employees, Employment Service, Employment Dept. Group (PL958)

The Workplace (Health & Safety at Work Regulations) 1992



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7.0 Roles and Responsibilities for this Policy

Title Role Key Responsibilities

New and Expectant Mothers Adherence - In order for the Trust to discharge its duties with regard to new and expectant mothers, you are advised to inform your

supervisor/line manager as soon as you become or aware that you are pregnant by using a copy of the draft letter as detailed in Appendix 1.

- Provide a certificate (MAT B1) form available from her GP or registered midwife; - Make her manager aware of any pregnancy related condition or health issue that may arise within the course of the

pregnancy so that control measures can be implemented. - Comply with the control measures identified in pregnancy risk assessment.

All Employees Adherence - Co-operate with managers to achieve the aims of the policy arrangements.

- Take reasonable care of themselves and other people who may be affected by their actions or omissions.

- Comply with the control measures identified in risk assessments. - Report all incidents including near miss incidents using the Trust’s Datix incident reporting system.

- Attend any training as directed by their manager. Line Managers Implement - Make sure that all staffs they manage are aware of these policy arrangements through effective dissemination of

information. - Must undertake a specific risk assessment when officially informed in writing by a GP or a midwife as to an employee

being pregnant, or following receipt of the letter from the employee (Appendix 1). Information will be treated in the strictest of confidence.

- Consideration will also have to be given to any advice received from the new and expectant mother’s GP or midwife. - A further risk assessment must be undertaken when the employee returns from maternity leave and until she stops

breastfeeding; - Implement appropriate control measures identified by the risk assessment; - Refer the new or expectant mother to Department of Occupational Health & Wellbeing where there is an immediate

concern raised by the GP, midwife or employee regarding a pregnancy related issue; - Identify training needs and provide adequate instruction and supervision as necessary.

Human Resources Advise - HR will advise managers where requested regarding alterations to the working hours sourcing alternative work or in situations where the employee has been instructed to refrain from work.

- HR will provide any assistance to managers regarding any HR issue following notification of pregnancy and following risk assessment.

Health & Safety Team Advise/Support - Will provide advice and guidance for staff and line managers, alike in completing risk assessments as necessary as and when required.

- Monitor the effective implementation of this policy through the undertaking of H&S = audits as part of an on-going programme;

- Provide proactive and competent health and safety assistance and advice to managers when requested.

Occupational Health Service

Guidance - Will provide help, advice and guidance for all staff during their pregnancy and on their return to work. - Managers should refer staff to Occupational Health & Wellbeing if there is cause for concern, e.g. issues identified

during the risk assessment; high level of maternity related sickness absence or evidence that member of staff is finding it difficult to cope.

- OH&W will review the manager’s risk assessment in respect of new or expectant mothers where appropriate and make adjustments and recommendations as necessary to advise of fitness to work;



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Health and Safety Committee

Monitoring - The Trust’s Health and Safety Committee is a focal point for effective staff consultation and participation in all aspects of health and safety. Accredited union safety representatives sit on the committee and represent all employees of the Trust. The Health and Safety Committee reports any escalations directly to the Trust Quality Steering Sub Committee.

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Chief Executive Accountability - The Chief Executive has overall final responsibility for the management of health and safety at work in the Trust, and for the health, safety and welfare of employees and others who may be affected, and:-

- Will ensure that there are effective, up to date policy arrangements for the assessment of risk to new and expectant mothers;

- Will make available sufficient funds to allow for the appropriate control of these risks; - Will ensure adequate resources for managers to fulfil their health and safety responsibilities; - Will ensure implementation of the policy and fully support with adequate resources, all persons who carry out this policy.

8.0 Training

What aspect(s)

of this policy will require staff

training?

Which staff groups

require this training?

Is this training covered in the

Trust’s Mandatory and Risk Management Training Needs

Analysis document?

If no, how will the training be delivered?

Who will deliver the training?

How often will

staff require training

Who will ensure and

monitor that staff have this training?

Risk Assessment Line Managers/Service

Managers/Ward Managers

Risk Management Training Not Applicable E-learning 2 years Workforce Committee

9.0 Equality Impact Assessment

Black Country Partnership NHS Foundation Trust is committed to ensuring that the way we provide services and the way we recruit and treat staff reflects individual needs, promotes equality and does not discriminate unfairly against any particular individual or group. The Equality Impact Assessment for this policy has been completed and is readily available on the Intranet. If you require this in a different format e.g. larger print, Braille, different languages or audio tape, please contact the Equality & Diversity Team on Ext. 8067 or email [email protected]

10.0 Data Protection and Freedom of Information

Data Protection Act provides controls for the way information is handled and to gives legal rights to individuals in relation to the use of their data. It sets out strict rules for people who use or store data about individuals and gives rights to those people whose data has been collected. The law applies to all personal data held including electronic and manual records. The Information Commissioner’s Office has powers to enforce the Data

mailto:[email protected]

http://simple.wikipedia.org/wiki/Information

http://simple.wiktionary.org/wiki/right



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Protection Act and can do this through the use of compulsory audits, warrants, notices and monetary penalties which can be up to €20million or 4% of the Trusts annual turnover for serious breaches of the Data Protection Act. In addition to this the Information Commissioner can limit or stop data processing activities where there has been a serious breach of the Act and there remains a risk to the data. The Freedom of Information Act provides public access to information held by public authorities. The main principle behind freedom of information legislation is that people have a right to know about the activities of public authorities, unless there is a good reason for them not to. The Freedom of Information Act applies to corporate data and personal data generally cannot be released under this Act. All staffs have a responsibility to ensure that they do not disclose information about the Trust’s activities; this includes information about service users in its care, staff members and corporate documentation to unauthorised individuals. This responsibility applies whether you are currently employed or after your employment ends and in certain aspects of your personal life e.g. use of social networking sites etc. The Trust seeks to ensure a high level of transparency in all its business activities but reserves the right not to disclose information where relevant legislation applies. The Information Governance Team provides a central point for release of information under Data Protection and Freedom of Information following formal requests for information; any queries about the disclosure of information can be forwarded to the Information Governance Team. 11.0 Monitoring this Policy is Working in Practice The Trust plans to monitor compliance with the policy by undertaking the following action:- The Governance Assurance unit supported by the Divisional Governance Teams (Divisional Risk and Governance Leads) will on a 6 monthly basis review a random sample of risk assessments undertaken across all Divisions. Any shortfalls identified will be reported to the appropriate line Manager and a summary report tabled at the Health and Safety Committee. Remedial action plans will be implemented within each Division supported by the Divisional Risk and Governance Leads and progress monitored via the Divisional Risk and Safety Groups. Progress will be reported to the Health and Safety Committee via the quarterly divisional performance reports.

What key elements will be monitored?

(measurable policy objectives)

Where described in

policy?

How will they be monitored?

(method + sample size)

Who will undertake this

monitoring?

How Frequently?

Group/Committee that will receive and

review results

Group/Committee to ensure actions

are completed

Evidence this has

happened

Sample audits of pregnancy

risk assessments

4.0 (4.1.2) The Divisional

Governance and Risk leads are to sample a

random number of pregnancy risk

assessments to ensure

they are being completed correctly

Divisional Risk and

Governance Leads

Every 6

months

Divisional Quality,

Risk and Safety Meetings

Health and Safety

Committee as and where Divisional

Risk and Safety meetings escalate

to Health and

Safety Committee

Assurance

Reports



Appendix 1

Draft Letter to inform Line Manager of Pregnancy

All staff Please complete this form and return to your supervisor/line manger as soon as possible. Name: _____________________________________ Address: ___________________________________ _____________________________________ _____________________________________ Date: _____________________________________ Notification of Pregnancy Dear Sir/Madam I am writing to inform you that I am pregnant and that my baby is due on the _______________________ I understand that as I have now informed you of my pregnancy I do have the right to a personal and specific risk assessment as set out in the Management of Health and Safety at Work Regulations 1999. I also understand that you should regularly review my initial assessment as my pregnancy progresses to take into account possible risks that may occur during the different stages of my pregnancy. I am aware of my responsibilities to inform you of any advice I have received from my doctor or midwife (e.g. pregnancy-related medical conditions such as high blood pressure, a history of miscarriages etc.) that could affect the outcome of the ongoing assessment of risk. I am writing to ask you to arrange to see me as soon as possible in order to conduct a risk assessment. Thank you for your time and attention to this matter. I look forward to hearing from you in the near future. Yours faithfully


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Appendix 2 Private and Confidential

Risk Assessment for New and Expectant Mothers

Name of News/Expectant Mother:

Department/Service: Location:

Job Title: Brief details of main work activities:

Date of initial assessment:

Review 1: (Monthly until 32 weeks) Review 2 (Fortnightly at 32-36 weeks and weekly

thereafter)

Intended start date of Maternity Leave: Expected delivery date: Expected date of return from maternity leave:

Return to work review:

Completed by:

Hazard

Yes No N/A Comments and Control Measures

Is there any risk to the employee from lone working activity?

Previous medical history of relevance?

Is the work free from risk of physical Violence (physical or verbal assault)?

Are there rest facilities available?

Contact with patients/clients?

Contact with blood or bodily fluids?



Physical Agents

Shocks, vibration or movement

Manual handling patients/other

Noise

Non ionising electromagnetic radiation

Ionising Radiation

Extremes of heat or cold

Movements and postures

Display Screen Equipment

Biological Agents

Hepatitis B/HIV (AIDS virus)/ Herpes/ TB/ Syphilis / chicken pox / typhoid

Rubella / Toxoplasma / Cytomegalovirus

All substances labeled R40, R45, R46 and R47

Mercury and Mercury derivatives

Antimitotic (cytotoxic) drugs

Chemical Agents

Carbon Monoxide



Lead and Lead derivatives

Other occupational hazards

Occupational stress

Personal Protective Equipment (suitability)

Action Plan Summary of the steps to be taken, if any, as a result of this risk assessment, to reduce level of risk for the mother, foetus or baby. (continue on a separate sheet if necessary) S- Be Specific about what you want to achieve, do not be ambiguous, and communicate clearly.

M- Ensure your result is Measurable. Have a clearly defined outcome and ensure this is measureable (KPIs).

A- Make sure it is Appropriate. Is it an Achievable outcome?

R- Check that its Realistic, it must be possible taking account of time, ability, resource and finances.

T- Make sure it is Time restricted, Set an achievable time frame, set deadlines and milestones to review progress.

Recommendations/

Objectives

Specific Action to

address

Recommendations

Lead

Time Scale/

Expected

Completion

Date

Success

Criteria/

Measurable

results

Progress/Status

Completion

Date

These should outlines

the recommendations

as detailed within the

report

This should be the

specific action to

address the

recommendations. All

actions should be

SMART

The lead should be

a person of

appropriate

authority to

complete the

action. The action

should be

This should

be not overly

ambitious or

cautious

How will we

measure

progress and

know when

the goal is

achieved

Any progress on the

action can be recorded

here. Progress should be

updated regularly, even if

the action has not yet

been completed. It is also

important to reference any

This will be

the date the

action was

completed



discussed with the

lead prior to being

assigned to them to

ensure they are in

a position to

complete it.

issues which may lead to

the timescale being

breached

Have the controls that have been implemented reduced the risk to an acceptable level? YES/NO If ‘NO’, please seek further advice from the Occupational Health Service Has a referral to Occupation Health been initiated YES/NO If so, please confirm by whom and when: Action plan completed by: …………………………………… Job Role: ……………………………. Date: ………………….



Appendix 3

Guidance for completion of Assessment Form

HAZARD

RISK PRECAUTIONS

Physical Agents

Shocks, vibration or movement

Regular exposure to shocks, low frequency vibration (for example driving or riding or excessive movement) may increase the risk of miscarriage. Long term exposure to vibration does not cause foetal abnormalities but often occurs with heavy physical work, so there may be an increased risk of premature or low birth weight

Pregnant workers and those who have recently given birth are advised to avoid work likely to involve uncomfortable whole body vibration, especially at low frequencies, or where the abdomen is exposed to shocks or jolts. Breastfeeding workers are at no greater risk than other workers

Violence and Aggression

Pregnant workers may be at no greater risk of violence and aggression. However the impact of violence and aggression on a new or expectant mother could be catastrophic to the mother and/or the baby.

If violence and aggression is deemed as a risk on the risk assessment, careful consideration should go into changing the person’s duties/role to remove the risk of violence and aggression. If this is not possible then you must follow section 4.1.3 of this policy and further guidance can be found in Appendix 4.

Manual handling Pregnant workers are especially at risk from manual handling injury e.g. Hormonal changes can affect the ligaments, increasing susceptibility to injury and postural problems may be increased as the pregnancy progresses There can also be risks for those who have recently given birth, for example after a caesarean section there is likely to be a temporary limitation of lifting and handling capability There is no evidence to suggest that breastfeeding mothers are at greater risk from manual handling injury than any other worker

It may be possible to alter the nature of the task so that tasks that have a manual handling risk are reduced for all workers including new or expectant mothers. It would be necessary to address the specific needs for the worker and reduce the amount of physical work she is required to do.

Noise Although no direct or specific risk to new or expectant mother or foetus, prolonged exposure may cause tiredness and increased blood pressure

Comply with the Noise at Work Regulations https://www.hse.gov.uk/noise/

Non ionising electromagnetic radiation

The term used to describe part of the electromagnetic spectrum covering two main regions, namely optical radiation (ultraviolet-UV, visible and

Exposure to electric and magnetic field should not exceed the restrictions on human exposure published by the NRPB (National Radiological Protection Board)_

https://www.hse.gov.uk/noise/



infrared) and electromagnetic fields (EMFs) (power frequencies, microwaves and radio frequencies. Optical Radiation – no greater risk than normal workers although extreme over exposure to radio frequency radiation could cause harm by raising body temperature

Further information can be obtained from the www.hse.gov.uk/radiation/nonionising/issue.htm

Ionising Radiation Significant exposure to ionising radiation can be harmful to the fetus. Work procedures should be designed to keep exposure of the pregnant woman as low as reasonably practicable. If a nursing mother works with radioactive liquids or dusts, these can cause exposure to the child, particularly through contamination of the mothers skin Also, there may be a risk to the foetus from significant amounts of radioactive contamination breathed in or ingested by the mother and be transferred across to the placenta

Work procedures should be designed to keep exposure of the pregnant woman as low as reasonably practicable and certainly below the statutory dose limit for pregnant women. Special attention should be paid to the possibility of nursing mothers receiving radioactive contamination and they should not be employed in work where the risk of such contamination is high. The working condition should be such as to make it unlikely that a pregnant woman might receive high accidental exposures to radioactive Contamination.

Extremes of cold or heat

Pregnant women tolerate heat less well and may be more susceptible to fainting and/or heat stress. The risk is likely to be reduced after birth but it is not certain how quickly an improvement comes about. Breastfeeding may be impaired by heat dehydration No specific problems arise from working in extreme cold, although clearly for other health and safety reasons, warm clothing should be provided

Pregnant workers should take great care when exposed to prolonged heat at work, for example when working near furnaces Rest facilities and access to refreshments would help

Movements and postures

Fatigue from standing and other physical work has long been associated with miscarriage, premature birth and low birth weight. Traveling either inside or outside the establishment – mental and physical fatigue and other physical burdens connected with the activity work of new or expectant mothers. Excessive physical or mental pressure may cause stress and give rise to anxiety and raised blood pressure.

Ensure that hours of work, volume and pace of work are not excessive. That, where possible, the employees themselves have some control over how their work is organised. Ensure that seating is available where appropriate and practical. Longer or more frequent breaks/change in task may be appropriate to help avoid fatigue. Adjusting workstations or work procedures may help remove postural problems and risk of accidents

http://www.hse.gov.uk/radiation/nonionising/issue.htm



Pregnant workers may experience problems in working at height e.g. Ladders, platforms and working in tightly fitting workspaces or with workstations, which do not adjust sufficiently to take account of increased abdominal size, particularly during the later stages of pregnancy. This may lead to strain or sprain injuries. Dexterity, agility, coordination, speed of movements, reach and balance may also be impaired, and an increased risk of accidents may need to be considered

Work with Display Screen Equipment (VDU’s/DSE)

Although not specifically listed in the Pregnant Workers Directive, anxiety about radiation emissions from display screen equipment and possible effects on pregnant women have been widespread However, there is substantial evidence that these concerns are unfounded. There has been considerable public concern about reports of higher levels of miscarriage and birth defects among some groups of visual display unit (VDU) workers, in particular due to electromagnetic radiation. Many scientific studies have been carried out, but taken as a whole their results do not show any link between miscarriages or birth defects and working with VDUs. Research and reviews of the scientific evidence will continue to be undertaken.

In the light of the scientific evidence pregnant women do not need to stop working with VDUs. However, to avoid problems caused by poor posture, stress and anxiety, women who are pregnant or planning children and worried about working with VDUs/DSE should be given the opportunity to discuss their concerns with someone adequately informed of current authoritative scientific information and advice (You should seek advice if required from the Health and Safety team)

Biological Agents

Hepatitis B HIV (Aids virus) Herpes TB, Syphilis Chickenpox Typhoid Rubella Toxoplasma Cytomegalovirus

Many biological agents can affect the unborn child if the mother is infected during pregnancy. These may be transmitted through the placenta while the child is in the womb, or during or after birth, for example through breastfeeding or through close physical contact between mother and child.

Depends on the risk assessment, which will take account of the nature of the biological agent, how infection is spread, how likely contact is, and what control measures there are. These may include physical containment, hygiene measures, and vaccines. Where there is a high risk then the pregnant worker should avoid exposure altogether

All substances Content With the exception of lead and asbestos these



labelled R40, R45, R46 and R47

R40 possible risk of irreversible effects R45 may cause cancer R46 may cause heritable genetic damage R47 may cause birth defect R61 may cause harm to the unborn child R63 possible risk of harm to the unborn child R64 may cause harm to breastfed babies NOTE: A risk assessment must be undertaken, as this is the only way to determine the actual risk to health. Although they have a potential to endanger health or safety there may be no risk in practice when below Occupational or Maximum Exposure Limit

substances all fall within the scope of Control of Substance Hazardous to Health (COSHH). For work with hazardous substances, which include chemicals which may cause heritable genetic damage, employers are required to assess the health risk to workers arising from such work, and where appropriate prevent or control the risk. In carrying out assessments employers should have regard for women who are pregnant, or who have recently given birth.

Mercury and Mercury derivatives

Organic mercury compounds could have adverse effects on the foetus. Animal studies and human observations have demonstrated that exposure to these forms of mercury during pregnancy can slow the growth of the unborn baby, disrupt the nervous system, and cause the mother to be poisoned. No clear evidence of adverse effects on developing foetus from studies of humans exposed to mercury and inorganic mercury compounds

Guidance Notes EH17: Mercury – health and safety precautions MS12: Mercury – medical surveillance Give practical guidance on the risks of working with mercury and how to control them

Antimitotic (cytotoxic) drugs

In the long term these drugs cause damage to genetic information in sperm and eggs. Some can cause cancer. Absorption is by inhalation or through the skin.

There is no known threshold limit and exposure must be reduced to as low a level as is reasonably practicable. Assessment of the risk should look particularly at preparation of the drug for use (pharmacists, nurses), administration of the drug, and disposal of waste (chemical and human). Those who are trying to conceive a child or are pregnant or breastfeeding should be fully informed of the reproductive hazard

Chemical agents of known and dangerous percutaneous absorption (i.e. That may be absorbed through the skin)

The HSE guidance booklet EH40 Occupational exposure limits, updated annually, contains tables of inhalation exposure limits for certain hazardous substances. Some of these substances can also penetrate intact skin and become absorbed into the body, causing ill-health effects.

Take special precautions to prevent skin contact. Where possible, use engineering methods to control exposure in preference to personal protective equipment, such as gloves, overalls or face shields. For example perhaps you could enclose the process or redesign it so that less spray is produced. Where you must use personal protective equipment (either alone or in combination with engineering methods),



These substances are marked ‘Sk’ in the tables. As with all substances, the risks will depend on the way that the substance is being used as well as on its hazardous properties. Absorption through the skin can result from localised contamination, for example from a splash on the skin or clothing, or in certain cases, from exposure to high atmospheric concentrations of vapour

ensure that it is suitable. The Control of Pesticides Regulations 1986 (COPR) sets out general restrictions on the way that pesticides can be used. In addition all pesticides must be approved before they can be advertised, sold, supplied, used or stored. Conditions can be put onto the approval, which may for example limit the way the product can be used (for example restrict the way it can be applied), require that certain safety precautions are followed, and restrict who may use it (for example professionals or amateurs). These conditions are reflected on the product label. Failure to comply is an offence

Carbon Monoxide Carbon monoxide readily crosses the placenta and can result in the foetus being starved of oxygen. Data on the effects of exposure to carbon monoxide on pregnant women are limited but there is evidence of adverse effects on the foetus. Both the level and duration of maternal exposure are important factors in the effect on the foetus. There is no indication that breast fed babies suffer adverse effects from their mother’s exposure to carbon monoxide, nor that the mother is significantly more sensitive to carbon monoxide after giving birth

HSEs guidance note EH43: Carbon monoxide – gives practical advice on the risks of working with carbon monoxide and how to control them. It warns that pregnant women may have heightened susceptibility to the effects of exposure to carbon monoxide.

Lead and lead derivatives – in so far as these agents are capable of being absorbed by the human organism

Occupational exposure to lead in the early 1990s, when exposure was poorly controlled, was associated with high frequencies of spontaneous abortion, stillbirth and infertility. More recent studies draw attention to an association between low-level lead exposure before the baby is born from environmental sources and mild decreases in intellectual performance in childhood. The effects of breastfed babies of their mothers’ lead exposure have not been studied. However, lead can enter breast milk. Since it is thought the nervous system of young children is particularly sensitive to the toxic effects of lead, the exposure of breastfeeding mothers to lead should be viewed with concern.

The Approved Code of Practice associated with the Lead Regulations “Control of Lead at Work” sets out the current exposure limits for lead and the maximum permissible blood lead levels for workers who are exposed to lead to such a degree that they are subject to medical surveillance. It gives a blood lead level for men and a lower level for women of reproductive capacity. This Is to help protect the foetus from injury in the weeks before a pregnancy is confirmed. Once their pregnancy is confirmed, women who are subject to medical surveillance under the lead regulations will normally be suspended from work which exposes them significantly to lead, by the Employment Medical Adviser or Appointed Doctor carrying out the medical surveillance



Appendix 4

Flow chart for managers when notified of pregnancy



Policy Details

* For more information on the consultation process, implementation plan, equality impact assessment, or archiving arrangements, please contact Corporate Governance

Review and Amendment History

Version Date Details of Change

2.0 March 2020

Amendments to sections – section 1.0 included guidance to the Equality Act 2010, 4.1.3 amended list of typical risks to new or expectant mothers, 4.3 included information about appendix 4, 4.4.4 added a section regarding the importance of the new expectant mother informing her employer of any additional information from her GP or health care professional. 4.4.5 included greater clarity on where the risk assessment should be sent and copied to. 6.0 added detail around the Equality Act 2010. 7.0 roles and responsibilities added a line regarding HR providing advice and guidance to managers when requested. 11.0 Included further clarity around auditing of the pregnancy risk assessments.

Title of Policy New and Expectant Mothers Policy and Risk Assessment Procedure

Unique Identifier for this policy BCPFT-HS-POL-14

State if policy is New or Revised Revised

Previous Policy Title where applicable Previously part of the Maternity Leave Handbook for Employees

Policy Category Clinical, HR, H&S, Infection Control etc.

Health and Safety

Executive Director whose portfolio this policy comes under

Director of Nursing

Policy Lead/Author Job titles only

Health and Safety Team

Committee/Group responsible for the approval of this policy

Health & Safety Committee

Month/year consultation process completed *

March 2020

Month/year policy approved May 2020

Month/year policy ratified and issued May 2020

Next review date March 2023

Implementation Plan completed * Yes

Equality Impact Assessment completed * Yes

Previous version(s) archived * Yes

Disclosure status ‘B’ can be disclosed to patients and the public

Key Words for this policy

Risk Assessment, New and Expectant Mothers, Given Birth, pregnancy a stillborn, Child Bearing Age, hazards



Appendix 3 has been updated to include violence and aggression as a risk. Appendix 4 has been added which provides a flow chart to assist managers.

1.1 August 2018 Amendment to sections- definitions, 1.0 & 7.0

1.0 June 2013 New Policy

Documents

New and Expectant Mothers Policy and Risk Assessment Procedure