[Histonet] pregnancy and chemical exposure

[Terri Braud]

Hi Val - 
I'm sorry that you feel that your concerns are not being addressed.  I am the safety officer for our entire lab as well as the chair on our hospital's Environmental Safety and Hazardous Materials Committee.  I do think that Tim has a valid point that Xylene is detectable by smell long before it poses a danger.  It can be smelled at 0.8ppm to 40ppm and only becomes unacceptable at 100ppm.
You should have access to your most recent exposure tests which should have been performed at the peak of your work exposure process (i.e. using a Short-term exposure value (STEL) measure while changing the processor, or stainer) This is the best look at your actual exposure.  If this STEL has not been done, ask for it to be repeated.  It is cheap and easy. Additionally, you should be provided with appropriate PPE which include NITRILE gloves that are approved for Chemical use (looks for the label to state "tested and approved for use with  Chemotherapy drugs.  Those should be sufficient.) The gloves should be changed every 30 minutes of exposure task time, or sooner if the gloves are compromised.  You should also have access to air flow studies for your fume hood that show it is performing according to specs.
There are no useful studies of xylene exposure and prenatal risk or developmental toxicity.  The best overall study can be found at the NIH, but the only ones that specifically address this had too many limitations to be considered useful and didn't even include exposure levels.
As a tech, I have been in the field for over 40 years, I can tell you that I can count over 20 pregnancies amongst me and my coworkers at 3 different institutions, with no problems whatsoever, and many of these were in a not-so-great  environment as the one I work in now.
As a manager, I would expect that if I gave you the provisions that I discussed, (within STEL, appropriate PPE with Nitrile gloves, and an the hood air flow check) that you should be able to perform your chemical related tasks with no problems. 
My personal advice is the stressing over this problem is not good for you or your baby either.  I wish you and your new baby only the best.  Sincerely, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Message: 7
Date: Tue, 21 Jan 2020 16:23:15 +0000
From: "Morken, Timothy" <Timothy.Morken at ucsf.edu>
To: Val L <histology400 at gmail.com>, "Eck, Allison" <aeck at dh.org>
Cc: Histonet <histonet at lists.utsouthwestern.edu>
Subject: Re: [Histonet] Pregnant in histo lab. Am I safe?

The problem with xylene is that the acceptable air level in the lab is 100ppm but humans can detect it by smell at the 5 - 20ppm range. So it seems like it is "everywhere" but it could still be at a very low level. What level is safe for a pregnancy?  CDC has some info on this:
https://www.cdc.gov/niosh/topics/repro/solvents.html

Tim Morken
Supervisor, Electron Microscopy/Neuromuscular Special Studies
Department of Pathology
UC San Francisco Medical Center

-----Original Message-----
From: Val L via Histonet <histonet at lists.utsouthwestern.edu> 

Sadly I have already been exposed to xylene several times as I cannot avoid the smell. It?s everywhere. There are not enough vents in the lab. I don?t know if it?s ignorance or malice but my manager and coworkers are not quite informed about the dangers that a pregnant woman face in a histology lab.
They feel that if the lab passed a xylene vapor tests and give me a general purpose respirator then that?s enough for me to be safe and I can do the same work as everybody else. There is a negligent attitude regarding safety in this laboratory. Also there has been a negative attitude towards pregnant women like if they were are a burden in the lab.  It makes me nervous to work here. I don?t think is a healthy work environment.

On Saturday, January 18, 2020, Eck, Allison <aeck at dh.org> wrote:

> From: Valerie Laughlin via Histonet 
> [histonet at lists.utsouthwestern.edu]
> Sent: Saturday, January 18, 2020 7:21 AM
> To: histonet at lists.utsouthwestern.edu
> Subject: [Histonet] Pregnant in histo lab. Am I safe?
>
> Hello everyone. I am currently in the last weeks of my first trimester 
> of my pregnancy.
>> I have asked this question to my Ob-Gyn, family and general pregnancy 
> forums but I wanted to ask people who understand the field of 
> Histotechnology better.
> I have been very concerned about the side effects of the chemicals 
> that might have on my baby.  The lab works with the typical stuff 
> (formaldehyde, xylene, alcohol of different percentages, glacial 
> acetic acid, stains etc) They make the fixative from scratch.
> I had to inform my supervisor and manager. I didn?t get the most 
> positive reaction from them but I don?t care as this is my personal 
> business and I have rights like everybody else.
> I gave them a letter from my doctor informing my pregnancy and that I 
> should be kept away from the chemicals for my own safety.
> They acknowledged the letter but still decided to buy a respirator 
> mask for me which is fine. It?s good to have protective equipment no 
> matter the circumstance.
> I told them that I can do the same tasks I do every day such as 
> grossing but with a mask, embedding, cutting and filing but that I 
> don?t feel comfortable changing the chemicals of the tissue processor 
> and slide stainer, and mixing chemicals. Also that I can?t dump the 
> chemicals in the biohazard room as there is not enough ventilation.
> Literally an hour after I informed this a nurse who was working in a 
> rojom close to the biohazard room had a negative reaction and had to 
> be sent to the ER where she was there for days. She blamed the 
> chemicals  from the biohazard room. Other nurses who work close to 
> that room had reported negative side effects as well. This situation 
> made me more uncomfortable specially when my coworkers think the 
> nurses are over reacting and it has to be some other cause because they don?t get the same reactions.
> My biggest concern is that despite the letter of my doctor and what 
> ocurred in the past weeks with the nurse I am still feeling pressured 
> by my coworkers to work with the chemicals as they feel that a mask, a 
> lab coat and gloves is enough protection. I am unsure about this.
> I didn?t get a proper fit test for my respirator by the way. I have 
> worked for another corporation where they did that right after getting hired.
> I have read that chemicals can be absorbed through the skin too.
> I just want to know the opinion of pregnant  lab techs and supervisors 
> who have worked with them.
> I have read older threads about this in this forum before and 
> everybody had positive and negative experiences. Some workers were 
> completely removed from the lab while others kept performing the same 
> tasks. Some say their babies turned out healthy while others blame the 
> job for causing short and long term health issues  for the babies.
> Most of the employers protected the pregnant worker from the chemicals 
> to avoid any risks which I feel that?s the direction my employer should take.
> There are 3 other histotechs in the lab and they don?t seem happy to 
> have that extra task in their hands, despite being the one who changed 
> the processor most of the time this past year besides the supervisor.
> Thank you for your help. This has caused a lot of distress in me and I 
> just want to be safe.