[Pregnancy and occupational environment. Counseling of pregnant women in the department of occupational medicine during the period 4 January--31 December 1992].

Since the new Sickness and Maternity Benefit Act was introduced in Denmark 1981, it has been possible to provide maintenance allowance for pregnant women working under conditions that might be harmful to the unborn child. The assessment of the risk is primarily undertaken by the general practitioner, but in cases of doubt, the pregnant women can be referred to the Department of Occupational Medicine. The assessment at the Department of Occupational Medicine is made one or two weeks after referral. It consists of a careful work history, which includes characterization of exposure, both qualitatively and quantitatively and a decision whether the exposure entails a risk to the foetus and which steps should be taken for the rest of the pregnancy. The purpose of this study was to describe the practice of risk assessment at the Department of Occupational Medicine in Denmark. Over a period of nine months all cases of pregnant women referred to 12 out of 14 departments were reviewed. Out of 60,000 births per year only 250 pregnant women were referred, which is less than 1%. Main risk factors in the assessment were of chemical (80%) or ergonomic (17%) origin. Forty-three percent were advised to leave work on maintenance allowance and 15% were advised to stay at work, on condition that the work environment was changed or they could be moved to a job without risk exposure. The study revealed big differences in referral incidence between the different counties as well as differences in risk assessment practice. It is concluded, that the best way to secure pregnant women and their foetus is by primary prophylactic measures at the workplace. Hopefully the new EU Directive 92/85 will be a step in that direction.