Health and Safety Report on Warfarin

To identify the nature and extent of the probability of risk/harm to a pregnant woman due to occupational exposure to the chemical agent Warfarin

Data collection

 It has been well established via numerous data sources that Warfarin needs to be directly consumed to cause an effect on a patient. However, it is difficult to establish the exact risk during the different stages of pregnancy. There is no clear data collection because this would involve administrating Warfarin directly into pregnant women. Much of the evidence relies on data which is specifically in relation to Warfarin being administered to Women as an oral anticoagulant. In this instance, the dosage varies from person to person and as a result has to be carefully monitored in order to prevent varied side effects such as uncontrollable bleeding (haemorrhage). “Acceptable Exposure Levels (AELs) were derived from data because NO Observable Adverse Effect Levels (NOAEL) for Warfarin could be derived from rodent repeated dose studies because of the particular susceptibility of rodents to anticoagulants effects”. Directive 98/8/EC Concerning the Placing of Biocidal Products on the Market pp.11.

Evaluating Prenatal Effects of Warfarin

There is a risk to both Mother and Progeny, it has been noted that during week six to nine of the pregnancy in particular are associated with Warfarin specific embryopathy (first trimester). However, the exposure to cause such affects would need to be administrated directly into a pregnant woman to cause the effect that Haly and Bernotts’ claim “Throughout gestastion and into the neonatal period, many organ systems are maturing and substantial cell-cell interactions are occurring especially in organ systems like the central nervous system, endocrine system, immune system, and urogential system” (1987:273). Warfarin disrupts normal embryonic and or foetal development (teratogenic effects). The second and third trimesters are associated with optic atrophy and dilation of the central ventricles associated with blindness, microcephaly and mental retardation. Therefore, it can be said that direct contact/exposure to Warfarin during any stage of pregnancy is extremely dangerous. Any hypothesis presented on the basis of indirect contact with Warfarin in an occupational setting could be said to be inconclusive.

Review of Risk Assessment

A new risk assessment is now in place and additional and necessary controls, rigorous policies and standards are in place to protect you and your unborn baby. I am satisfied that no harm will come to you or the baby as adequate controls are in place. To have any adverse effect, a person would have to be in physical contact with the agent (skin contact) or ingest it. I have looked over your training files and you are competent and adequately trained in the use of Personal Protective Equipment (PPE) (respirator/dust mask, gloves, overalls, goggles/face shield). Distance is a great protector and because you are not in direct contact you do not need to be removed from the laboratory.

Recommendations

As part of the updated Risk Assessment wider conditions were considered laboratory work is characterised as requiring long periods of standing and thus I would strongly advise you to liaise with the Human Resources Department to ensure you get regular rest breaks or to be repositioned in another department such as Administration where you would not be required to stand for the duration of your shift.

A. Murphy

Anita Murphy

Health and Safety Officer

Date: 10^th Oct 2011