The Pregnant Officer
Fabrice Czarnecki. M.D.
From Clinics In Occupational and Environmental Medicine
Volume 3, Issue 3, Pages 641-648 (August 2003)
In 2000, women
accounted for 10.6% of local law enforcement officers and 14.4% of federal law
enforcement officers. These numbers are likely to rise in the next few years.
New issues that are relevant to female officers have been raised, such as
adjusting the working conditions of pregnant officers.
Every employer must make the workplace as safe as possible for all employees.
Pregnant employees tend to be more susceptible to chemical and physical hazards
and deserve special consideration to minimize risks to the fetus. Law
enforcement agencies should implement policies to ensure the best possible
outcome of the pregnancy and to decrease the woman's professional risks. This
article presents these professional hazards and how to mitigate them while
complying with the law.
Occupational chemical hazards faced by pregnant workers include exposure to
heavy metals (lead, mercury), organic solvents (acetone, benzene, formaldehyde,
halogenated hydrocarbons, styrene, toluene, trichloroethylene, xylene), and
pesticides. Physical hazards include trauma, radiation, and noise. Additional
pregnancy hazards that are specific to the law enforcement profession include
firearms training and an increased likelihood of trauma.
The safety of firearm use during pregnancy has been questioned. A search of the
medical literature and a survey of a large number of police physicians and
firearms instructors revealed no definitive answer. Several police departments
and military units from the survey had policies regarding firearms training
during pregnancy, but these policies were not consistent. Instructors at one
training facility claimed that pregnant officers could shoot there because
lead-free ammunition was used. None of these agencies could articulate why
shooting was allowed during one part of the pregnancy but not at others. Most
police departments relied on the officer's personal physician to make
recommendations regarding weapon use during pregnancy; however, obstetricians
and family physicians were unlikely to have access to appropriate information on
There is an extensive body of research showing that lead exposure is harmful to
the fetus. Lead crosses the placenta and is transmitted from the mother to the
fetus . Lead exposure during pregnancy has been associated with serious
complications, including spontaneous abortion, premature membrane rupture,
preeclampsia, pregnancy hypertension , and neurobehavioral effects in infants
and children . Even at low levels, lead exposure has been associated with
preterm delivery; congenital abnormalities ; and decreased birth weight,
length, and head circumference .
Noise usually is considered to be detrimental during pregnancy. In most European
countries, health regulations forbid pregnant women from working in surroundings
with a continuous noise level greater than 80 dB or a rapid-impulse noise level
greater than 40 dB, which is much less than the noise of a firearm . In the
United States, the Occupational Safety and Health Administration permissible
exposure limit for rapid-impulse noise is 140 dB, with additional regulations
for continuous noise. The sound levels of firearms are about 125 to 140 dB for
rimfire rifles; 140 to 150 dB for rimfire pistols; and 150 to 160 dB for
centerfire rifles, pistols, and shotguns .
Intrauterine measurements showed that the fetus was not significantly protected
against loud noises . One study in human volunteers found a maximal
intrauterine noise attenuation of 10 dB at 4000 Hz . In a study of ewes, the
noise attenuation was 20 dB at 4000 Hz, but the noise inside the uterus was 2 to
5 dB greater at 250 Hz . In comparison, foam plugs offer attenuation of 12
to 20 dB and are considered to be the least effective hearing protection .
Noise exposure during pregnancy has been associated with several disorders,
including miscarriage [11,12], intrauterine growth retardation [13,14,16],
preterm delivery [12,15,16], hearing loss in babies and children , altered
immune response in the fetus , and hypertension . A combined exposure to
noise and lead seems to have an increased toxicity, causing heart lesions, which
are not observed for those agents alone .
Other chemical hazards
Besides lead, firearms training exposes officers to other metals, including
barium, antimony, copper, and arsenic . These metals could be toxic,
depending on the concentration. Their concentrations seem to be nontoxic for
nonpregnant adults at a shooting session, but their safety has not been assessed
for pregnant shooters. Another source of chemical hazards related to firearms
are the cleaning products, which contain organic solvents. Some of these
solvents are known to be teratogenic.
The available scientific knowledge does not provide evidence that firearm use is
safe during pregnancy. Data also show that noise and lead are significantly
toxic during pregnancy.
Pregnant officers should not shoot firearms, unless in self-defense, and should
avoid shooting ranges. Officers who are breastfeeding should only shoot
lead-free ammunition. Pregnant women should not clean their guns because of
possible exposure to chemicals. The guns should be cleaned by other people and
away from the pregnant woman.
Law enforcement agencies should not require pregnant officers to train and
qualify with live ammunition and should inform them about the health hazards
involved with firearms training. Alternative solutions to live-fire
qualification should be developed. One alternative is the use of a simulation
shooting system, which employs lasers and CO2 or compressed air to create
recoil. These systems are available commercially. Progressive law enforcement
agencies already possess these simulators to train officers in the judgmental
aspects of the use of deadly force.
If a pregnant officer chooses to attend a firearms training session, the author
recommends the following steps to reduce the health hazards to the fetus:
ammunition (with lead-free primers)
(to reduce exposure to noise and chemicals)
smallest possible number of rounds
respirator with a high-efficiency particulate air filter
Wash hands and
face carefully after a shooting session
and eating within 1 hour after shooting session
Use a silencer
clothing that covers the abdomen
up spent brass
The work of
pregnant officers should be adapted to decrease the risk for trauma, whether it
results from assaults or accidents, which would expose the mother and the fetus.
Typically, the patrol position is the most vulnerable position and should be
avoided during pregnancy.
The law enforcement agency should reduce the exposure of pregnant officers to
physical confrontations. Assaults seem to be most frequent during patrolling,
arresting, and search-warrant service. Custody of prisoners should be avoided if
it involves direct contact with prisoners.
Light duty positions include office work and certain investigative positions.
The optimal level of physical activity during pregnancy is unknown. It usually
is suggested that pregnant women keep the same level of work until 32 weeks of
gestation, in the absence of a clear professional hazard and pregnancy
complications. Work by itself is not correlated with the incidence of birth
defects . Lifting heavy objects should be avoided during pregnancy. The risk
for low back injury and back pain is increased in pregnant women, especially
during the last trimester.
Training should be limited and adjusted to avoid accidental injuries. During
defensive tactics (hand-to-hand combat) training, pregnant officers should not
participate in combat simulations. Training that involves physical contact
should be limited to restraint techniques. Falls and blunt trauma should be
avoided. Ground-fighting techniques that require the officer to lie on her back
should be avoided after the third trimester, because the uterus could compress
the inferior vena cava.
The taser is an electrical restraint device that is used in law enforcement. It
is common for officers to have the taser applied to themselves during training.
One study suggested an association between the taser and miscarriage after
reviewing a case report and the literature on electrical injuries during
pregnancy . Pregnant officers should not be subjected to the taser and
should not try to restrain subjects during a taser application.
Pregnant officers should be protected against other job-related hazards as much
as possible. Physical confrontations  or close contacts could increase the
risk for transmission of several infectious diseases, including HIV, viral
hepatitis, and tuberculosis. Avoiding patrol and prisoner custody would decrease
The chemical hazards that are faced by police officers are likely to be more
toxic to the fetus than to healthy adults. Situations should be avoided that,
although acceptable to most officers, might be dangerous pregnant officers, such
as clandestine drug laboratories, traffic enforcement, and hazardous-material
scenes. Clandestine drug laboratories can expose officers to a variety of toxic
chemicals, some of which are potentially deadly (eg, phosphine). Traffic
enforcement might be dangerous because of exposure to benzene and other organic
solvents from motor vehicles. A study found that benzene exposure in traffic
officers was about twice as high as in a control population of office workers
. In developing countries that use leaded gasoline, lead exposure is a
significant problem for traffic officers . Pregnant officers probably should
avoid any type of traffic enforcement on foot patrol, especially near tunnels
and tolls, where the concentration of traffic is high.
Shift work and night work have been associated with preterm birth . Shift
work also results in increased fatigue in pregnant women.
Law enforcement agencies should design and implement policies that address the
needs of pregnant officers. These policies should cover issues that are specific
to law enforcement and those that are not included in the Family and Medical
Leave Act of 1993 (FMLA), which established federal minimum leave requirements
for private and public sector employees.
The Pregnancy Discrimination Act of 1978 states that discrimination on the basis
of pregnancy or childbirth constitutes unlawful sex discrimination under Title
VII of the Civil Rights Act of 1964 . Women who are pregnant or have related
conditions must be treated in the same manner as other applicants or employees
with similar abilities or limitations. An employer cannot force a pregnant
employee to take disability leave if she is able to work and cannot remove her
from her duty assignment if she is able and willing to perform it.
The US Supreme Court ruled in 1991 that an employer cannot exclude pregnant
women from hazardous jobs . Police agencies should give options to pregnant
officers, but ultimately it is up to the individual officers to decide, after
consultation with their personal physician, whether they want a light duty
assignment or other reasonable changes in their job assignments.
Notification of pregnancy
Officers should be encouraged to report the pregnancy as soon as possible. They
should receive an information package describing the available benefits, the
occupational hazards, and the steps taken by the employer to mitigate the
hazards. Pregnant officers should be encouraged to stop working after 32 weeks
of gestation, or sooner if they have complications, after consultation with
their personal physician. Female officers should understand that changes in
their jobs are implemented after the pregnancy has been detected and reported.
They might be exposed to reproductive hazards during the early part of the
pregnancy before they know that they are pregnant.
Benefits for law enforcement officers usually include paid and unpaid leave. The
FMLA allows 12 weeks of unpaid leave. Employers should not require that a
pregnant employee exhaust all her paid leave before applying for unpaid leave.
Light duty assignments
Pregnant officers should be accommodated as much as feasible. The employer
should encourage the officer to have her personal physician involved in deciding
how to make the job as safe as possible for herself and the fetus. Pregnant
officers should not be mandated to stop a crime in progress, as they would not
have their full physical capacity.
Pregnant officers should be given the option not to participate in aggressive
law enforcement functions, which include restraining and arresting suspects,
performing search and arrest warrants, conducting vehicular stops, and taking
prisoners into custody. Daytime assignments should be offered, with no night
shifts and no shift work.
Typical light duty positions include office work. An investigative position may
or may not be appropriate, depending on the risk for physical confrontation.
White collar crime investigations are probably safer than narcotics
investigations. Not every job inside a police station would be considered safe
for pregnant officers, especially if the duties include contact with prisoners,
such as work in a booking area.
Mandated training should be limited to what is recommended to be safe during the
pregnancy, after consulting with the officer's personal physician and the
employer's medical advisor. Defensive tactics training that involves physical
contact should be limited. Pregnant police officers should not be required to
participate in live-fire range qualification. Alternative firearms training
should be implemented, using simulation systems instead of real ammunition.
Some agencies remove arrest powers and previously issued firearms from pregnant
officers; however, pregnant officers should be allowed to keep their firearms.
Officers are more vulnerable during the pregnancy and could be targeted by
criminals for revenge or crimes of opportunity. Pregnant officers need their
firearms for self-defense even more than nonpregnant officers.
Regular uniforms may not be appropriate for pregnant officers. These officers
should be given the option to wear specially designed maternity uniforms or
civilian maternity clothing if a regular uniform cannot be worn because of
problems with size and comfort.
Law enforcement agencies must ensure the best working conditions for all
employees, including pregnant officers. Knowledge of possible medical problems
and work-related hazards help agencies design appropriate policies to inform and
protect the officers and their families, while also serving the public and
complying with current laws.
. Gardella C. Lead exposure in pregnancy: a review of the literature and
argument for routine prenatal screening. Obstet Gynecol Surv. 2001;56(4):231-238
. Osman K, Akesson A, Berglund M, Bremme K, Schutz A, Ask K, et al. Toxic and
essential elements in placentas of Swedish women. Clin Biochem.
. Winder C. Lead, reproduction and development. Neurotoxicology.
. O'Halloran K, Spickett JT. The interaction of lead exposure and pregnancy.
Asia Pac J Public Health. 1992–93;6(2):35-39 MEDLINE
. Dams R, Vandecasteele C, Desmet B, Helsen M, Nagels M, Vermeir G, et al.
Element concentrations in the air of an indoor shooting range. Sci Total
Environ. 1988;77(1):1-13 MEDLINE
. Brezinka C, Lechner T, Stephan K. The fetus and noise.
Gynakologisch-geburtshilfliche Rundschau. 1997;37(3):119-129 MEDLINE
. Shimm DS, Passamaneck M. Shooting noise, hearing loss, and hearing
protection. Berryville (AR): International Defensive Pistol Association 2001
. Gerhardt KJ, Abrams RM, Huang X, Griffiths SK, Peters AJ. Intra-abdominal
sound pressure levels during impulse noise exposure in sheep. Mil Med.
. Richards DS, Frentzen B, Gerhardt KJ, McCann ME, Abrams RM. Sound levels in
the human uterus. Obstet Gynecol. 1992;80(2):186-190 MEDLINE
. Gerhardt KJ, Abrams RM, Oliver CC. Sound environment of the fetal sheep.
Am J Obstet Gynecol. 1990;162(1):282-287 MEDLINE
. Zhang J, Cai WW, Lee DJ. Occupational hazards and pregnancy outcomes. Am J
Ind Med. 1992;21(3):397-408 MEDLINE
. Zhan C, Lu Y, Li C, Wu Z, Long Y, Zhou L, et al. A study of textile noise
influence on maternal function and embryo-growth. Hua Xi Yi Ke Da Xue Xue Bao.
. Hruba D, Kukla L, Tyrlik M. Occupational risks for human reproduction:
ELSPAC Study. European Longitudinal Study of Pregnancy and Childhood. Cent Eur J
Public Health. 1999;7(4):210-215 MEDLINE
. Hartikainen AL, et al. Effect of occupational noise on the course and
outcome of pregnancy. Scand J Work Environ Health. 1994;20(6):444-450 MEDLINE
. Luke B, Mamelle N, Keith L, Munoz F, Minogue J, Papiernik E, et al. The
association between occupational factors and preterm birth: a United States
nurses' study. Research Committee of the Association of Women's Health,
Obstetric, and Neonatal Nurses. Am J Obstet Gynecol. 1995;173(3 Pt 1):849-862
. Nurminen T. Female noise exposure, shift work, and reproduction. J Occup
Environ Med. 1995;37(8):945-950 MEDLINE
. Pierson LL. Hazards of noise exposure on fetal hearing. Semin Perinatol.
. Sobrian SK, Vaughn VT, Ashe WK, Markovic B, Djuric V, Jankovic BD.
Gestational exposure to loud noise alters the development and postnatal
responsiveness of humoral and cellular components of the immune system in
offspring. Environ Res. 1997;73(1–2):227-241 MEDLINE
. Cary R, Clarke S, Delic J. Effects of combined exposure to noise and toxic
substances–critical review of the literature. Ann Occup Hyg. 1997;41(4):455-465
. Shi LM, Chia SE, Chan OY, Chew SK, Foong BH. Prevalence of birth defects
and parental work in Singapore live births from 1994 to 1998: a population-based
study. Occup Med (Lond). 2002;52(6):325-331
. Mehl LE. Electrical injury from Tasering and miscarriage. Acta Obstet
Gynecol Scand. 1992;71(2):118-123 MEDLINE
. Abel S, Cesaire R, Cales-Quist D, Bera O, Sobesky G, Cabie A. Occupational
transmission of human immunodeficiency virus and hepatitis C virus after a
punch. Clin Infect Dis. 2000;31(6):1494-1495 MEDLINE
. Tomei F, Ghittori S, Imbriani M, Pavanello S, Carere A, Marcon F, et al.
Environmental and biological monitoring of traffic wardens from the city of
Rome. Occup Med (Lond). 2001;51(3):198-203
. Kamal AA, Eldamaty SE, Faris R. Blood lead level of Cairo traffic
policemen. Sci Total Environ. 1991;105:165-170 MEDLINE
. Bodin L, Axelsson G, Ahlborg Jr. G. The association of shift work and
nitrous oxide exposure in pregnancy with birth weight and gestational age.
Epidemiology. 1999;10(4):429-436 MEDLINE
. Pregnancy Discrimination Act, 42 USC §2000e(k)
. Automobile Workers v. Johnson Controls, Inc., 499 US 187 (1991)
a The Gables Group, Inc., 1172 South Dixie Highway, Coral Gables, FL 33146, USA
b Family Health Center, Franklin Square Hospital Center, 9101 Franklin Square
Drive, Suite 205, Baltimore, MD 21237, USA
* Family Health Center, Franklin Square Hospital Center, 9101 Franklin Square
Drive, Suite 205, Baltimore, MD 21237
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