How to talk about biosafety when I might soon be pregnant
November 8, 2015 7:22 PM Subscribe
I've been offered a position working in a lab that does research on human cytomegalovirus (HCMV, a common type of herpesvirus that can cause mono-like symptoms). I'm excited about the position and really want to take it, but I have some concerns about biosafety during hypothetical pregnancy and I'm trying to gather my thoughts before talking to the PI. Looking for personal experience working in a bio lab while pregnant (or immuno-compromised) and suggestions for how to talk to the PI about this.
The PI is a new faculty and told me in the interview that he'd really hope whoever takes this position to stay for at least two years, because he'll be investing time training me while working towards tenure. I am currently actively trying to get pregnant with my first child. I have no idea how long it will take me to get and stay pregnant - I had a miscarriage a few months ago. I would like to work throughout pregnancy (assuming a normal pregnancy) and work at least part time after having kids. In terms of shooting myself in the foot by openly talking about getting pregnant at a future date, I don't 100% NEED this job. I would like to have it for money and gaining experience reasons, but it's not an issue of not making rent or having health insurance if he doesn't want to hire me considering I might get pregnant. I'd rather hash that out now than have hurt feelings all around if a few months after starting I do get pregnant.
I'm a bit concerned about working in this lab during pregnancy because although HCMV is a commonly acquired virus, it can have really bad effects on a fetus (including miscarriage and birth defects) if a primary infection happens during pregnancy. The CDC guide on Biosafety in laboratories says that lab acquired infections for all the herpesviruses are rare, but I don't know if I would even be allowed by the Environmental Health and Safety department to work in the lab if I became pregnant. I was thinking of trying to get my GP to run an antibody test to see if I've already had HCMV, because then it wouldn't be as much of a concern.
So, in conclusion:
Am I over-reacting about risks? Under-reacting? If you've been in a similar job situation, how did you hash this out with respect to chemicals/biosafety while pregnant or immuno-compromised?
How should I talk to the PI about this - health concerns and possible pregnancy? He's worked with this virus for awhile, so it might have come up with any woman of child-bearing age working on projects in the lab he was in before coming here.
Thanks for your help!
Background From the CDC handbook on biosafety in biomedical laboratories:
HCMV infection is common and often undiagnosed presenting
as a nonspecific febrile illness. HCMV causes up to 10% of all cases of
mononucleosis in young adults. The most severe form of the disease is seen
in infants infected in utero. Children surviving infection may evidence mental
retardation, microencephaly, motor disabilities and chronic liver disease.42
HCMV is one of the most common congenital diseases.
...
Clinical materials and isolates of herpesviruses may pose a risk of infection
following ingestion, accidental parenteral inoculation, and droplet exposure of the
mucous membranes of the eyes, nose, or mouth, or inhalation of concentrated
aerosolized materials. HHV-8 may be present in human blood or blood products
and tissues or saliva. Aerosol transmission cannot be excluded as a potential
route of transmission. Clinical specimens containing the more virulent
Herpesvirus simiae (B-virus) may be inadvertently submitted for diagnosis of
suspected herpes simplex infection. HCMV may pose a special risk during
pregnancy because of potential infection of the fetus. All human herpesviruses
pose an increased risk to persons who are immunocompromised.
BSL-2 practices, containment equipment, and facilities are recommended for
activities utilizing known or potentially infectious clinical materials or cultures of
indigenous viral agents that are associated or identified as a primary pathogen of
human disease. Although there is little evidence that infectious aerosols are a
significant source of LAI, it is prudent to avoid the generation of aerosols during
the handling of clinical materials or isolates, or during the necropsy of animals.
Primary containment devices (e.g., BSC) should be utilized to prevent exposure
of workers to infectious aerosols. Additional containment and procedures, such
as those described for BSL-3, should be considered when producing, purifying,
and concentrating human herpesviruses, based on risk assessment.
The PI is a new faculty and told me in the interview that he'd really hope whoever takes this position to stay for at least two years, because he'll be investing time training me while working towards tenure. I am currently actively trying to get pregnant with my first child. I have no idea how long it will take me to get and stay pregnant - I had a miscarriage a few months ago. I would like to work throughout pregnancy (assuming a normal pregnancy) and work at least part time after having kids. In terms of shooting myself in the foot by openly talking about getting pregnant at a future date, I don't 100% NEED this job. I would like to have it for money and gaining experience reasons, but it's not an issue of not making rent or having health insurance if he doesn't want to hire me considering I might get pregnant. I'd rather hash that out now than have hurt feelings all around if a few months after starting I do get pregnant.
I'm a bit concerned about working in this lab during pregnancy because although HCMV is a commonly acquired virus, it can have really bad effects on a fetus (including miscarriage and birth defects) if a primary infection happens during pregnancy. The CDC guide on Biosafety in laboratories says that lab acquired infections for all the herpesviruses are rare, but I don't know if I would even be allowed by the Environmental Health and Safety department to work in the lab if I became pregnant. I was thinking of trying to get my GP to run an antibody test to see if I've already had HCMV, because then it wouldn't be as much of a concern.
So, in conclusion:
Am I over-reacting about risks? Under-reacting? If you've been in a similar job situation, how did you hash this out with respect to chemicals/biosafety while pregnant or immuno-compromised?
How should I talk to the PI about this - health concerns and possible pregnancy? He's worked with this virus for awhile, so it might have come up with any woman of child-bearing age working on projects in the lab he was in before coming here.
Thanks for your help!
Background From the CDC handbook on biosafety in biomedical laboratories:
HCMV infection is common and often undiagnosed presenting
as a nonspecific febrile illness. HCMV causes up to 10% of all cases of
mononucleosis in young adults. The most severe form of the disease is seen
in infants infected in utero. Children surviving infection may evidence mental
retardation, microencephaly, motor disabilities and chronic liver disease.42
HCMV is one of the most common congenital diseases.
...
Clinical materials and isolates of herpesviruses may pose a risk of infection
following ingestion, accidental parenteral inoculation, and droplet exposure of the
mucous membranes of the eyes, nose, or mouth, or inhalation of concentrated
aerosolized materials. HHV-8 may be present in human blood or blood products
and tissues or saliva. Aerosol transmission cannot be excluded as a potential
route of transmission. Clinical specimens containing the more virulent
Herpesvirus simiae (B-virus) may be inadvertently submitted for diagnosis of
suspected herpes simplex infection. HCMV may pose a special risk during
pregnancy because of potential infection of the fetus. All human herpesviruses
pose an increased risk to persons who are immunocompromised.
BSL-2 practices, containment equipment, and facilities are recommended for
activities utilizing known or potentially infectious clinical materials or cultures of
indigenous viral agents that are associated or identified as a primary pathogen of
human disease. Although there is little evidence that infectious aerosols are a
significant source of LAI, it is prudent to avoid the generation of aerosols during
the handling of clinical materials or isolates, or during the necropsy of animals.
Primary containment devices (e.g., BSC) should be utilized to prevent exposure
of workers to infectious aerosols. Additional containment and procedures, such
as those described for BSL-3, should be considered when producing, purifying,
and concentrating human herpesviruses, based on risk assessment.
Anectodately, I had an atypical reaction to CMV when I was 19, and it massively messed with my immune system. I conceived two years later, and my daughter is now a healthy teenager. You likely already have it, as most people do. I agree with getting tested. Having been through a worst case scenario (I was getting tested for HIV every month for six months when I got sick) I think you'll be okay.
posted by Ruki at 8:46 PM on November 8, 2015 [1 favorite]
posted by Ruki at 8:46 PM on November 8, 2015 [1 favorite]
Best answer: Hm. I know I'm CMV negative because I've been tested by my local blood bank (Stanford); they test blood that they want to give to immuno-compromised patients. I don't think they usually would mention CMV status except if they want you to come in to donate platelets. So if you're a blood donor they might already know your status.
Your doctor might be able to run titers, too. That would be a way to get your own peace of mind without necessarily making the lab orchestrate & pay for it.
I've worked with radiation before and this is an item that comes up. Radiation exposure limits are lower in pregnancy than the rest of the time. So you have to disclose pregnancy pretty much ASAP, but also it means there are different protocols for what people have to do depending on their condition.
So the way I would approach this with your lab is to let him know that you want to know more about the lab's safety practices, specifically as a woman of child-bearing age. "In time I may want to have children, and I want to know if this lab has protocols in place to handle pregnant workers. What are they? If they don't exist, who would create those and what might they look like?"
I think this would be best suited as part of a larger conversation of safety protocols, of course. "Has anyone in the lab ever been infected or had a suspect incident (needle stick)? What was the response? Do they do immune response testing, either before or after starting work in the lab?" (heck, testing might be standard and you don't even have to ask for special treatment!) And then somewhere in there you can do the 'has anyone here been pregnant or immuno-compromised?' question.
posted by Lady Li at 1:06 AM on November 9, 2015 [1 favorite]
Your doctor might be able to run titers, too. That would be a way to get your own peace of mind without necessarily making the lab orchestrate & pay for it.
I've worked with radiation before and this is an item that comes up. Radiation exposure limits are lower in pregnancy than the rest of the time. So you have to disclose pregnancy pretty much ASAP, but also it means there are different protocols for what people have to do depending on their condition.
So the way I would approach this with your lab is to let him know that you want to know more about the lab's safety practices, specifically as a woman of child-bearing age. "In time I may want to have children, and I want to know if this lab has protocols in place to handle pregnant workers. What are they? If they don't exist, who would create those and what might they look like?"
I think this would be best suited as part of a larger conversation of safety protocols, of course. "Has anyone in the lab ever been infected or had a suspect incident (needle stick)? What was the response? Do they do immune response testing, either before or after starting work in the lab?" (heck, testing might be standard and you don't even have to ask for special treatment!) And then somewhere in there you can do the 'has anyone here been pregnant or immuno-compromised?' question.
posted by Lady Li at 1:06 AM on November 9, 2015 [1 favorite]
Best answer: If you're this worried, the first step is to find out if you're already CMV positive: chances are fairly high that you are. However, considering the amount of CMV in the population as a whole (60-70% of people in the developing world have this virus), I would think you are much more likely to acquire CMV during pregnancy from your everyday environment, rather than by working with samples in a lab while obeying basic safety precautions. Apparently the place where one has highest risk of acquiring a primary CMV infection is a daycare centre, because it's full of toddlers who have recently seroconverted and also suck, dribble and drip snot everywhere.
To be honest, personally I'd be more worried about exposure to chemicals such as formaldehyde, but that's another story.
You could also talk with your doctor or occupational health department about being on prophylactic antivirals, as given to recipients of pos-to-neg transplanted organs, through the pregnancy, although I would hazard a guess that the risks would outweigh the benefits there.
I am not a scientist, or a medical professional, but I work in a transplant research lab.
posted by Acheman at 3:44 AM on November 9, 2015 [1 favorite]
To be honest, personally I'd be more worried about exposure to chemicals such as formaldehyde, but that's another story.
You could also talk with your doctor or occupational health department about being on prophylactic antivirals, as given to recipients of pos-to-neg transplanted organs, through the pregnancy, although I would hazard a guess that the risks would outweigh the benefits there.
I am not a scientist, or a medical professional, but I work in a transplant research lab.
posted by Acheman at 3:44 AM on November 9, 2015 [1 favorite]
In a perfect world, you could have an open conversation with this PI about the risks and trying for a baby without it impacting your chances of getting hired. The reality I've seen is that science PIs, especially men, hugely discriminate against pregnant women and Moms. PIs have openly said, pregnant women and Moms have no business in the lab at my university. Some PIs may be very supportive but seemingly kind ones may try to force you out. You may want to have this conversation with the PI anyway to see what camp he's in but be aware it may lead to discrimination in his and other labs.
posted by Kalmya at 4:54 AM on November 9, 2015 [4 favorites]
posted by Kalmya at 4:54 AM on November 9, 2015 [4 favorites]
Many universities (and industrial labs) have programs for pregnant women, to offer them guidance and resources during the pregnancy. You might check with your Environmental Health and Safety department and see if they can offer any advice about CMV specifically.
For instance, here's the Reproductive Health website from UC Riverside. Some of these regulations are likely specific to California, but it's an example of what you might find.
posted by zenzicube at 5:30 AM on November 9, 2015 [1 favorite]
For instance, here's the Reproductive Health website from UC Riverside. Some of these regulations are likely specific to California, but it's an example of what you might find.
posted by zenzicube at 5:30 AM on November 9, 2015 [1 favorite]
Once upon a time I was in a photography course, and the faculty mentioned that pregnancy was a bad fit for operating the equipment, but there are options.
It may be possible to inquire about safety protocols in the lab and see what's in place, because the premise likely is that it's set up so NO ONE gets exposed, which includes pregnant people.
This line of thinking may need more development
posted by childofTethys at 6:02 AM on November 9, 2015 [1 favorite]
It may be possible to inquire about safety protocols in the lab and see what's in place, because the premise likely is that it's set up so NO ONE gets exposed, which includes pregnant people.
This line of thinking may need more development
posted by childofTethys at 6:02 AM on November 9, 2015 [1 favorite]
I'd rather hash that out now than have hurt feelings all around if a few months after starting I do get pregnant.
This. It's okay to do this. Putting the PI's potential "hurt feelings" aside, if:
- being very open about your concerns will let you make sure you're comfortable in this workplace, and
- you luckily have the flexibility to walk if it turns out the PI's a jerk or cavalier about safety
then go for it and don't worry about him finding out that you, like most other people, want to have children. Only worry about clever phrasing of questions if you'd still want the job even if he didn't want to hire someone who might have a baby. (To be fair, there's plenty of gray area where he'd slightly prefer to hire someone who isn't planning on taking some leave and then perhaps moving to part-time. But I think the type of person you really want to work for will be trying to think longer-term and will understand that even folks who don't "admit" they're planning a pregnancy may well take medical leave or move to part time!)
(I haven't dealt with bio lab safety during pregnancy, but did have to decide how open to be about being a (single) parent when interviewing for grad school. It was so, so worth it to find a lab where this wasn't viewed as some sort of terrible handicap that would limit my productivity.)
posted by cogitron at 7:17 AM on November 9, 2015 [1 favorite]
This. It's okay to do this. Putting the PI's potential "hurt feelings" aside, if:
- being very open about your concerns will let you make sure you're comfortable in this workplace, and
- you luckily have the flexibility to walk if it turns out the PI's a jerk or cavalier about safety
then go for it and don't worry about him finding out that you, like most other people, want to have children. Only worry about clever phrasing of questions if you'd still want the job even if he didn't want to hire someone who might have a baby. (To be fair, there's plenty of gray area where he'd slightly prefer to hire someone who isn't planning on taking some leave and then perhaps moving to part-time. But I think the type of person you really want to work for will be trying to think longer-term and will understand that even folks who don't "admit" they're planning a pregnancy may well take medical leave or move to part time!)
(I haven't dealt with bio lab safety during pregnancy, but did have to decide how open to be about being a (single) parent when interviewing for grad school. It was so, so worth it to find a lab where this wasn't viewed as some sort of terrible handicap that would limit my productivity.)
posted by cogitron at 7:17 AM on November 9, 2015 [1 favorite]
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