There are very few times in a woman’s life when she thinks more about her health than when she is pregnant. Most women are willing to make extraordinary sacrifices to ensure that their children will have every benefit a mother can provide. Regardless of why they work-whether by choice or from need –most working women experience anxiety about how their work will affect their children.

Women who work in professions where they are exposed to potentially harmful chemicals, X-rays, or infections have cause to be concerned about their baby’s safety. Pregnant nail technicians are rightfully concerned about their exposure to chemicals used in the salon, which, in high concentrations, can be harmful to unborn babies.

For example, toluene, a solvent commonly used in nail polish, has been associated with mental retardation and physical deformities similar to those that can be caused by alcohol consumption during pregnancy. These deformities resulted from women sniffing toluene during pregnancy to get high; they were not caused by occupational exposure.

Toluene and other solvents have also been associated with birth defects in animal studies. These studies are valuable because they document that while extremely high exposures to toluene and other chemicals can result in problems, very low-dose exposures to the same chemicals may have little or no effect on an unborn baby. The animal studies also demonstrate a level below which ill effects are not seen. This is known as the “No Observable Effect Level” (NOEL). When permissible exposure levels (PELs) are set for humans, it is common practice to set those levels substantially lower than the NOEL-often by a factor of 100 or greater-in order to compensate for differences in sensitivity and unknown factors when comparing animal and human experience. OSHA sets PELs for exposure to chemicals in the workplace.

A recent study titled “Spontaneous Abortions Among Cosmetologists, “which appeared in Epidemiology magazine in March 1994, raised additional concerns for nail technicians. The analysis, which was co-authored by Esther John, M.D., at the University of North Carolina at Chapel Hill School of Public Health with professors David Savitz and Carl Shy, was restricted to 96 cosmetologists who had a single live birth and who worked either full-time in cosmetology or in other jobs during the first trimester of pregnancy. The investigators found associations between spontaneous abortion and the number of hours worked per day in cosmetology, the number of chemical services performed per week, use of formaldehyde-based disinfectants, and work in salons where nail sculpting was performed by other employees. The study did not prove that there was an increased risk based on exposure to nail sculpting; it only suggested a possible association. Interestingly enough, there was no association found between spontaneous abortions and manicuring in general, and when the cosmetologists wore gloves, a protective effect was seen.

Does this mean you should stop doing nails if you’re pregnant? Not necessarily. The risks might just be higher in another profession. Remember, this is just one relatively small study that did not specifically analyze nail technicians’ exposure.

Although this is the only currently available study that addresses nail technicians at all, numerous studies have been done to look at chemical exposures in a variety of occupations. One study of 3,901 pregnancies found no significant differences in the incidence of adverse pregnancy outcome in nine occupational categories when non occupational factors were controlled. No increased risk was found for exposure to organic solvents in this study, but the authors point out that working conditions were “favorable and results cannot be generalized to working conditions with higher exposures.”

What does all of this mean? First of all, approximately 15% of all established pregnancies naturally end in spontaneous abortion. If pregnancy testing is done earlier (before a missed menstrual cycle), the rate of pregnancy loss is even higher. Even a two-or three-fold increase in spontaneous abortions can be attributed to other variables that have nothing to do with your job.

While most studies don’t definitely link a particular occupation to an increase in spontaneous abortions, they do mark important associations. The studies that I reviewed show that women who have high levels of exposure to chemicals also have the greatest level of risk for spontaneous abortions. However, where precautions were taken to limit exposure, the risks were not found to be different than the background expected risks, such as age or family history.

How can you protect yourself and your unborn baby without quitting your job? By taking common sense protective measures. Look at these scenarios:

Jackie is a nail technician who works in a small beauty shop with poor ventilation. The hairstylists in the shop need a lot of room to move around, so Jackie’s workstation is located in a small corner. Jackie never wears gloves, a gown, or other protective clothing when she works. Jackie often drinks and eats at her station while she is working. Jackie leaves the lids off her products during the day so as not to waste time taking them on and off. She’s been having a lot of headaches and has been feeling dizzy and sick to her stomach lately, but these are the symptoms of pregnancy, aren’t they?

Trudy, on the other hand, works in a well-ventilated salon. She wears a protective gown and gloves when she works, and she caps all products after use. Trudy carefully cleans up any spills immediately, tries to avoid physical contact with the chemicals, and immediately takes a break to get some fresh air if she feels that she has been over exposed to any of the chemicals. She pays careful attention to symptoms such as headaches, dizziness, or nausea, especially if the symptoms appear to be related to her working hours. Trudy never eats, drinks, or smokes in her work area, and she carefully washes her hands and removes her protective clothing before handling any food or drink. Trudy’s coworkers are aware of her pregnancy and make every effort to help her minimize her exposure. If Trudy thinks she has any symptoms of overexposure, she brings this to the attention of her obstetrician and also may discuss her concerns with an occupational health physician.

These are exaggerated scenarios, of course, but they highlight that the best ways to protect your unborn baby are the same precautions you should already take yourself. I hope that most of you are like Trudy and not like Jackie, even if you’re not pregnant.

If you have concerns about your level of exposure to chemicals, you might want to contact a Teratogen Information Service in your area. It would also be worthwhile to provide your obstetrician with copies of Material Safety Data Sheets (MSDS) for the products you work with.

Most of all don’t let your worrying affect your health. The fact that you are reading this article indicates that you have already taken an important step in protecting your precious baby, and you are on your way to being a great mom.

By Karen Filkins, M.D., and Michael Kerr, M.S. Dr. Filkins is director of reproductive genetics at Western Pennsylvania Hospital in Pittsburgh, Pa., and is a practicing obstetrician. Mr. Kerr is a genetic counselor at the Pregnancy Safety Hotline at Western Pennsylvania Hospital.