Are you being fair to pregnant employees in a dental office?

By Olivia Wann

Recently Walgreens was ordered to pay $205,000 in EEOC pregnancy and disability discrimination lawsuit.  Evidently a Walgreens store located in Alexandria, Louisiana refused to let an employee take emergency leave to seek medical attention.   The pregnant employee suffered with diabetes and hypoglycemia and was spotting.  The store manager refused to let the employee leave until she found a replacement. The employee had no choice but to resign so that she could seek medical care.  The employee miscarried that day.  Walgreens violated Title VII of the Civil Rights Act of 1964 and the Americans with Disabilities Act.[1]  Are you in compliance with state and federal laws?

There is a fairly new federal law, the Pregnant Workers Fairness Act (PWFA), passed June 27, 2023.[2]  This federal law requires covered employees (those with 15 or more employees) to provide “reasonable accommodations” to a qualified worker’s known limitations related to pregnancy, childbirth, or related medical conditions unless the accommodation will cause the employer an “undue hardship.”  An undue hardship is one that causes significant difficulty or expense. 

There are also state laws. For example, in Tennessee we have the Tennessee Pregnant Workers Fairness Act that was signed into law June 22, 2020[3]. This state law which applies to employers with 15 or more requires the employer to provide reasonable accommodations which may include:

• More frequent, longer, or flexible breaks;
• Private place, other than a bathroom stall, for expressing milk;
• Assistance with manual labor and lifting limits;
• Job restructuring for light-duty if available;
• Providing or modifying equipment;
• Providing time for prenatal visits. 

The federal Pregnant Workers Fairness Act which applies to employers with 15 or more employees requires reasonable accommodations to include:

• Being able to sit or drink water;
• Receiving closer parking;
• Flexible hours;
• Appropriately sized uniforms and safety apparel;
• Receiving additional break time to use the bathroom, eat, and rest;
• Taking leave or time off to recover from childbirth;
• Being excused from strenuous activities and/or exposure to chemicals not safe for pregnancy.

How do we apply these accommodations to a dental office environment when necessary?  In working with dental groups, I have observed pregnant workers with lab coats that were too small.  Rather than wearing cloth lab jackets, it may be wise to consider disposable jackets or gowns and in the correct size for the pregnant workers.

The schedule may require adjustments to allow more time between patients to drink adequate fluids particularly since food and drink is prohibited in the clinical areas. 

Rather than using glutaraldehyde which is used as a “cold sterile,” ensure that items are either disposable or heat sterilizable.  The National Institute for Occupational Safety and Health (NIOSH) provides information to raise awareness on the adverse health effects of glutaraldehyde and how you can be exposed to it plus work practices to prevent or reduce your exposure.[4]

Allow unpaid time or accumulated paid time off if available for prenatal care and time off to recover from childbirth.  It may be helpful to seek out a temporary to fill in to avoid gaps in the schedule.

The question also comes up regarding taking radiographs during pregnancy.  According to the American Dental Association, it is recommended that dentists provide pregnant staff members with dosimetry badges and limit exposure to 0.5 mSv/month (or in accordance with state requirements).  Even though the radiation exposure is extremely low in dental radiography, this is a good risk management tool to prove that the radiation exposure was not above the recommended limits.[5]

When dealing with a pregnant worker and there is question of whether an accommodation should be made or could be made, consult with your legal counsel.