Practices should take precautions to protect pregnant workers

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When developing your hospital's policy for pregnant employees, keep in mind that the Supreme Court of the United States upheld the law that prohibits an employer from removing an employee from a hazardous job simply because the employee is pregnant and the fetus may be affected.

On the other hand, the court did reaffirm that the employee must be capable of performing the essential elements of the job to be protected by this ruling. In other words, it would be appropriate to transfer a pregnant worker because she cannot perform the physical tasks required of the job, but a transfer would not be appropriate solely because she is pregnant.

Dr. Sara Mey and patient, Solomon
An associate at a Chicago-area small animal hospital, Dr. Sara Mey plans to continue caring for patients such as Solomon until a week before her due date later this month.

In the past, the most common concerns relating to veterinary employment centered around exposure to radiation, waste anesthetic gases, and cats. Those hazards are controllable, but many others warrant attention.

To start with, every practice should have a written policy (as part of its employee manual) that requires a staff member to notify the hospital leadership as soon as she becomes aware of her pregnancy. When notified, the leadership must act in a timely manner—days, not weeks—to counsel the staff member on the hazards and obtain her intentions about continuing to work. An employer should not make a staff member feel she is putting the practice in a bind. Instead, the focus should be on how the practice and the staff member will interact during the next year, relying on the type of coaching and goal setting that should be done on a regular basis. That understanding is best documented in a written agreement.

The staff member and the practice administrator should collect articles from journals and similar educational materials related to pregnancy and occupational exposure in veterinary hospitals. They should both educate themselves on the real risks and on necessary adjustments. Chat areas of online services and bulletin boards may also provide useful information.

The practice should always maintain strict personal hygiene protocols for handling animals, animal exudates, and chemicals. Thorough hand washing and the use of disposable gloves are the two most important factors in reducing the risk of exposure to hazardous chemicals or biologic agents. These precautions are especially important during pregnancy. Employee training should also emphasize hazards and precautions associated with animal handling.

Hazard assessments
All employers should conduct periodic hazard assessments of their workplaces. A hazard assessment is a systematic documentation process to evaluate the workplace, identify potential hazards related to the performance of job duties, and determine the best way to reduce or eliminate those hazards. Two hazard assessments should be conducted.

A Personal Protective Equipment Hazard Assessment is required of all veterinary practices by federal regulation (29 CFR 1910.132(d)). This assessment evaluates the hazards associated with each job or task. Once the assessment is complete, the employer must identify areas where PPE is required, determine the type(s) of PPE necessary to protect the worker, and identify the types of PPE that meet the requirement and are accessible to the worker. The completed assessment should be used to train the worker.

A Job Hazard Analysis or a Job Safety Analysis should also be conducted. A Job Hazard Analysis involves studying and recording the tasks associated with a job, identifying hazards related to the tasks, and recommending actions or procedures to reduce or eliminate the hazards, which may include engineering and/or administrative controls. A Job Safety Analysis is similar to the PPE Hazard Assessment and may overlap it somewhat, but the former focuses on identifying the steps needed to complete the job safely.

The employer should encourage the pregnant staff member to take a copy of the hospital's written hazard assessment documents to her obstetrician and seek advice on any procedures that might warrant additional protection or avoidance. On the basis of the obstetrician's input, the employer should be ready to revise the written agreement made with the pregnant employee.

Transfer vs leave
If the staff member requests a transfer to an administrative job, the practice should accommodate the request if a position is available. This does not mean that a position must be created to accommodate the request. If there is no position available and it is not reasonable to create a temporary one, the staff member should be offered the chance to take pregnancy leave or other earned leave in accordance with the hospital policy. The participants should ask a local labor consultant or attorney for advice on establishing a fair policy.

If the staff member elects to stay on the job, the employer should make it clear that performance is still the key, but should be willing to make reasonable accommodations. For instance, the staff member could still administer medications and perform many animal husbandry chores, but it's reasonable to transfer any heavy lifting duties to other staff members.

Employers should also keep in mind that the staff member's physical limitations will change as the pregnancy progresses. In the third trimester she may have severe limitations with standing, lifting, or working. She may want to work throughout her pregnancy, but she may not be able to do so. If at any point in the pregnancy this becomes evident, the written agreement between employer and pregnant staff member should be reviewed and revised as necessary. A transfer to an administrative job, if one is available, and pregnancy leave are still options.

Staying on the job
If the pregnant staff member stays on the job, the employer should reinforce the need to follow all safety policies. It's also an ideal time to examine available PPE to ensure it is not damaged and still fits the staff member. Of course, defective or improperly sized devices must be replaced.

In general, if proper PPE makes a procedure safe and eliminates the hazardous exposure, the pregnant staff member may reasonably expect to perform that procedure. However, procedures for which PPE is not used or mechanical controls are not available (eg, pouring or mixing formaldehyde, mixing or administering chemotherapeutic agents) should be left to other workers who are at lower risk.

Although veterinary practice hazards are the same for male and female workers, those hazards pose a much greater threat to a developing fetus than they do to mature adults. With common sense and thoughtful planning, a pregnant staff member can be as productive during her pregnancy as she was before it. Only through the application of knowledge and practical procedures will the hospital, the mother, and the fetus be safe.