See Something? Say Something: You Could Save a Life

See something?
    The question I asked was this, “By a show of hands, how many of you have heard of the Pregnant Workers Fairness Act?” I was testing if a “conspiracy of silence” on this topic had validity. See last month’s “redux” article. Among all the people housed in the large ballroom, instructors included, not a single hand was raised. This was a very troubling find.
    The federal PWFA became law in December 2022 and went into effect in June 2023. I believe that all EHS pros have a moral or ethical duty to remain abreast of law or best practice to save lives from workplace hazards.

Saving lives
    On February 20, 2025, the March of Dimes and A Better Balance submitted an Amicus Curiae brief to the US Court of Appeals for the Fifth Circuit in the State of Texas v Bondi. The brief includes evidence that the PWFA prevented 152,440 miscarriages, i.e., saved lives.
    Evidence also shows that since the first year that the PWFA went into effect, there has been an increase in babies born with a healthy Apgar scores. Furthermore, and not the least of the benefits, the number of miscarriages prevented, increased the US’s record low birth rate by 3.2%. These additional births represent nearly 150,000 future tax paying workers that EHS pros may again help to protect.

Dollars saved and lost
    Ethics aside, most people in business are motivated by dollars. Per the ABB and March of Dimes brief, “The improved pregnancy outcomes attributed to the PWFA have already resulted in an estimated savings to society of $294.58 million.”

    Less than one week after the EHS ethics course, news across our nation, and other countries, included headlines such as “Ohio Jury Awards $22.5 Million in Pregnancy Accommodation/Wrongful Death Case.” It’s the same old story, someone in business, usually HR, makes a health risk decision that goes horribly wrong. Our societal peers, i.e. juries, are sending a stern message to US employers and their decision makers, that they had best wake up and do things right or pay an enormous price for their ignorance or indifference.

Ethical dilemma
    I see the problem. I have spoken up repeatedly and as of late, loudly, as to what must change. But have I done enough? Section II (A)(8) in the Code of Ethics for the Board for Global EHS Credentialing, that oversees my CIH®, states: “Communicate clearly, to clients and/or employers, the potential consequences if professional decisions or judgments are overruled or disregarded.”
    Am I explaining things clearly? Seriously, I need your input. I don’t let AI write or influence any of my articles. ISHN editors help to ensure clarity in my writing. I am confident that my clients know where I stand.

    CIH® ethics, however, does not direct how I should engage organizations that represent industrial hygienists. Here are the potential consequences if my professional decisions or judgments are overruled or disregarded by these organizations: Let me be clear, lives will be lost, dollars will be lost, and the advancement of IHs will be flushed down the toilet unless they get involved on this topic. Get involved or get out of the business. Clear enough?

Role of an IH
    The PWFA final rule includes an industrial hygienist for a very important reason. An IH’s observations and skills are rooted at the workplace while other PWFA recognized health care providers, such as MDs, OBGYNs, and nurse-midwives, are mostly housed at clinical settings. IHs are trained to use the hierarchy of controls to achieve reasonable accommodation for pregnant workers.
    IHs are highly necessary for the PWFA’s continued success. Consider this extended quotation (less cited references) from the ABB and March of Dimes brief:
    “The risk of miscarriage and stillbirth increases with the frequency and weight of lifting, exposure to chemicals, irregular or long work hours, night shifts, and even the denial of accommodations as simple as bathroom breaks because of the resulting risk of serious infections. Failure to accommodate pregnant employees’ needs could result in other dangerous pregnancy outcomes, including placental separation and/or uterine rupture associated with falls, and fetal malformations associated with certain chemical exposures.”
    Well trained IHs may easily navigate among the above hazards. There is not one playbook, there are many, consider global too, but sufficient guidance such as NIOSH’s lifting equation for pregnant workers and considering chemical exposures beyond OSHA’s minimums, such as a DNEL, exist to keep pregnant workers and their future children safe at the work they do, with reasonable accommodations. My ISHN articles over the past years have explained many of these hazards and controls.

Future
    Since the PWFA first recognized IHs as health care providers, the American Medical Association (AMA), the American College of Obstetricians and Gynecologists (ACOG) and other like-minded organizations, have issued new guidelines, reports and recommendations to modernize prenatal care and delivery in the US. ACOG’s May 2025 Clinical Consensus for “Tailored Prenatal Care Delivery for Pregnant Individuals” acknowledges that “formalized models for prenatal care have changed little since they were first published in 1930.” Change is under way. The AMA’s decades old maternity care coding system for recording pregnancy services, for example, will dramatically change in January 2027.
    Prevention services to address maternal mortality, infant mortality, miscarriages, preterm births, low birthweights and other poor outcomes, which the the US performs the worst among peer nations, are being addressed. US organizations that represent IHs have remained silent on this front. None of these organizations did anything to support the IH role in the PWFA final rules. Nevertheless, we need the organizations to come forward now.
    For example, organizations that represent IHs should collectively prepare their own Amicus Curiae brief, similar to what the ABB and March of Dimes created. I have cleared the path for this objective. Ilise Feitshans, a member of the US Supreme Court bar, that is best qualified for this topic, will support IH organizations if they intend to remain relevant with PWFA participation. Will they contact Feitshans? Doing nothing is not an option.

Conclusion
    The PWFA risk-matrix has a low frequency but devastatingly high severity. Monetary severity for a single claim reaching north of $20 million dollars, as mentioned, could be a career ending mistake. OSHA, EPA, CDC and other agencies have rules that intertwine with PWFA objectives.
    This is a “see something, say something” article. Your eyes should be wide open on this topic. Ensure that your senior management clearly understands that the PWFA is about occupational health. If you belong to any EHS/OHS organization, demand that they establish a position statement on this topic.