Women in the Trades: Is Occupational Health Keeping Up?
We're exploring something new — and we want your input
In a discussion with a sales & marketing group last week the topic of women in construction came up, then yesterday was International Women's Day, and this all got me thinking about a gap I keep running into.
Women now make up 14% of the U.S. construction workforce, and they're showing up in growing numbers across manufacturing, utilities, the trades, public safety, and other physically demanding industries. That's a good thing. But the more I look at the occupational health side of this, the more I wonder if we're actually serving this population well — or if we've mostly been building programs around assumptions that don't fit them.
I don't think this is anyone's fault. It's just where the field has been. But it feels like the right time to pay more attention.
Some Things That Are Hard to Ignore
The numbers that keep coming up in this space are pretty striking.
Close to 70% of women on construction sites report problems with PPE that doesn't fit right — gloves too wide, harnesses built for a different body type, safety glasses that don't seal. That's not a minor nuisance. Gear that doesn't fit doesn't protect.
Beyond fit, there are real clinical questions that don't get much attention. Women account for 63% of all work-related repetitive motion injuries, but most ergonomic protocols were designed around male body dimensions. Chemical exposures linked to menstrual irregularities and pregnancy complications are documented in industrial settings — but how often is that part of a standard occupational health intake? A recent survey found 70% of women in physically demanding roles lose productivity every month due to women's health issues, and only 10% said their employer gives them real support or resources.
And last December (‘24), OSHA issued a final rule requiring individual PPE fit assessment for every worker, with gender-specific options where needed. Safety directors are trying to figure out what compliance actually looks like in practice — and there isn't a lot of clear, clinically-grounded guidance out there yet.
I keep thinking: this is exactly the kind of problem our community should be helping solve.
Why This Feels Like Our Territory
Occupational health professionals are probably better positioned for this than anyone. We do fit testing. We assess reproductive hazard exposures. We build fitness-for-duty protocols. We advise EHS teams. We run employee health programs that touch thousands of women in physically demanding clinical and support roles.
We're just not pointing that expertise at this population in any organized way yet.
The employers who need guidance — safety directors, EHS managers, women business owners in the trades — aren't finding it from PPE manufacturers, who have a product to push, or from trade publications, which don't have clinical depth.
Here's What We're Thinking About
Some ideas we're kicking around, and where we'd love your reaction:
Clinical practice briefs targeted at OHPs — reproductive hazard screening for female workers, MSK risk assessment using female anthropometrics, fit-for-duty considerations during and after pregnancy, mental health in safety-sensitive environments. Is this something your team would use?
An employer-facing guide to the OSHA PPE fit rule — practical, not just regulatory summary. Sample policies, documentation templates, sourcing guidance for women-specific gear. Would this be useful for your employer clients?
Evidence-based PPE reviews — harnesses, gloves, respiratory protection, footwear — written for safety directors doing procurement. Does this land better as NAOHP content, or would you expect to see this elsewhere?
OccMarket integration — flagging member clinics with specific expertise serving female-dominated or mixed-gender industrial workforces. Are there clinics already doing this well that we should be learning from (yours)?
What I'd Really Like to Know
If you're an occupational health professional: are you already navigating these issues with your employer clients? What are the clinical questions you don't have good answers to?
If you're a safety director or work closely with construction or industrial employers: what would actually be useful — and what's missing right now?
And honestly — does this feel like the right direction for NAOHP, or are there other workforce health gaps you think deserve more attention first?
Reply to this email. I read every response and this kind of feedback genuinely shapes where we go.
— Larry
What Do You Think About Occupational Health issues for Women in Trades?
OSHA PPE Fit Rule — December 2024 Individual PPE fit assessment is now required. We're working on a practical guide for safety directors — what it means operationally, how to document it, and where to find women-specific gear across categories. 👉 OSHA Reference: 29 CFR 1910.138
OccMarket If your clinic already serves female-dominated industries or has specific experience with women's occupational health, we'd love to know — there may be a way to make that expertise more visible to employers who are looking for it. 👉 Submit your locations (make an editable copy of this template, share or email to [email protected])
Interested in a Women at Work webinar or working group? If there's enough interest from this community, we'd love to put something together this spring — a practical session on building women-specific protocols, or a roundtable with safety directors and OHPs working through the same questions. Reply if that sounds useful.
🪢 Tying in to Last Week’s Conversation
Onboarding velocity & clearance governance — Last week's lead piece was about governing medical clearance at scale across multi-site systems. What happens when clearance processes fail women specifically? — e.g., pregnancy-related restrictions, postpartum return-to-work, or how functional evaluation standards may not account for female physiology.
TB & immunization in high-risk female worker populations — Last week noted CDC guidance and immunization matrix consistency. Consider pregnancy contraindications for certain vaccines (live vaccines, etc.) and how health systems should be handling that within their clearance algorithms.
Respirator clearance & fit testing for women — This was called out last week under OSHA 1910.134. There's a well-documented problem with standard respirator fit tests being normed on male facial dimensions.
Leadership visibility / "When Leadership Can't Answer" follow-up — Last week's prior issue (linked in the brief) was about program vulnerability when leaders can't articulate costs, volumes, or strategy. What does a defensible women's occupational health program look like on paper to leadership?
Reply, comment or email me [email protected] if you’ve dealt with these issues and have solutions to share.
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Uberdoc has exams available right now in most parts of the country. Reply here if you're ready to accept exams from Uberdoc and we'll get you set up. (members only)
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🏪 Occmarket
All corporate members are eligible to list your clinic locations on the Occmarket.
We’ve got a bit of “chicken or the egg” issue to fully launch -
Many members are ready right now for our first 2 use cases:
Your own health system hires from out of state - instead of relying on random TPA locations or competitors, now you can choose other qualified NAOHP members.
Existing employer clients asking if you can serve them in other locations outside your service area.
But we need to have enough locations listed for them/you to access.
If you haven’t yet, PLEASE submit your locations using this template - make a copy, add your organization name to the title, then share or email back to me - [email protected], then we’ll meet to get your full account set up.
These listings are free for corporate members and will begin to attract outside business.
When ordering exams and testing employers (including you for out of state hires) will pay a transaction fee. This will be far less than going through a traditional TPA.
We have maybe 200-300 locations submitted so far, about half are vetted and up on the site. My goal is to have 1000 by year-end. Just NAOHP and affiliate organization members. Not 15k random “collection sites”.
When we talk to employers/payers about using our Occmarket network, we are looking for value based contracts - better outcomes, not cut rates.
🧑🤝🧑 OccNation
🎗 Reminder that all member resources are now in OccNation. Corporate/group members - you have a “main” member or account holder. Fill in your profile, then follow this guide to invite your submembers - you can swap them out as staffing changes dictate.
You’ve probably seen member-only practice briefs, guides and checklists posted here in the newsletter about every week, all in the OccNation Resource Library.
Non-member subscribers are welcome in the main discussion groups and some resources are available, please consider membership to access everything!
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🗓 Upcoming Events
A View of Occ Med Growth Across 50 Plus Markets
How should you approach a new Occ Med market in a way that reflects the unique realities of that specific location?
In our March Occ Med Sales Office Hours, A View of Occ Med Growth Across 50 Plus Markets, Ira Pasternack and David Saslavsky from WebForDoctors will be joined by special guest Lisa Smith Robertson.
Drawing on experience growing more than 50 individual locations across healthcare systems and urgent care organizations in Illinois, California, and across Texas, Lisa will walk through how she evaluates a location, understands the competitive and employer landscape, identifies early traction, and builds toward long term account growth.
Virtual Ortho & MSK Solutions
Dr. Jay Kimmel will walk through Upswing's approach to virtual musculoskeletal care, its role within a Total Worker Health strategy, and how organizations are using it to reduce injury, improve outcomes, and lower costs — with plenty of time for your questions.
Becoming a Safety Leader in Healthcare
The Expanding Role of the Nurse in Health Care Safety
Goal: Master the evolving intersection of occupational health and safety leadership.
Key Topics:
• Shifting expectations of OHNs: from clinical care to system safety oversight.
• Understanding the dual lens of employee and patient safety.
• Introduction to Total Worker Health® principles in hospital settings.
• The business case for nurse-led safety programs (ROI, risk reduction, engagement).
Target Audience:
Registered Nurses, Occupational Health Nurses, and Employee Health professionals transitioning into or expanding safety leadership roles in healthcare systems.
Free Intro Class:
Date: March 18, 2026, 9 AM Pacific
Speaker: Shanna Dunbar
Health systems are increasingly hiring clinicians and staff from outside their immediate market, adding complexity to onboarding and clearance workflows.
In partnership with SensiaTech, we’ll discuss how to align governance with execution, reduce variability in immunization, TB, drug testing, and respirator clearance, and maintain compliance while improving onboarding velocity.
Thursday, March 26, 9 AM pacific
Recent Events:
Advanced biomarker testing has become an area of growing interest for me, particularly as it relates to employee health, long-term resiliency, and disease prevention. The opportunity is not simply to collect more data, but to use more precise data to identify emerging risk patterns earlier—cardiometabolic strain, inflammatory burden, and in some cases cancer-related signals—before they evolve into disability, career interruption, or preventable claims.
This topic comes up frequently in workforce discussions, and especially in conversations surrounding firefighter medical surveillance. Important questions remain. Which biomarkers are clinically meaningful in asymptomatic populations? Which tests are appropriate for higher-exposure or safety-sensitive groups? How should testing differ across employee populations? And once results are obtained, what constitutes responsible follow-up, monitoring, and intervention?
These are complex issues that deserve careful, evidence-based discussion. I am exploring them more deeply in my new publication, Elucidate, where I focus on biomarker science and its practical application to workforce health, prevention strategy, and long-term resiliency.
If this topic is of interest to you, I invite you to read and subscribe to Elucidate.
The first post is: A Physician Looks at His Own Biomarker Data
🏭 Occupational Health Industry News & Signals
Healthcare Workforce Pressures Intensify Heading Into 2026
The AHA's newly released 2026 Health Care Workforce Scan identifies six defining pressures: financial stress, demographic demand shifts, rapid technological transformation, changing worker expectations, pipeline gaps, and geographic disparities. American Hospital Association For occupational health programs, this means more out-of-state hires, more travelers, and more pressure on onboarding timelines.
What This Means for You: Clearance delays directly affect start dates. If your program doesn't have consistent governance across markets, now is the time to act. Join our upcoming webinar with SensiaTech, Modernizing Healthcare Worker Medical Clearance, for a structured framework to improve consistency and onboarding velocity. 👉 Register Here
OSHA's 2026 Compliance Agenda: What Healthcare Employers Need to Know
OSHA's 2026 focus centers on chemical hazard communication, electronic injury and illness reporting, heat-related hazards, and targeted enforcement — with covered employers required to submit 2025 injury and illness data through the Injury Tracking Application by March 2, 2026, and post their 300A summary through April 30. ROI Safety Services OSHA has also proposed new workplace violence prevention rules specifically targeting healthcare and social services. WorkCare
What This Means for You: Multi-site systems should verify respirator program documentation, injury recordkeeping, and audit readiness across all locations. NAOHP regulatory resources — and the structured execution model OccMarket provides — help ensure institutional standards are applied consistently. 👉 Access NAOHP Regulatory Resources in OccNation
Drug Testing in 2026: Fentanyl Panels, Marijuana Rescheduling, and Policy Complexity
A DOT final rule adding fentanyl and norfentanyl to drug testing panels is expected to take effect in early 2026, applying to private transportation employees across trucking, aviation, rail, transit, pipeline, and maritime industries. Ogletree Meanwhile, cannabis rescheduling to Schedule III has created confusion — but DOT published a compliance notice in December 2025 making clear that until rescheduling is finalized, all current drug testing requirements remain unchanged. Universalbackground
What This Means for You: Multi-state employers need to review panel configuration, MRO oversight, and documentation language — especially as state-level cannabis laws continue to diverge. NAOHP's MRO and drug testing resources support policy clarity, while OccMarket provides scalable execution where internal infrastructure doesn't exist. 👉 NAOHP Drug Testing Resources
OccNation Reminder: Your Member Resource Library Is Growing
Practice briefs, guides, and checklists are posted regularly — including TB testing toolkits, regulatory compliance guides, and sales resources. All member resources live in the OccNation Resource Library.