TUTTLE, Senior Circuit Judge:
Historically, an effective means for employers, legislatures, and courts to limit the equal employment opportunities of women was to restrict their employment out of a professed concern for the health of women and their offspring.
See, e.g., Muller v. Oregon,
208 U.S. 412, 28 S.Ct. 324, 52 L.Ed. 551 (1908).
In this appeal we are asked to
determine whether a hospital can fire an x-ray technician when she becomes pregnant to protect the pregnant employee’s fetus from potentially harmful radiation, and to protect the hospital’s finances from potential litigation. We affirm the district court’s finding that under the circumstances of this case Shelby Memorial Hospital violated the Pregnancy Discrimination Act of 1978 when it fired Sylvia Hayes from her position as an x-ray technician immediately upon learning of Hayes’s pregnancy.
I. BACKGROUND
On August' 11, 1980, Shelby Memorial Hospital (the “Hospital”) hired Sylvia Hayes, a certified x-ray technician, to work the 3-11 p.m. shift with one other technician in the Hospital’s radiology department. Two months later, Hayes was fired after she informed her supervisor that she was pregnant. The supervisor fired Hayes after consulting Dr. Cecil Eiland, the Hospital’s then recently appointed radiology department medical director and radiation safety director, who recommended that Hayes be removed from all areas in which ionizing radiation was being used. The Hospital claims that it fired Hayes because it was unable to find alternative employment for her.
Following her dismissal from the Hospital, Hayes filed suit in the United States District Court for the Northern District of Alabama, charging that the Hospithl had denied Hayes her equal employment opportunities as guaranteed by Title VII of the 1964 Civil Rights Act, 42 U.S.C. § 2000e
et seq.,
as well as her constitutional and civil rights guaranteed under 42 U.S.C. § 1983. The Hospital defended its dismissal of Hayes on the grounds, among others, of “business necessity” and “bona fide occupational qualification.” Following a nonjury trial the district court concluded that the Hospital’s “abrupt termination” of Hayes violated both Title VII and § 1983. The district court awarded Hayes modest damages totalling less than $8,000.00, and entered final judgment on the award, from which the Hospital took this appeal.
II. DISCUSSION
This is a case of first impression in the Eleventh Circuit, and one of only a few .cases of this nature to reach a court of appeals.
The issues raised by this case are (1) What is the proper legal framework for analyzing a case in which an employer fires a pregnant woman because of the employer’s belief that the woman’s continued employment presents a substantial hazard to her fetus? (2) Does an employer’s desire to avoid or minimize potential liability for fetal exposure to radiation constitute an affirmative defense to a Pregnancy Discrimination Act claim? (3) Did the Hospital meet its burden of proving an affirmative defense to its discriminatory policy?
A.
The Legal Framework
We start our analysis with Title VII and the- Pregnancy Discrimination Act, 42 U.S.C. § 2000e(k). Prior to passage of the Pregnancy Discrimination Act, the Supreme Court had held in
General Electric Co. v. Gilbert,
429 U.S. 125, 97 S.Ct. 401, 50 L.Ed.2d 343 (1976), that Congress did not
include discrimination on the basis of pregnancy within Title VII’s definition of gender based discrimination. By adopting the Pregnancy Discrimination Act in 1978 as an amendment to Title VII, Congress in effect overruled
Gilbert.
Under the Pregnancy Discrimination Act, discrimination on the basis of pregnancy is discrimination on the basis of sex. Thus, our analysis of this case must follow the same type of analysis used in any other Title VII sex discrimination suit.
There are three theories under which a suit of this nature may be analyzed.
The first applies to those situations in which an employer has engaged in “facial” discrimination. Facial discrimination occurs when an employer adopts a policy that explicitly treats some employees differently from others on the basis of race, religion, national origin, or gender (pregnancy). The only affirmative defense to facial discrimination is the existence of a bona fide occupational qualification (BFOQ), by which an employer may establish that religion, sex, or national origin (but not race) is, in the words of Title VII, a “bona fide occupational qualification reasonably necessary to the normal operation of that particular business or enterprise.” 42 U.S.C. § 2000e-2(e). The second theory applies when an employer adopts what appears to be a facially neutral policy, but one which a plaintiff contends is a “pretext” for forbidden discrimination. Both facial discrimination and pretext cases are referred to as “disparate treatment” cases.
The third theory applies when the employee concedes that the employer’s policy is neutral, but seeks to demonstrate that the policy has a disproportionate impact on a group protected from discrimination under Title VII. ■ Those cases are labelled “disparate impact” cases. An affirmative defense to a prima facie case of disparate impact is “business necessity,” which is a broader defense than BFOQ.
We analyze this case under all three theories.
B.
Analysis
1.
The Pretext Theory
Initially, the Hospital argues that we should analyze this case under the pretext theory as set forth in
Texas Department of Community Affairs v. Burdine,
450 U.S. 248, 101 S.Ct. 1089, 67 L.Ed.2d 207 (1981). Under
Burdine,
an employer may “articulate” a “legitimate nondiscriminatory reason” to rebut an employee’s prima facie ease of discrimination as made out under the requirements of
McDonnell Douglas Corp. v. Green,
411 U.S. 792, 93 S.Ct. 1817, 36 L.Ed.2d 668 (1973). The employee must then show that the employer’s nondiscriminatory reason is a “pretext” for discrimination. The Hospital argues that its stated reason for firing Hayes — to protect her fetus from the harmful effects of radiation— is a sufficient nondiscriminatory reason to shift the burden back to Hayes to prove pretext. The Hospital then argues that Hayes failed to prove that its reasons for firing her were a pretext for discrimination.
Prior to passage of the Pregnancy Discrimination Act, the Hospital’s
Burdine
argument might have had some merit,
because pregnancy was considered a legitimate, nondiscriminatory basis for differential treatment.
See Nashville Gas Co. v. Satty,
434 U.S. 136, 98 S.Ct. 347, 54 L.Ed.2d 356 (1977);
General Electric Co. v. Gilbert,
429 U.S. 125, 97 S.Ct. 401, 50 L.Ed.2d 343 (1976). That is no longer the case, however, because the Pregnancy Discrimination Act mandates that a pregnancy-based rule can never be “neutral.”
In other words, firing
Hayes because she was pregnant is just as facially discriminatory under the Pregnancy Discrimination Act as it would be to fire her solely because she was black under Title VII. Therefore,
Burdine
is inappropriate here, since the Hospital admits that Hayes was fired because of her pregnancy, rather than because of some other, potentially nondiscriminatory reason.
2.
Facial Discrimination
Plaintiff, supported by amici curiae American Civil Liberties Union Foundation Women’s Rights Project, et al.,
contends that this is a case of facial discrimination, to which the only affirmative defense is BFOQ. Although we tend to agree that this is a facial discrimination case, to ensure complete fairness to the Hospital, we will also analyze this case under the disparate impact/business necessity theory.
First, we must establish an analytic framework. We begin by establishing a
presumption
that if the employer’s policy by its terms applies only to women or pregnant women, then the policy is facially discriminatory. That presumption may be rebutted, however, if the employer can show that although its policy applies only to women, the policy is neutral in the sense that it effectively and equally protects the offspring of all employees. In other words, the employer must show (1) that there is a substantial risk of harm to the fetus or potential offspring of women employees from the women’s exposure, either during pregnancy or while fertile, to toxic hazards in the workplace, and (2) that the hazard applies to fertile or pregnant women, but not to men.
The burden of proving a substantial risk of harm to the fetus is a threshold requirement. “This burden may not be carried by proof alone that the employer subjectively and in good faith believed its program to be necessary and effective for the purpose.”
Wright v. Olin Corp.,
697 F.2d at 1196. Rather, the employer must produce objective evidence of an essentially scientific nature supported by the opinion evidence of qualified experts in the relevant scientific fields.
Id.
The employer need not prove the existence of a general consensus on the points within the qualified scientific community.
Id.
at 1191. Rather, the employer carries its burden by showing that the body of opinion believing that significant risk exists is so considerable “that an informed employer could not responsibly fail to act on the assumption that this opinion might be the accurate one.”
Id.
If the employer carries the threshold burden of proving significant risk of harm, it must then prove that the hazard does not also apply to the offspring of male employees. Again, scientific evidence is necessary. We note that at present there is, .even within the scientific community, a certain
amount of subtle bias that has focused research on the hazardous effects of workplace substances as they pertain to reproductive health on women more so than on men.
See
Williams,
Firing The Woman,
69 Geo. L.J. 641, 661. In those instances in which scientific evidence points to a hazard to women, but no scientific evidence exists regarding men, an employer may be allowed to adopt a suitable policy aimed only at women. As additional research on men becomes available, however, the employer must adjust its policy or risk running afoul of Title VII.
If an employer fails to overcome the burden of proving that its policy is not facially discriminatory, then its only defense is BFOQ. Under traditional analysis, the BFOQ defense is available only when the employer can show that the excluded class is unable to perform the duties that constitute the essence of the job, duties that Title VII defines as “necessary to the normal operation of the particular business or enterprise.” 42 U.S.C. § 2000e-2(e); see
Dothard v. Rawlinson,
433 U.S. 321, 97 S.Ct. 2720, 53 L.Ed.2d 786 (1977);
Weeks v. Southern Bell Telephone & Telegraph Co.,
408 F.2d 228 (5th Cir.1969);
Burwell v. Eastern Air Lines, Inc.,
458 F.Supp. 474 (E.D.Va.1978),
aff’d in part and rev’d in part,
633 F.2d 361 (4th Cir.1980) (en banc) (per curiam),
cert, denied,
450 U.S. 965, 101 S.Ct. 1480, 67 L.Ed.2d 613 (1981). Thus, as the district court noted in this case, “[potential for fetal harm, unless it adversely affects a mother’s job performance, is irrelevant to the BFOQ issue.”
Hayes v. Shelby Memorial Hospital,
546 F.Supp. 259, 264 (N.D.Ala.1982). We hold that when a policy designed to protect employee offspring from workplace hazards proves facially discriminatory, there is, in effect, no defense, unless the employer shows a direct relationship between the policy and the actual ability of a pregnant or fertile female to perform her job.
The Hospital never asserted that Hayes’ pregnancy, at least until the final few weeks, would interfere with her ability to perform the duties of an x-ray technician. Nor did the Hospital try to prove that a woman’s fear for potential harm to her fetus might somehow affect job performance adversely. Therefore, under traditional BFOQ analysis, the defense is inapplicable to this case.
At least one commentator, as well as amici curiae, have argued that we should resist the “predictable” temptation to allow concern about the health interests of the fetus to prompt an expansion of the BFOQ defense. Williams,
Firing The Woman,
69 Geo.L.J. at 681. Williams argues that “the effect of adhering to the traditional analysis is likely to prove more beneficial to the health interests of the fetus than such an expansion” because an employer ostensibly seeking to protect fetal health will be forced to develop a gender neutral policy to avoid Title VII liability.
Id.
at 681-82. By adopting a general, rather than gender-specific approach, the focus is shifted to the health of offspring as affected by the exposure to toxic substances of both men and women.
Id.
at 682. Such an interpretation of Title VII “thereby encourages employers to address and solve what experience has shown to be a problem for workers of both sexes.”
Id.
We agree with the Williams approach. We believe that the Pregnancy Discrimination Act mandates that an employer treat its workers equally when it seeks to protect their offspring.
We now apply our framework to the facts of this case.
The Hospital in
tended that its policy apply only to pregnant x-ray technicians.
Under our framework, that raises the presumption of facial discrimination.
As we have stated, however, the Hospital may rebut the presumption of facial discrimination. Therefore, we must examine whether the Hospital met the threshold requirement of its rebuttal case by proving that radiation from x-rays posed a significant risk of harm to Hayes’s fetus. At trial, the Hospital’s radiation safety director, Dr. Cecil Eiland, took the extreme position that
any
dose of radiation is “excessive” and therefore potentially harmful to a developing fetus. Dr. Eiland even stated that it would be dangerous for a pregnant woman to sunbathe in a bikini, which would expose her fetus to radiation from the sun. Although Dr. Eiland’s statement regarding the amount of radiation he considered “excessive” appears to have been hyperbolic, his statement illustrates the fact that scientists know little about the detrimental effects of even the lowest levels of radiation. The evidence at trial, however, suggests that the general scientific approach to protecting people from radiation has shown that although
any
amount of radiation
can
have a detrimental effect on humans, it is extremely unlikely in most cases that radiation below certain doses
will
have a detrimental effect on any particular individual. Therefore, scientists have established various maximum “safe” levels of radiation exposure. Even the “maximum safe” levels of radiation exposure are set with a large margin of error on the side of safety, so that one exposed to a “maximum” dose normally is in no real danger, at least with our present state of knowledge. Despite the margin of safety, experts caution that even within the “safe” levels, one should always limit his or her exposure to what the industry calls “ALARA” — As Low As Reasonably Attainable — to increase that margin.
At any rate, the employer’s burden of persuasion requires that it show more than simply some risk of harm to an employee’s fetus from a workplace hazard. In this case the Hospital was required to show that the level of radiation to which Hayes would normally be exposed during the period of pregnancy, assuming she was carrying out her usual duties, would pose an
unreasonable
risk of harm to the fetus. The district court found that the Hospital failed to demonstrate that Hayes’s fetus would be exposed to an unreasonable amount of radiation, stating, “the defendant’s termination of the plaintiff’s employment, albeit motivated by concern for the welfare of the
fetus, was an unnecessarily extreme measure.”
Hayes,
546 F.Supp. at 265.
The evidence in the record supports the district court’s conclusion. Much of the expert testimony at trial centered on the question of what amount of radiation exposure is “reasonable” for a pregnant woman. Those who testified more or' less agreed that standards set by the National Council on Radiation Protection and Measurements (“NCRP”) are authoritative, and are based on conservative principles that provide for a wide margin of safety. In NCRP Report No. 53, “Review of NCRP Radiation Dose Limit For Embryo And Fetus In Occupationally-Exposed Women,” which was introduced into evidence at trial, the NCRP proposes .5 rem as the maximum radiation dose to which a fetus should be exposed. (A rem is a unit of radiation, and .5 rem is also equal to 500 millirems). By contrast, the generally accepted maximum level of exposure for a nonpregnant employee is 5 rems per year.
Most employers whose employees are occupationally exposed to radiation require their employees to wear radiation badges, small dosimeters that monitor the amount of radiation to which an employee is exposed. The radiation badges are checked periodically to ensure that an employee has not been over-exposed. At Shelby Memorial Hospital all x-ray technicians wore two radiation badges — one on the chest, and one on the finger — which were checked at least once a month. During the two months she was at the Hospital, Hayes’s chest badge showed an exposure of 20 millirems per month, and her ring badge showed an exposure of 60 millirems per month. Taking the higher reading of the ring badge, which is a less accurate measure of radiation to the abdominal area than is the chest badge, and multiplying it by the eight months thát Hayes would work before taking maternity leave, reveals a total exposure of 480 milli-rems, which is within the 500 millirems limit set by NCRP. Multiplying the lower reading from the chest badge shows a total eight month exposure of 160 millirem, well within the NCRP limits.
Nevertheless, the Hospital argues that one cannot extrapolate accurately from only two months of badge readings because the total amount of exposure each month varies widely from technician to technician. The Hospital cites evidence that some of the day shift technicians occasionally received doses of several hundred millirems in one month. But the Hospital has argued consistently, in a different context, that the duties of the day and night shift technicians are quite different. Therefore, evidence that day technicians occasionally received high doses of radiation is irrelevant to Hayes’s case. The Hospital failed to show that Hayes’s duties as a night technician were
likely
to ever expose her to such high levels of radiation. Of course, if.Hayes’s badge readings, as continuously monitored, ever showed that she was approaching the 500 millirem mark after only five or six months, the Hospital would have been free to reevaluate her duties. We stress, however, that the Hospital would be under a heavy burden to examine all alternative possibilities for keeping Hayes employed in some capacity.
Thus, we hold that the Hospital failed to meet the threshold requirement that it prove that its discriminatory policy was necessary in Hayes’s case.
Because the Hospital failed to prove its policy was necessary we need not reach the factual issue of whether x-ray radiation affects the offspring of employees only through pregnant women, or whether similar effects can occur from exposure to males. Documents cited by amici do suggest that radiation induced mutations can pass to offspring from the male sperm, but neither party developed the evidence on this issue at trial.
Because the district court lacked the benefit of the approach we have outlined here, and therefore did not try this case using the framework we have outlined, the Hospital might argue that we should remand this case to give it a second chance to prove its firing of Sylvia Hayes was justified under Title VII. Although we believe the district court’s findings of fact were sufficient to support our holding of facial discrimination; we must be completely fair to the Hospital. Therefore, we will assume that the Hospital could rebut Hayes’s casé of facial discrimination, and show that the Hospital would, nevertheless be liable in this case, under the disparate impact theory.
C.
Disparate Impact
If an employer proves that a policy applying only to women or pregnant women employees is justified on a scientific basis and is not necessary to protect the offspring of male employees, the employer has shown that its policy is neutral, in the sense that it equally protects the offspring of all employees. Nevertheless, such a “fa-daily neutral” policy clearly has a disproportionate impact on women since only they are affected by it. Therefore, even if the employer rebuts the prima facie case of facial'discrimination, the employee has an automatic prima facie case of disparate impact. Under the disparate impact theory, however, the employer is entitled to assert the defense of business necessity.
See Griggs v. Duke Power Co.,
401 U.S. 424, 91 S.Ct. 849, 28 L.Ed.2d 158 (1971).
One problem with business necessity as defined under traditional Title VII analysis, but applied in the context of an employer’s fetal protection program, is the requirement that the employer’s policy be related to job performance,
id.
at 431, 91 S.Ct. at 853, because fetal protection does not in a strict sense have anything to do with job performance.
For example, Hayes’s can perform her job as an x-ray technician as well while pregnant as she could beforehand. Nevertheless, the federal courts and several commentators who have considered the issue of employer fetal protection plans have recognized the need for a narrowly circumscribed business necessity defense.
See Wright v. Olin Corp.,
697 F.2d 1172,1188-91 (9th Cir.1982);
Zuniga v. Kleberg County Hosp.,
692 F.2d 986, 992 (5th Cir.1982); Williams,
Firing The Woman,
69 Geo.L.J. at 687;
cf. Hayes v. Shelby Mem. Hosp.,
546 F.Supp. 259, 263-64 (N.D.Ala.1982).
But see Burwell v. Eastern Air Lines, Inc.,
633 F.2d 361, 371 (4th Cir. 1980) (en banc) (concurring opinion),
cert, denied,
450 U.S. 965, 101 S.Ct. 1480, 67 L.Ed.2d 613 (1981). We agree that the defense should be allowed.
The employer’s business necessity defense applies automatically, just as the employee’s prima facie case of disparate impact applies automatically. That is because to reach the disparate impact stage of analysis in a fetal protection case, the employer has
already
proved — to overcome the presumption of facial discrimination — that its policy is justified on a scientific basis and addresses a harm that does not affect men. To add any more requirements would be to render it nearly impossible to have a fetal protection program under any circumstances.
Nevertheless, the employer’s business necessity defense may be rebutted by proof that there are acceptable alternative policies that would better accomplish the purposes of promoting fetal health, or that would accomplish the purpose with a less adverse impact on one sex.
See Wright v. Olin Corp.,
697 F.2d at 1191. The burden of rebuttal is on the employee. In other words, to avoid Title VII liability for a fetal protection policy, an employer must adopt the most effective policy available, with the least discriminatory impact possible. To require any less would be to return to the days of
Muller v. Oregon.
In the case at hand, the district court found that the Hospital failed to consider acceptable alternatives that would accomplish the Hospital’s purpose with a less discriminatory impact. In particular, the district court found that Hospital officials failed to explore seriously other duties
within the Hospital that Hayes could perform. Additionally, the court found that the Hospital failed to consider rearranging Hayes’s duties within the radiology department to minimize her radiation exposure. Those findings are supported by ample evidence, and thus are not clearly erroneous. Therefore, even if we were persuaded that the Hospital’s policy was justified by business necessity, we would hold that Hayes successfully rebutted the Hospital’s business necessity defense.
CONCLUSION
In sum, we have attempted to set forth a framework using traditional Title VII principles for analyzing cases in which an employer seeks to fire (or not hire) an employee to protect that employee’s offspring from some workplace hazard. Although our discussion has been lengthy, theoretical, and perhaps confusing, the effect of our analysis is fairly simple: If an employer has a fetal protection policy that applies to members of one sex only, the policy violates Title VII unless the employer shows (1) that a substantial risk of harm exists and (2) that the risk is borne only by members of one sex; and (3) the employee fails to show that there are acceptable alternative policies that would have a lesser impact on the affected sex.
In the case at hand, we hold that the Hospital failed to rebut the presumption that its abrupt firing of Sylvia Hayes when she revealed her pregnancy was the result of a facially discriminatory policy. The Hospital also failed to consider less discriminatory alternatives to firing Hayes. Therefore, we affirm the district court’s finding of liability.
The Hospital has also raised several issues regarding the district court’s computation of a modest award of damages to Hayes. Finding no clearly erroneous factual findings and that the district court applied the correct law, we affirm the damage award.
AFFIRMED.