Sex and Gender-based Analysis of this topic
Definition
The workplace environment is a significant determinant of women’s health. Work-related “injuries” (which include illnesses) [1] are notoriously under-reported [2]. In Canada, the official rates for these injuries are going down; women’s rates have not declined as much as men’s [3]. Health and social work sectors, where women dominate, accounted for about one-third of 2008’s injuries [4].
Other types of hazards, including ergonomic and stress/work organization (common hazards for women), can lead to and/or worsen health effects of chemical exposures [5,6]. Chemicals that women encounter range from anaesthetic gases in health care and cleaning ingredients in many settings, to heavy metals and solvents in manufacturing and electronics, pesticides in agriculture, and poor indoor air quality in offices and schools. The exposures can be multiple and complex, affecting physical and mental health [7] (e.g., hairdressing and teaching have high rates of neurodegenerative diseases8]).
Sex Issues
Historically, OHS research focused on reproductive outcomes for women, especially to the foetus [9,10]. Recently, some researchers are studying specific effects on women themselves (e.g., menstruation, endometriosis [11,12]).
Chemical exposures can have different outcomes for men and women [13,14]. On average, women breathe differently than men [15], have skin reactions/diseases more often [6], and metabolise chemicals differently at different life stages [16]. Yet there is overlap between the sexes [17]. Anthropometry (the size and shape of body parts) is an important consideration in OHS research as women’s hands and faces are different sizes and shapes than men’s. Personal protective equipment and clothing (PPE) designed for white men offers many women little protection and/or increases exposure by adding constraints to how a job is done [18].
Gender Issues
The gendered combination of working conditions and non-work responsibilities affect women’s health [7,19]. A focus on women’s ability to bear children (whatever their intentions) has kept women out of well-paid manufacturing jobs (where men’s reproductive hazards typically were ignored) and in traditionally-female ones where chemical hazards were ignored or accepted [20].
While men’s job hazards usually include chemicals, forceful exertions, and vibration, women’s work is likely to be repetitive, monotonous, and stressful. Gendered job segregation leads to different tasks and hazards for women compared to men with the same job title [19]. Women also report unclear job and/or task requirements, multi-dimensional constraints and isolation in terms of their labour relationships and coping strategies [21]. When men dominate decision-making positions in hierarchal workplaces, vertical segregation takes a toll on those in female-dominated jobs with low status/authority [22] Women’s concerns also are often de-legitimised: they have “mass psychogenic illness” or are “natural” complainers at work [23], while young men generally do not complain about pain and fatigue at work to prove they can do the job [24].
Sexual harassment and discrimination also contribute to chemical exposures. For example, female firefighters have won complaints that included lack of proper clean-up facilities and interference with fire hoses that jeopardized their safety and health [25]. Female construction workers report similar discrimination [26].
Diversity
Disparities in women’s occupational hazards may be linked to age, class, heritage, language skills, physical and mental dis/abilities, sexual orientation and economic vulnerability [27-30]. The same factors affect reporting of work-related symptoms, illnesses and diseases by equity-seeking groups [31,32]. For example, residential school experiences led Manitoba Aboriginal workers to leave jobs to avoid punishment anticipated if they raised concerns about workplace hazards [33].
Critique
Women’s OHS has been largely invisible and/or discounted [34]. Governments and research funders priorise “real” hazards in male-dominated industries and sectors [19]. We know little about the effects of most chemicals; long-term effects and exposures to multiple substances and hazards are rarely studied [17]. Canadian databases do not capture the complexity of women’s workplace experiences [21]. Workers’ compensation data are flawed making the data unreliable for prevention planning and policy for women’s occupational health [35].
Exposure assessment and research analysis methods (e.g., controlling for sex/gender, when it is a proxy for working conditions) distort and/or under-estimate the state of women’s occupational health [14,36]. These kind of inappropriate approaches lead to standards based on men’s experiences and jobs [19], women’s compensation cases being refused [35] and missed opportunities to protect all workers [37,38].