Trades Union Congress -

The TUC established its "women, work and health" initiative in 1997 to address the perceived imbalance in the gender aspect of health and safety. Key issues to be addressed included the lack of research into women’s health and safety, and the "gender neutral" approach of the Health and Safety Commission and the European Commission.

On 3 November 1998, the TUC held an international seminar on research into women’s health and safety, of which this is the report. Sixty trade unionists (including women’s officers and health and safety specialists), researchers and managers gathered in Congress House in London.

The TUC is very grateful to those who took part, whether as speakers or participants. This report is intended to explain why the TUC believes that health and safety should be "gender sensitive" rather than "gender neutral", and to encourage others - safety reps, employers, researchers and the enforcement and regulatory agencies - to address the gender agenda.

TUC Women, Work and Health Steering Group

Veronica Bayne (PCS) - until 1999

Hope Daley (UNISON) - from 1999

Liz Jenkins (IPMS)

Jane Paul (BECTU) - until 1999

Imogen Radford (PCS) - from 1999

Eleanor Ransom (SoR) - from 1999

Doug Russell (USDAW)

Claire Sullivan (CSP)

Owen Tudor (TUC)

Ministerial introduction

Alan Meale MP, health and safety minister

Alan Meale opened the TUC’s symposium on Women, Work and Health by stressing the government’s commitment to improving the working conditions of all workers.

The HSE’s traditional approach to health and safety at work had been to apply the same standards to men and women, he said. Mr Meale admitted that this approach may be inadequate for many women in the labour market today.

‘If we need a different approach for women, we want to know this,’ he said. ‘That is why current research into women’s health in the workplace is so important.’

Mr Meale acknowledged that new working structures affect women workers particularly.

‘Women are becoming an increasingly large proportion of the workforce, and many of them have flexible working patterns like part-time work, or having to do several part-time jobs. These changes provide new opportunities for women, but they can also pose problems with health and safety at work.’

Mr Meale talked about workers - the majority of them women - who now found themselves outside the traditional employer/employee relationship. He mentioned those who worked at home or on short-term contracts. Many of them had little back-up or support, particularly on health and safety.

‘It is our duty to ensure that we protect the health and safety of these workers as far as we can,’ he said.

Health at work: European perspective

Dr Elizabeth Lagerlof, Director, Nordic Institute of Advanced Training in Occupational Health, Finland.

Health and safety legislation is failing women at work across the European Union, said Dr Elizabeth Lagerlof. Laws which were framed by men, often several years ago, do not take into account the changing nature of employment, the increase of women in the workforce and the types of work they are doing. As a result, they do not address the particular health and safety issues that affect many women.

In recent years, more and more women have joined the workforce - this is seen across the European Union where now 42 per cent of the workforce is female. However, ‘the segregation between men and women in the labour market is strong,’ according to Dr Lagerlof. There are significant differences in the types of work done by women, in the hours they work and their rates of pay. The result is that men and women face different health and safety risks at work.

Dr Lagerlof has found that across the EU, women are more likely to:

· work in the public sector;

· do different, specific types of tasks at work to men;

· have less power over decisions and work, including the flexibility of their work; and

· work in insecure and part-time jobs.

While men are evenly spread across all occupational groups, women predominately work as clerks, shop assistants or in other service industries, or in elementary, unskilled occupations. Women tend to work in jobs which involve contact with people; they take on more caring or support jobs and work more in computerised areas, while men have monopolised the heavy technical and managerial jobs.

These differences are reflected in the types of occupational health problems faced by men and women, said Dr Lagerlof.

She went on to outline the different types of health and safety issues in the workplace, and show which affected women in particular.

Accidents

Men are more likely to have accidents at work, although women are catching up in this area, said Dr Lagerlof.

The types of accident women suffer reflects the different tasks they undertake. For example, women are more likely to have an accident because they are tired. This is not surprising, given that many working women are mainly responsible for work in the home on top of their paid work. Another reason why women face accidents at work is because many of them are using tools and equipment designed for men - these can be more difficult for women to work with.

Upper limb disorders

‘Upper limb disorders are probably the most common work-related disease today amongst women in industrialised countries,’ said Dr Lagerlof. They are usually associated with monotonous, repetitive tasks, heavy lifting, awkward postures and bad work organisation. Women are more often found working in such conditions.

Ergonomics play a part too, with most work places designed for an ‘average male’. As a result, work stations may be too high and loads to be lifted too heavy for most women.

Respiratory diseases

Whilst men are more likely than women to suffer from breathing problems related to their work, women are more prone to skin allergies, and to multiple chemical sensitivity and ‘sick building syndrome’, said Dr Lagerlof.

Skin allergies can be largely explained by the high numbers of women working with detergents, solvents and water in professions such as hairdressing, health care and sales. ‘Sick building syndrome’ occurs mainly among office workers, particularly those in low-paid, routine jobs. ‘As we have seen, these jobs are predominantly done by women,’ said Dr Lagerlof.

Hearing and vibration diseases

These occur more frequently in men who dominate jobs working with high levels of noise and vibrations. However, Dr Lagerlof quoted new research which suggests that when pregnant women are regularly exposed to whole body vibrations there is an increased risk that their babies will have hearing problems.

Cancer

Certain types of work seem to increase the risk of cancers which affect women. Women working with pesticides, solvents and in health care seem to have a slightly increased risk of developing breast cancer; ovarian cancer has been connected to herbicides and work in the cosmetics industry; brain cancer has been reported amongst women in agriculture; bladder cancer for those in the cosmetics or food industries; and lung cancer amongst women working in the furniture, asbestos or food industries.

Lung cancer is increasing amongst women, probably caused in large part by the increasing numbers of women who smoke. However, ‘smokers are more frequent in stressful jobs with low control,’ said Dr Lagerlof. She suggested that many women workers rely on smoking to relieve the boredom and frustrations of monotonous work.

Risks to the foetus

Pregnant women whose work involves heavy lifting or long periods of standing have an increased risk of premature labour, according to research quoted by Dr Lagerlof. One in five premature births has been linked to such activity, she said.

Stress

High demands and low control contribute to stress at work - and both factors dominate many women’s working lives. Even women in white collar jobs have less control over their work schedules, time off and breaks than their male colleagues. In blue collar work, two out of three women have high-demand, low-control work compared with 50 per cent of men. And women are stuck in such jobs, said Dr Lagerlof.

‘Women are less likely to move on to more responsible, less controlled work than men. To some extent, women take over men’s bad work tasks,’ she said.

Women are more likely to be bullied, harassed and face sex discrimination and violence at work than men. Once again, women in precarious jobs are more likely to be affected than those in permanent work.

Stress levels at work are a direct cause of absenteeism, said Dr Lagerlof, and studies show that in male-dominated sectors, such as breweries, paper and textile industries, women’s sick leave is twice as high as that for women in general. The conclusion was that women seem more prone to health problems caused by stress at work.

Different symptoms

Dr Lagerlof summarised the findings on women’s occupational health by saying that while men seem to suffer ill health from specific factors, with a single cause, women are more prone to general illness caused by a variety of factors at work.

Legislation - gender neutral?

Current occupational safety and health legislation is presumed to be gender-neutral. But, said Dr Lagerlof, in fact it is based on a male norm.

There are historical reasons for this: legislation was initially focussed on machinery, safety and accidents. Regulations specifically designed for women were then introduced: for example the lower maximum weights to be lifted by women, restrictions on work time.

A more useful approach would be to evaluate the specific risks women workers are exposed to and form legislation that accounts for gender differences, said Dr Lagerlof. Used in this way, health and safety could become a tool to promote equality at work for men and women.

The way forward

Dr Lagerlof briefly ran through a list of positive suggestions to enhance women’s health at work:

· better information and research on women’s occupational health;

· gender impact assessments in relation to health and safety directives and appropriate guidelines drawn up;

· equipment must be designed for women, instead of expecting them to fit in with that designed for men;

· new forms of work, such as teleworking and new time patterns - many of which are undertaken predominantly by women - must be assessed, particularly in their impact on the balance of work and family life;

· good practice of employers who are sensitive to gender in the workplace should be publicised;

· models for empowering women in participating in decision-making at work should be developed;

· local equality programmes need to be developed and evaluated locally; and

· attitudes to women as ‘inferior workers’ must change.

In the final analysis, said Dr Lagerlof, women’s health at work will only be significantly improved when men take on a fairer share of work in the home.

‘A more equal division of responsibilities at home as well as at work can bring about many positive changes,’ she said.

Recent findings in Britain

The 1995 Self-Reported Work-Related Illness Survey, introduced by Dr John Osman, Health and Safety Executive (HSE).

Dr Osman explained that the HSE relies on a series of sources of information to build up a full picture on the state of occupational health.

These include:

· information from the occupational diseases compensation scheme;

· mortality and cancer incidence data;

· specialist surveillance schemes; and

· population-based surveys.

‘Information from the occupational diseases compensation scheme give a useful picture of the areas where serious incidents occur,’ said Dr Osman. In terms of deaths from occupational disease, these sources show a steady decline in deaths from incidents at work over recent years.

Mortality and cancer incidence data

Mortality and cancer incidence data are often used in the UK for identifying links between particular occupations and specific fatal diseases. On the whole, these are also declining, said Dr Osman, but one notable exception is the area of mesothelioma.

‘There has been a steady increase in deaths in women from asbestos-related disease since the early 1970s. Deaths in the last few years probably reflect exposure to asbestos before the early 1970s, but even so, there is still probably a lot of asbestos around today,’ he said.

Lead is another well-established hazard. ‘We monitor data separately for men and women because of the implications for reproduction.’ said Dr Osman. ‘I’m glad to say that for most women - 78 per cent - the levels of lead in the blood are well below the target levels.’ However, he added, the picture varies from industry to industry.

Specialist based surveillance schemes

Specialist based surveillance schemes have been running since 1989 when chest physicians first started reporting incidents of occupational lung disease. This has developed into the Occupational Disease Information Network (ODIN) schemes in which chest physicians, dermatologists, audiological physicians, specialists in communicable diseases, rheumatologists and psychologists report cases of disease which they attribute to work.

Dr Osman outlined the example of dermatitis. ‘Statistics show that women under the age of 30 seem to be at particular risk of contracting dermatitis,’ he said. The low age was important because the development of an allergy may completely prevent a person from working in that profession because, once established, the sensitivity will never go away.

Statistics showed a correlation between contact dermatitis and certain chemicals.

‘It’s interesting to pick up on nickel because it reflects the increasing problem that we have that many of these sensitisations have work and non-work causes,’ said Dr Osman. ‘In the case of nickel, it’s contact with jewellery at home, made worse by contact with certain chemicals at work.’

Women dominate the occupations which have the highest risk. For instance hairdressers are 16 times more likely to experience dermatitis than the working population as a whole.

The Labour Force Survey

The HSE added a number of questions about people’s perception of the relationship between their work and their health to the 1990 and 1995 Labour Force Survey.

The first question was: ‘In the last 12 months have you experienced an illness which you think was caused or made worse by your work?’

In 1995, the HSE got permission to access information from the individuals’ doctors to get an idea of whether it was their opinion that the illness was work-related.

‘We also asked a general section of the population whether they were exposed to particular problems at work, such as violence, noise or ergonomic factors,’ said Dr Osman.

Initial results

For women, the number reporting a work-related illness in the preceding 12 months was 40 per thousand. Extending this result to the whole working population gives 800,000 women. The commonest illnesses, both for men and women, were musculo-skeletal, stress and stress-ascribed conditions.

On the specific questions on working conditions, about a third of women reported never having to work to tight deadlines, while half said they had to work to tight deadlines about half the time.

The future

Dr Osman said that the early results from the survey suggest that women do experience a different set of health and safety problems at work. Given the changes in work and the population, it was likely that these differences would come to have an increasingly profound effect on health at work.

‘It is predicted that the number of men aged 60-64 who are economically active will go on decreasing through to 2006, whereas the number of women is predicted to go on increasing,’ he said. ‘This will have implications for health and safety, both on sex and age grounds.’

What women safety reps think

The TUC Survey of Women Safety Reps, introduced by Pete Kirby

The TUC’s 1998 survey attempted to discover the workplace health and safety problems faced by women, and to explore the priorities for dealing with them, said Pete Kirby.

Of the 687 respondents, 78 per cent were from the public sector, with 42 per cent of those from the health service; 16 per cent were in education and 13 per cent in local government. Sixteen per cent were in the private sector, the majority from manufacturing.

Eight-five per cent of respondents said they had never been asked for information on women’s health and safety in the past.

The questions in the survey were directed at health problems for women caused, or made worse, by work. Mr Kirby said the results showed seven main groups of concern. He said it was particularly interesting to compare the results of this survey with the TUC’s wider survey of health and safety aimed at both men and women.

Stress was identified by 88 per cent, higher than the 77 per cent from the survey for men and women.

Manual handling came next, mentioned by 63 per cent as a cause of ill health. This result, said Mr Kirby reinforces research that shows that women are increasingly working in jobs where frequent manual handling is required.

Repetitive Strain Injury was identified by 53 per cent as a problem for women, compared with 37 per cent for all workers.

Violence was fourth, with 36 per cent identifying this as a particular risk, compared with 28 per cent for all workers.

Reproductive health was mentioned as a specific worry by 29 per cent.

Chemicals were seen as a problem for 25 per cent of women, a smaller proportion than that for men and women, but still significant.

The menopause was thought to be made worse by conditions at work by 22 per cent. The TUC believes that this high level calls for more investigation into the effects of work on the menopause, with a view to controlling them.

Consistency across regions

Mr Kirby said that the survey showed a consistency of problems faced by women workers across the country. Stress was the number one priority in every geographical region - consistently mentioned by over 80 per cent of respondents. The top four priorities - stress, manual handling, RSI and violence - were in the same order from every region.

In the north east it was clear that manual handling at 78 per cent and RSI with an average of 73 per cent were particular problems.

Problems in different sectors

The main sectors looked at by the survey were health, education, local government and manufacturing.

Within health, stress was the biggest problem but manual handling was identified by 86 per cent. Violence, at 48 per cent, was significantly higher than the average.

In education, stress was identified by over 90 per cent of respondents.

In local government, stress was identified by 94 per cent, and violence by 51 per cent.

In manufacturing, 81 per cent said that RSI was being caused or made worse by work.

Apart from showing a remarkable level of consistency of the health and safety issues affecting women, there was a long list of other concerns identified - 59 in all - showing that women at work had a wide range of different experiences, said Mr Kirby. The main factors to emerge were back problems at 10 per cent; heavy lifting at 3 per cent; heating, ventilation and air conditioning at 7 per cent; headaches at 6 per cent; and bullying and harassment at 5 per cent.

What have employers been doing?

The survey went on to ask safety reps about the attitude of employers to health and safety problems. According to the responses, fewer than one in four always take problems raised by employees seriously; 56 per cent sometimes do; 12 per cent rarely; 3 per cent never.

Fewer than three in ten fully address women’s concerns on carrying out thorough risk assessments. Twenty-seven per cent had not addressed the concerns of working women at all; 41 per cent had only partly done so; fewer than three in ten had addressed them fully.

On the issue of risk assessments for pregnant women, 54 per cent of employers had not conducted any assessment at all and only three out of ten had.

In 68 per cent of health and safety policies, women’s health and safety had not been specifically addressed.

TUC action

Mr Kirby outlined a number of initiatives the TUC was instigating in the wake of the survey. These included:

· giving a special focus to women’s health and safety on Workers’ Memorial Day in 1999;

· establishing women as a special focus in campaigns on musculo-skeletal disorders and violence;

· producing guidance for safety reps to assist in getting women’s health and safety dealt with in a better way through risk assessments;

· further investigation into work and the menopause; and

· work with the Health and Safety Executive on an action programme on women’s health and safety in conjunction with the Department of Health.

What women do makes all the difference

The European Foundation Survey, introduced by Mia Heikkinen research manager for the European Foundation for the improvement of living and working conditions.

Mia Heikkinen described the results of the European Foundation Survey, a survey of 1,000 workers from each member country of the European Union in 1991/2 and 1996. Work was already in progress on the third survey, she said.

‘In the first survey we didn’t really analyse gender,’ she said. ‘But now we have moved to having a lot of gender analysis, including gender-specific questions.’

The survey covered a large range of issues - working hours, examination of the division of labour by gender, work and family roles, stress and wellbeing at work, workplace interactions and psychosocial issues - the results of which were analysed in as many ways as possible.

Types of work

‘We defined four types of work,’ said Ms Heikkinen, ‘hectic, active, passive and relaxed. We looked at the psychological demands of the work, the control freedom of the work and social support.’

The best place to work in would be the active zone, Ms Heikkinen explained. ‘This is where you have some time pressure but you still have autonomy.’

The survey revealed that 40 per cent of women workers are in the hectic work sector: they have low autonomy and high time pressure. The results of hectic work include fatigue, anxiety, stress and irritability.

‘We have already seen that most part-time jobs are done by women,’ said Ms Heikkinen. ‘What we also established was that as women have more children, they work fewer hours, whereas for men, they tend to work more.’

Violence - a particular problem

The 1996 survey began to look at violence at work, an area that will be extended in the third survey. The survey found that 8 per cent of the female workforce faced intimidation, 4 per cent physical violence, 4 per cent sexual discrimination and 3 per cent sexual harassment.

‘These are significant percentages and show an important issue,’ said Ms Heikkinen.

Women’s work

The survey also looked at women’s job profiles. It established that women:

· have more contact with people outside the workplace;

· mainly (66 per cent) deal with caring and support; and

· do more routine computer-based work - 30 per cent deal with one on a day-to-day basis.

‘There is still a glass ceiling,’ said Ms Heikkinen. ‘About 70 per cent of the managerial jobs are occupied by men, although this varies between different sectors. Services and clerical jobs are for women.’

Dealing with the problems

One of the ways the Foundation is seeking to tackle the specific problems of women’s health at work is through a collective bargaining project. Ms Heikkinen said she believed that this was a useful way to proceed. ‘We’ve collected 250 collective bargaining agreements from different EU states, which contain clauses which deal with equality issues like sexual harassment, family commitments as well as inequality in general.’

Collecting better data

The European Union’s Project on Epidemiological Research: how gender can be taken into account, by Dr Lesley Rushton, University of Leicester

‘Are we going to be able to study women and occupational health? Have researchers been obstinate, or is it particularly hard to study them?’ These were the questions which the European Union Project started out with in its study of gender and health at work.

Dr Lesley Rushton explained that the project was concerned with women’s occupational health for a number of reasons. These included:

· the increasing numbers of women in the workforce;

· the fact that there were clearly particular occupations, dominated by women, where certain diseases were affecting workers; and

· women’s work-related illnesses were under-researched.

In the past, said Dr Rushton, occupational research has tended to concentrate on deaths and cancer - problems associated with the ‘heavy industries’ usually dominated by men.

This project would focus on non-life threatening disorders such as musculo-skeletal disorders, neuro-behavioural effects, stress-related and reproductive problems - problems that affect industries dominated by women, and those specific to women.

The first stage of research

Dr Rushton explained that the team had started work by looking at industry records of women’s health problems. The level of records were poor. The main reasons were that:

· records were incomplete (due to loss or destruction, difficulty in finding records, or the fact that many were not kept up to date);

· work history was difficult to determine (job titles were not task-specific, were often changed and changes were not recorded);

· exposure to risk was difficult to measure in a systematic way (measurements were rarely made, and when they were, techniques varied and changed).

The EU study therefore circulated three questionnaires to companies across seven EU member states. These looked at the records held by companies in three main areas: the biographies, health and exposure to risk of workers.

Results - who keeps what records

‘Nearly all companies keep details of workers’ names, gender, date of birth and addresses,’ said Dr Rushton. Information on marital status, children, place of birth and nationality were less often kept. For example, only 35 per cent of companies always recorded which of their workers had children, while 26 per cent said they never did.

When it came to health records, 47 per cent of employers screened their employees for health problems (this was most prevalent in France, Spain and the UK), while 37 per cent did not.

The maintenance of records on employees’ exposure to risk varied enormously from industry to industry, with the chemical, manufacturing and mineral extraction industries keeping the best records. Of these, 85 per cent measure noise levels, 49 per cent measure exposure to chemicals and 49 per cent measure exposure to minerals.

Where companies did keep records of exposure, 82 per cent did so for legal reasons; 39 per cent recorded exposure only when problems occurred; and 55 per cent did so for surveillance purposes (Swedish firms were most likely to carry out surveillance). In the case of surveillance, 51 per cent of firms made measurements for individual workers, 55 per cent measured exposure on particular jobs and 75 per cent measured exposure in specific locations. (Again, Swedish firms were the most likely to carry out all three types of measurement.)

When it came to storing records, 42 per cent of firms kept personnel records for ‘six to ten years’; 42 per cent kept health records for ‘zero to five years’ and 44 per cent kept exposure records for ‘zero to five years’.

French companies kept records the longest, followed by the UK, Germany, Italy, Spain, Sweden and the Netherlands.

Recommendations

Dr Rushton outlined the report’s main recommendations. These were made in the form of principles designed to be European-wide, cover all forms of employment, all sizes of industry and all hazards.

The aim was to benefit workers and employers. For workers, implementation of the recommendations would improve protection and so ensure a decrease in illness caused in the workplace. Where illness did occur, it should be easier to obtain fair compensation. The industry would benefit from a more healthy workforce, a better relationship with workers and the wider community and, potentially, from improved productivity.

Improving data

Dr Rushton’s first principle was that firms should improve their data on employees’ health.

‘Companies should have the ability to identify individuals and keep sufficient data to make links between health threats and particular risks,’ she said. It was essential that records on gender and date of birth be kept in order to make this possible.

The second principle was that the data should be accessible, regularly updated, kept secure and confidential. The system for storing data was not important, ‘but it must be able to make links and show patterns of occupational health and workers at risk,’ she said.

The third principle was that the data should be kept, in the best case scenario, ‘forever’.

‘In order to effectively study a generation over time, complete records are necessary for 30 to 40 years,’ said Dr Rushton. ‘For studying health across generations, an even longer period of records would be needed.’

The fourth principle was that the records should be kept by the company where possible, and measures taken to ensure they were safe in the event of take-over or changes to the company.

‘There are difficulties to overcome if these objectives are to be achieved,’ said Dr Rushton. Industries need to be educated and motivated on the importance of such a study. A sensible balance must be struck between research needs and potential burdens to industry. Much could be achieved by working with and improving existing methods of collecting data, and upgrading linkage and retention of records.

In the final analysis, national approaches would be to be developed to address the issues of unwanted records and those of companies that go out of business.

Learning from women

What we can learn about occupational health from observing women at work, by Professor Karen Messing, University of Quebec.

Professor Karen Messing described the work she was doing at the University of Quebec, working with the major trade unions.

‘Our job has been to identify the health and safety risks that affect women (often reported by the trade unions), identify discrimination in the treatment of women in health and safety practices, change work places and the social context,’ she said.

‘Our research bears out the previous speakers’ claims that women workers are understudied,’ said Professor Messing. Any studies that were done on heart disease and stress among women workers for example were smaller than those done on men and so gave very little basis for useful conclusions. Similarly, few studies have been done on occupational cancer among women.

Vicious circle

This patchy research led to a vicious circle, said Professor Messing. ‘Little research leads to a blinkered view of women’s health problems at work - they are put down to ‘getting old’ or the menopause, or hysteria. Women’s problems are seen as unreal. So there’s little incentive to do research - or to do any prevention.’

Professor Messing displayed a graph which showed a correlation in a Canadian jurisdiction between sectors which employ mostly women and the areas where there is a low amount of legislation or concern about health and safety.

This lack of concern is shown on death certificates, where the cause of death for women is much less likely to be put down to injury at work.

Professor Messing gave another example. She said that according to the research of Katherine Lippel, chronic stress in women is much less likely to be compensated for than that in men. And it was the same story for musculo-skeletal problems - often because in women these are caused by long-term exposure to stresses, while men are more likely to develop problems after an accident at work.

The biscuit factory

Professor Messing’s team has carried out a series of studies. One was of a biscuit factory in which they looked at the different jobs done by men and women.

‘The men did all the heavy carrying and lifting of raw ingredients and then the finished product,’ she said. ‘The women did everything in between: lined up the cookies, boxed them and wrapped the boxes.

‘There is a perfect sexual division of labour in this factory.’

The women on the production line manipulated small units of weight at an extraordinarily fast pace, while the men did more occasional manipulations of bigger weights. The result was different types of injury, with the women suffering more chronic problems acquired over a long time and the men more prone to single, severe accidents.

‘A particular fact to note is that many of the men at the toughest jobs such as carrying heavy baking pans are young, doing occasional shifts during college. They only stay in the job for a short time because it’s a very tough job to do - very prone to injury,’ said Professor Messing. ‘The women tend to be in the same job for 25 to 30 years. They are exposed to this lower intensity physical stress over a very long period of time.’

The clothes factory

Quebec’s heat regulations categorise the amount of heat a person can be exposed to during their work, depending on whether the work is classified as ‘heavy’, ‘moderate’ or ‘light’. Sewing garments on a machine is classified as ‘light’ which means workers can be exposed to a greater degree of heat than a person doing heavier work.

‘But, if you compare the amount of weight a machinist lifts to the material and parts the sewing machine operator manipulates, and the resistant pedal she pushes down with her foot, she is actually lifting more in a working day than a man who is lifting occasional, heavier loads.’ After ergonomic studies, some of the women’s ‘light’ work has been reclassified and the temperature lowered.

‘Often people who seem to be doing no heavy work are actually doing a lot of physical work,’ said Professor Messing. ‘Sales workers who stand all day, are another example. They work their muscles hard to keep them in these static positions.’

The hospital cleaners

In Quebec hospital cleaning is separated into heavy and light work. Women tend to do the light work (dusting and cleaning bathrooms); men do the heavy (sweeping).

‘The women move their postures much more rapidly than the men - up and down to reach places,’ said Professor Messing. ‘Men spend about two thirds of their time in "neutral postures" whereas women spend a lot of their time bending over, in a posture that is often related to back problems. Dusting also involves moving a lot of other objects.’

This separation was useful for employers: the men were called on for any occasional dangerous work such as subduing a violent patient, and the women were used for all the most monotonous repetitive work. But, according to Professor Messing, the separation militates against health and safety. If the men did have accidents and were then put on to doing ‘light work’, it was always much too heavy for them.

Partly as a result of Professor Messing’s recommendations there was a fusion of the jobs. ‘However, it seems as though all the new people who have been hired in the new fused jobs are men,’ she said, ‘because if you can only have one, employers want the one that can physically control a violent patient if the need arises.

‘This is why it is so important that the equality and health and safety committees work together.’

The primary school classroom

Professor Messing was involved in a study with the primary school teachers’ union to address the problem of occupational stress. The primary school sector is dominated by women. She observed teachers at work to see what the determinants of stress were.

The first thing she noticed was the pace of the work. ‘Everything has to be done to fit in with the short attention span of small children - the average length of explanation is under nine seconds; up to 14 seconds in sixth grade.

‘It requires tremendous concentration because of the huge number of factors involved - discipline, fairness, orchestration of the class, keeping the physical conditions right for the children.’

The length of the workday showed that these teachers were not taking their breaks and were devoting many extra hours outside school to their work. Part of this was due to the huge amount of time they devoted to thinking about problems at work when they were at home, particularly when they had children with severe emotional or economic problems.

The high pressure and long hours of the job were clearly a factor in higher levels of stress amongst primary school teachers.

‘It’s multi-determined: i.e. the stress is caused by a large number of small factors, which makes it very hard to intervene with a solution,’ said Professor Messing. ‘You can’t do risk-based intervention. You really have to do health based intervention on this kind of profession.’

The telephone operators

Professor Messing carried out a study of telephone operators, a sector again dominated by women. Their shifts varied enormously from week to week and were determined by TV schedules, weather and other factors that might affect the number of people phoning in.

In this workplace, the operators received their weekly schedules on the Thursday before the week beginning the following Sunday. Hours varied widely, and so did break times.

The study looked at operators with children under 13 to see how they handled the erratic nature of their hours.

‘They have to try and trade hours, and this can be very complicated,’ said Professor Messing. ‘It has to be done over the phone, in their own time, and takes a huge amount of time.’

The average success rate of exchanging shifts is one success for every five attempts. When that didn’t work, they had to organise changes to their day-care. On average, these women use four day-care resources to cover all their shifts. Many carers are grandmothers.

‘So this has become a social problem rather than a work health and safety problem,’ said Professor Messing. ‘It’s become a women’s problem. Except that having a family is part of the human condition, and there’s no reason why employers should be allowed to organise work so that it is incompatible with having a family.’

Recommendations

Professor Messing briefly outlined the action plan devised by a Canadian group of workers’ representatives and researchers. It included:

· involving women’s committees with health and safety committees;

· a contribution to the debate on standards versus guidelines in health and safety;

· educating judges who hear health and safety cases on the particular issues affecting women; and

· listening to women’s voices.

The TUC gender agenda

The TUC has set out a gender agenda for health and safety to increase the profile of women’s health and safety, based on the 3 November seminar, the safety rep survey reported to it, and subsequent discussions at the TUC 1999 Safety Convention.

In January 1999, the TUC published Violent times, a report on physical and verbal assaults at work, which revealed that young women were more likely than any other group to be assaulted. As a direct result, Ministers asked the Health and Safety Commission to develop a programme of work to combat workplace violence.

On 28 April 1999, International Workers’ Memorial Day was devoted to women’s health and safety. The TUC issued Restoring the balance, guidance for safety reps on how to build women’s health and safety into their employer’s health and safety work (a direct proposal to arise from the safety rep survey) and published a report called A woman’s work is never safe, by Jacqueline Paige. This set out the risks faced by working women, notably stress, RSI and back strain.

On the evening of Workers’ Memorial Day, Minister for Women and for Public Health Tessa Jowell MP gave the first Workers’ Memorial Day lecture at the TUC’s headquarters in London, endorsing the TUC’s gender sensitive approach and announcing the next step in the Government’s back strain initiative, Back in Work.

In May, partly at the behest of the TUC, the Health and Safety Commission’s first ever three year corporate plan committed the HSC/E to social equality (including gender) as one of its five strategic themes.

The TUC is continuing to press the HSC/E to:

· take on board the steps proposed in Restoring the balance in inspecting workplaces;

· improve the sensitivity of HSE staff, so that they understand the need for a gender sensitive rather than gender neutral approach;

· deal with gender issues as a matter of course in the collection and analysis of data about health and safety; and

· promote positive images of women at work in HSE publicity so that women are aware that health and safety is about their concerns, as well as men’s.

On 1 September, the TUC’s new health and safety web-site will go live at www.tuc.org.uk with a specific section devoted to women’s health and safety. This will complement a new training module for workplace safety reps which is being developed.

In October 1999, the TUC and the National Back Pain Association will join forces in a campaign to prevent back strain among working women, through Back Care Week (4-10 October) and Health and Safety at Work Week (25-31 October), with guidance for safety reps, posters and a report on women’s experiences.

And later this year, the TUC will survey safety reps about the health and safety aspects of the menopause (flagged up by the earlier safety rep survey), as well as considering ways to ensure that the TUC’s representation on HSC advisory committees represents working women adequately.

This programme of work, which will continue to develop, should finally put women on the health and safety map. The TUC is committed to equality in all of its work, and health and safety is an area where inequality cannot be tolerated.

TUC publications

Protecting the future , by Owen Tudor, 1998. TUC statement to the joint TUC-Maternity Alliance conference on reproductive health and safety

No more "men only" health and safety , by Pete Kirby, 1998. Report of a TUC survey of what women safety reps want.

Violent times , by Julia Gallagher, 1999. A TUC report on physical and verbal assaults at work.

Restoring the balance , TUC guidance for safety reps, 1999. A brief guide to how women’s health and safety can be taken into account in the workplace.

A woman’s work is never safe , by Jacqueline Paige, 1999. A TUC report on the risks faced by women workers.

Union publications

Women’s health at work - an information pack for members , MSF, 1996.

Dealing with sexual harassment - T&G guidelines for members and representatives , T&G, 1998.

UNISON women’s health pack , UNISON, 1998

Other publications

One-eyed science: occupational health and women workers by Karen Messing, Temple University Press, 1998.

Integrating gender in ergonomic analysis: strategies for transforming women’s work , edited by Karen Messing, TUTB 1999

What makes women sick? by Lesley Doyal, Macmillan Press, 1995.

Hazards magazine and Workers Health International Newsletter carry regular information about women’s and reproductive health at work - Hazards 63 featured a centrepage spread on the issue. Subscription information from PO Box 199, Sheffield S1 1FQ or by e-mail from sub@hazards.org

About the speakers

Alan Meale MP

Alan Meale was Parliamentary Under Secretary of State at the Department of the Environment, Transport and the Regions at the time of the conference. Educated at Durham University; Ruskin College, Oxford; and Sheffield Hallam University, Mr Meale was a seaman in the Merchant Navy before joining NACRO as National Employment Development Officer in 1977. He was assistant to the General Secretary of ASLEF from 1980 to 1984 and a political advisor to Shadow Secretaries of State from then until 1987.

Elisabeth Lagerlof

Elisabeth Lagerlof holds an MSc in Psychology and a BA in Physical Education. She is currently the Director of the Nordic Institute of Advanced Training in Occupational Health in Helsinki, and previously worked for the European Agency for Safety and Health at Work, Bilbao; the National Institute of Working Life, Stockholm; the Swedish Embassy in Washington DC; and the National Board of Occupational Safety and Health, Stockholm. In 1992/3, she worked for OECD as the technical office for their report on Women, Work and Health.

John Osman

John Osman graduated from the University of Bristol Medical School in 1973. Initially he took up a career in hospital medicine, specialising in chest diseases, but in 1986 he decided to change course and develop his interest in preventive medicine by joining the Health and Safety Executive. In 1988 he became Head of the HSE’s Epidemiology and Medical Statistics Unit.

Pete Kirby

Pete Kirby holds an LLB; an MA in Industrial Relations and a Postgraduate diploma in Safety and Hygiene. He has been a trade union health and safety educator for many years, helping to develop course materials for the TUC, Commonwealth TUC and trade unions. He is currently involved in an EU Leonardo Project, developing course materials for the TUC, the CC.OO (Spain) and LO (Denmark). Mr Kirby is a TUC member of the HSC Agriculture Industry Advisory Committee and represents the TGWU on EU agricultural safety bodies. He is the author of the 1998 TUC Survey of Safety Reps and of No more ‘men only’ health and safety.

Lesley Rushton

Lesley Rushton holds a degree in Mathematics from Oxford University, a Masters degree in statistics and a PhD in community health. She has recently taken up the post of Head of Epidemiology at the Medical Research Council at Leicester University’s Institute for Environment and Health. Dr Rushton is a member of the Government’s Industrial Injuries Advisory Council (IIAC) and the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment.

Karen Messing

Karen Messing is a professor of biology at the University of Quebec at Montreal and a researcher at CINBIOSE (the Centre for the Study of Biological Interactions in Environmental Health), a WHO collaborating centre in occupational and environmental health. She received her Ph. D. in biology in 1975 from McGill University. She has examined the best way to analyse data by sex, presented in journal articles and in more detail in her most recent book, One Eyed Science: Occupational Health and Women Workers, published by Temple University Press in 1998. Dr. Messing has been consulted on women's occupational health by Canadian and Swedish government agencies and by the European Trade Union Technical Bureau.

Contact : Owen Tudor on 0207 467 1325 or at otudor@tuc.org.uk

TUC, Congress House, Great Russell Street, London WC1B 3LS

telephone 020 7636 4030 fax: 020 7636 0632

Report (7,800 words) issued 18 Feb 2001

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