PREVENTIVE
MEDICINE
7, 281-
293 (1978)
FORUM: WOMEN’S OCCUPATIONAL HEALTH: MEDICAL, SOCIAL, AND LEGAL IMPLICATIONS Occupational
Health
Hazards
Guest Editor: Division
of Women:
An Overview
JEANNE M. STELLMAN’
.---_.
of Occupational Health and Toxicology, 320 East 43rd Street, New York,
American New York
Health 10017
Foundation,
There is a dearth of evidence available on the occupational health hazards that may be encountered by women working in traditionally female jobs. In this overview, demographic data on the distribution of women in major employment areas are given and particular hazards such as stress and a variety of chemical and physical agents are discussed. Stress is considered in relation both to the nature of women’s work and to the dual role of employment at home and in the paid workplace. Ergonomics, infections, and injuries on the job are considered. A review of this Forum is provided.
INTRODUCTION
Comparatively little systematic research or writing has been devoted to the elucidation or description of health hazards to which the paid female work force may be exposed on the job. There are only a limited number of epidemiological studies on the health status of-workers in traditionally female-dominated occupations, such as waitressing or nursing (11). In fact evidence has been presented which shows that not only are traditional women’s jobs generally ignored but rather there has been a bias against the inclusion of women in occupational health studies even when they are members of a cohort of workers under investigation (6). Further, virtually all of the scientific effort as well as social policy and legal restrictions that have been devoted to the health status of gainfully employed women, now and in the past, has been directed toward the effects of the work environment on the female reproductive system both prior to pregnancy and during pregnancy (5,6). Since the participation of women in the paid work force is rapidly growing and substantial numbers of women workers are, in fact, exposed to a variety of potentially hazardous substances and conditions throughout their working lifetimes, it is appropriate to discuss here the numbers and distribution of women in paid occupations and to review the known potential hazards in those fields of employment. It should be noted that an overview of the occupational health hazards of women workers is necessary, not because it has been demonstrated that females respond differently to their environments than males, but rather because female workers are occupationally segregated into a narrow range of “traditional” female jobs and there is very little occupational overlap between the sexes, as will be r Address requests for reprints to: Jeanne M. Stellman, Ph.D., Chief, Division of Occupational Health and Toxicology, American Health Foundation, 320 East 43rd St., New York, New York 10017. 281 0091-7435/78/0073-0281$02.00/O Copyright 0 I978 by Academic Press. Inc. All rights of reproduction in any form reserved
282
JEANNE
hi.
STELLMAN
described below. Thus the hazards to which females may be occupationally exposed are simply different than those to which male workers are exposed. In summary, although a substantial body of evidence has been available for many years which shows that there is little physiological basis for predicting that most chemical and physical agents encountered in an occupational setting will affect nonpregnant females to any greater extent than males (l), and although evidence is also rapidly becoming available which shows that the male reproductive system is also vulnerable to environmental agents, the socioeconomic constraints of women’s work, rather than the biological ones, make an overview of the occupational health hazards of women workers necessary. OCCUPATIONAL
DISTRIBUTION
OF THE PAID FEMALE
WORK
FORCE
Table 1 shows the distribution of female workers by occupation in 1973. Approximately 34% of all females were employed in clerical work and 15% worked in factories, largely in textile, clothing, and small electrical machine manufacture. Female workers were disproportionately represented in assembly line jobs (16). Almost every factory job that is shown in Table 1 is in a paced, controlled work environment. More than seven million women, or 22%, were engaged in the service sector, where they cooked, cleaned, and waited on the public or labored in private households. Sales work represented employment for approximately 6.9% of all female workers and there were almost one-half million female farm workers, of whom approximately 270,000 were unpaid workers on the family farm. It is interesting to note that, despite the current publicity regarding the expansion of females into previously male-dominated professions, management and skilled crafts still represented a very small number of jobs for women workers. Only about 4.1% of female workers were employed in the skilled crafts and another 4.1% in management. In the management category, the vast majority of jobs were in retail trade and restaurant management or in school administration. The two areas with major growth potential for women are clerical work and the health care industries. SOME Stress
POTENTIAL
OCCUPATIONAL HAZARDS EMPLOYMENT:
IN WOMEN‘S
Stress is a major occupational hazard faced by the great majority of employed women. As described below both the nature of traditional female-dominated occupations and the dual roles of work in the workplace and work at home are potential sources of stress for women. The health hazards associated with stress are not completely understood yet it is clear that stress plays an important role in the etiology of most chronic disease. Part of the lack of definition of the relationship between occupational stress and disease is due to the nonspecific and ubiquitous nature of the stress response (2). It is not the purpose of this paper to discuss the etiology of stress-induced diseases, which have been extensively discussed elsewhere, but rather to enumerate potential sources of stress in women’s work.
(continued
WORKERS
on next
IN MAIN
TABLE WITH
Number (in thousands)
CATEGORIES,
1
1,590 99 9.5 160 84 90 2,240 142 1,561
Managers, administrators Bank officers and financial managers Buyers and purchasing agents Restaurant, cafeteria, and bar managers Sales managers and department heads (retail trade) School administrators
Sales workers Real estate agents and brokers Salesclerks (retail trade) page)
19,681 4,711 162 133 104 42 805 236 161 133 2,038 1,094 18.5 565 a7 313
WOMEN
White collar workers Professional, technical woskers Accountants Librarians, archivists and curators Personnel and labor relations workers Physicians Registered nurses Health technologists and technicians Social workers Teachers, college and university Teachers (except college and university) Elementary school teachers Kindergarten and prekindergarten teachers Secondary school teachers Engineering and science technicians Writers, artists, and entertainers
OF
32,446
DISTRIBUTION
Total female employment
Occupation
OCCUPATIONAL
SELECTED
6.9 0.4 4.8
4.9 0.3 0.3 0.5 0.3 0.3
60.7 14.5 0.5 0.4 0.3 0.1 2.5 0.7 0.5 0.4 6.3 3.4 0.6 1.7 0.3 1.0
100.0
Percentage distribution
SUBCATEGORIES,
1973”
41.4 36.4 69.0
18.4 19.4 25.1 32-4 28.9 29.0
48.7 40.0 21.6 82.1 33.7 12.2 97,8 71.3 60
MEDICINE
7, 281-
293 (1978)
FORUM: WOMEN’S OCCUPATIONAL HEALTH: MEDICAL, SOCIAL, AND LEGAL IMPLICATIONS Occupational
Health
Hazards
Guest Editor: Division
of Women:
An Overview
JEANNE M. STELLMAN’
.---_.
of Occupational Health and Toxicology, 320 East 43rd Street, New York,
American New York
Health 10017
Foundation,
There is a dearth of evidence available on the occupational health hazards that may be encountered by women working in traditionally female jobs. In this overview, demographic data on the distribution of women in major employment areas are given and particular hazards such as stress and a variety of chemical and physical agents are discussed. Stress is considered in relation both to the nature of women’s work and to the dual role of employment at home and in the paid workplace. Ergonomics, infections, and injuries on the job are considered. A review of this Forum is provided.
INTRODUCTION
Comparatively little systematic research or writing has been devoted to the elucidation or description of health hazards to which the paid female work force may be exposed on the job. There are only a limited number of epidemiological studies on the health status of-workers in traditionally female-dominated occupations, such as waitressing or nursing (11). In fact evidence has been presented which shows that not only are traditional women’s jobs generally ignored but rather there has been a bias against the inclusion of women in occupational health studies even when they are members of a cohort of workers under investigation (6). Further, virtually all of the scientific effort as well as social policy and legal restrictions that have been devoted to the health status of gainfully employed women, now and in the past, has been directed toward the effects of the work environment on the female reproductive system both prior to pregnancy and during pregnancy (5,6). Since the participation of women in the paid work force is rapidly growing and substantial numbers of women workers are, in fact, exposed to a variety of potentially hazardous substances and conditions throughout their working lifetimes, it is appropriate to discuss here the numbers and distribution of women in paid occupations and to review the known potential hazards in those fields of employment. It should be noted that an overview of the occupational health hazards of women workers is necessary, not because it has been demonstrated that females respond differently to their environments than males, but rather because female workers are occupationally segregated into a narrow range of “traditional” female jobs and there is very little occupational overlap between the sexes, as will be r Address requests for reprints to: Jeanne M. Stellman, Ph.D., Chief, Division of Occupational Health and Toxicology, American Health Foundation, 320 East 43rd St., New York, New York 10017. 281 0091-7435/78/0073-0281$02.00/O Copyright 0 I978 by Academic Press. Inc. All rights of reproduction in any form reserved
282
JEANNE
hi.
STELLMAN
described below. Thus the hazards to which females may be occupationally exposed are simply different than those to which male workers are exposed. In summary, although a substantial body of evidence has been available for many years which shows that there is little physiological basis for predicting that most chemical and physical agents encountered in an occupational setting will affect nonpregnant females to any greater extent than males (l), and although evidence is also rapidly becoming available which shows that the male reproductive system is also vulnerable to environmental agents, the socioeconomic constraints of women’s work, rather than the biological ones, make an overview of the occupational health hazards of women workers necessary. OCCUPATIONAL
DISTRIBUTION
OF THE PAID FEMALE
WORK
FORCE
Table 1 shows the distribution of female workers by occupation in 1973. Approximately 34% of all females were employed in clerical work and 15% worked in factories, largely in textile, clothing, and small electrical machine manufacture. Female workers were disproportionately represented in assembly line jobs (16). Almost every factory job that is shown in Table 1 is in a paced, controlled work environment. More than seven million women, or 22%, were engaged in the service sector, where they cooked, cleaned, and waited on the public or labored in private households. Sales work represented employment for approximately 6.9% of all female workers and there were almost one-half million female farm workers, of whom approximately 270,000 were unpaid workers on the family farm. It is interesting to note that, despite the current publicity regarding the expansion of females into previously male-dominated professions, management and skilled crafts still represented a very small number of jobs for women workers. Only about 4.1% of female workers were employed in the skilled crafts and another 4.1% in management. In the management category, the vast majority of jobs were in retail trade and restaurant management or in school administration. The two areas with major growth potential for women are clerical work and the health care industries. SOME Stress
POTENTIAL
OCCUPATIONAL HAZARDS EMPLOYMENT:
IN WOMEN‘S
Stress is a major occupational hazard faced by the great majority of employed women. As described below both the nature of traditional female-dominated occupations and the dual roles of work in the workplace and work at home are potential sources of stress for women. The health hazards associated with stress are not completely understood yet it is clear that stress plays an important role in the etiology of most chronic disease. Part of the lack of definition of the relationship between occupational stress and disease is due to the nonspecific and ubiquitous nature of the stress response (2). It is not the purpose of this paper to discuss the etiology of stress-induced diseases, which have been extensively discussed elsewhere, but rather to enumerate potential sources of stress in women’s work.
(continued
WORKERS
on next
IN MAIN
TABLE WITH
Number (in thousands)
CATEGORIES,
1
1,590 99 9.5 160 84 90 2,240 142 1,561
Managers, administrators Bank officers and financial managers Buyers and purchasing agents Restaurant, cafeteria, and bar managers Sales managers and department heads (retail trade) School administrators
Sales workers Real estate agents and brokers Salesclerks (retail trade) page)
19,681 4,711 162 133 104 42 805 236 161 133 2,038 1,094 18.5 565 a7 313
WOMEN
White collar workers Professional, technical woskers Accountants Librarians, archivists and curators Personnel and labor relations workers Physicians Registered nurses Health technologists and technicians Social workers Teachers, college and university Teachers (except college and university) Elementary school teachers Kindergarten and prekindergarten teachers Secondary school teachers Engineering and science technicians Writers, artists, and entertainers
OF
32,446
DISTRIBUTION
Total female employment
Occupation
OCCUPATIONAL
SELECTED
6.9 0.4 4.8
4.9 0.3 0.3 0.5 0.3 0.3
60.7 14.5 0.5 0.4 0.3 0.1 2.5 0.7 0.5 0.4 6.3 3.4 0.6 1.7 0.3 1.0
100.0
Percentage distribution
SUBCATEGORIES,
1973”
41.4 36.4 69.0
18.4 19.4 25.1 32-4 28.9 29.0
48.7 40.0 21.6 82.1 33.7 12.2 97,8 71.3 60
