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Bonnie Rogers, DrPH, COHNS, LNCC

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Women make up about 42% of the global paid workforce ... Varicella. Rubella. Cytomegalovirus. Women and Work: Hazards, Protection, and Health Promotion ... – PowerPoint PPT presentation

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Title: Bonnie Rogers, DrPH, COHNS, LNCC


1
Women and Work Hazards, Protection, and Health
Promotion
  • Bonnie Rogers, DrPH, COHN-S, LNCC
  • , FAAN
  • Professor Director
  • North Carolina Occupational Safety and Health
    Education and Research Center
  • University of North Carolina
  • School of Public Health
  • Chapel Hill, North Carolina, USA

2
Women and Work Hazards, Protection, and Health
Promotion
  • Women make up about 42 of the global paid
    workforce
  • Contributions to health and economic development
    are often undervalued or not included
  • Work-related hazards persist for both paid or
    unpaid work

3
Women and Work Hazards, Protection, and Health
Promotion
  • Increasing burden of women and unpaid health
    work
  • Aging population
  • Increasing incidence of disease requiring
    long-term care
  • Increasing reliance of health sector on
    ambulatory and out-patient services

4
Women and Work Hazards, Protection, and Health
Promotion
  • Canada USA research survey (1997) 70-80 of
    care for the elderly is provided by family
  • Canada 80 of paid and unpaid caregivers are
    women 75 between the ages of 50 and 65
  • USA 55-70 of primary caregivers are women
    average woman will spend 18 years taking care of
    a parent

5
Women and Work Hazards, Protection, and Health
Promotion
  • Positive aspects of womens employment
  • Socialization
  • Increased self-esteem
  • Skill development
  • World Health Organization (WHO)
  • Many jobs in low income countries or poor,
    less-educated women expose women to harmful
    working environments
  • These women shoulder extremely heavy workloads at
    home and work

6
Women and Work Hazards, Protection, and Health
Promotion
  • Harmful working environments
  • Pesticide exposures result in
  • Poisoning
  • Cancer
  • Skin diseases
  • Abortions
  • Premature deaths
  • Malformed babies

7
Women and Work Hazards, Protection, and Health
Promotion
  • Harmful working environments
  • Reproductive problems - (miscarriages, low birth
    weights, and malformations) result from exposure
    to
  • Solvents
  • Pesticides
  • Organic pollutants
  • Heavy workload
  • Postural factors
  • Shift work

8
Women and Work Hazards, Protection, and Health
Promotion
  • Harmful working environments
  • Chemical exposures affects breast milk
  • Contaminate breast milk, leading to breastfeeding
    problems, reducing vital milk supply for infants
    in poor populations
  • Interfere with fertility-suppressing effects of
    breastfeeding, increasing chance of early
    conception

9
Women and Work Hazards, Protection, and Health
Promotion
  • Harmful working environments
  • In developing countries, such as Latin America
    and Asia, women work in office and factory jobs
  • Low status of work causes stress
  • Lack of social services makes life taxing

10
Women and Work Hazards, Protection, and Health
Promotion
  • Harmful working environments
  • Sexual harassment is common and may result in
    guilt, shame, anxiety, depression, and other
    health consequences
  • Survey of nurses in Turkey 75 experienced
    sexual harassment in the hospital
  • 44 by male physicians
  • 34 by patients
  • 14 by relatives of patients

11
Women and Work Hazards, Protection, and Health
Promotion
  • Harmful working environments
  • Health care workers are exposed to
  • Infection
  • Needlestick injuries
  • Violence
  • Musculoskeletal injuries
  • Burnout

12
Women and Work Hazards, Protection, and Health
Promotion
  • Harmful working environments
  • Women in developed countries are exposed to
    physical tasks, such as
  • Highly repetitive movements
  • Awkward postures
  • Biological agents

13
Women and Work Hazards, Protection, and Health
Promotion
  • Harmful working environments
  • Psychological risk factors
  • Psychological harassment
  • Sexual harassment
  • Monotonous work
  • Discrimination from low status
  • Less control over work environment, which is
    associated with cardiovascular, mental, and
    musculoskeletal ill health

14
Women and Work Hazards, Protection, and Health
Promotion
  • Women in paid employment
  • Work more hours on household tasks than men
  • Child care
  • Elder care
  • Subsistence activities
  • Housework
  • Generally have simultaneous family and household
    obligations
  • Comprise the largest group in office, sales, and
    health care

15
Women and Work Hazards, Protection, and Health
Promotion
  • Workplace Hazards
  • Biological
  • Chemical
  • Enviromechanical
  • Physical
  • Psychosocial
  • Reproductive

16
Women and Work Hazards, Protection, and Health
Promotion
  • Biological Hazards
  • Infected patients of healthcare workers - 35
    million or 12 of the workforce are health
    workers
  • Bloodborne pathogens contamination - from blood
    and body fluids and tissues
  • Biological agents in lab workers - 80 are women

17
Women and Work Hazards, Protection, and Health
Promotion
  • Biological Hazards
  • Hepatitis B, C, and HIV infections - from 2
    million needlestick injuries/year
  • Hepatitis C and HIV - 2 of 20 most serious
    bloodborne pathogens
  • Hepatitis B - most common bloodborne
    infection - only one of three serious viruses
    for which immunization exists

18
Women and Work Hazards, Protection, and Health
Promotion
  • Biological Hazards transmitted from patient to
    healthcare workers by direct contact, aerosol,
    and needlestick
  • Staphylococcal
  • Streptococcal
  • Syphilis
  • Tuberculosis
  • Herpes simplex
  • Varicella
  • Rubella
  • Cytomegalovirus

19
Women and Work Hazards, Protection, and Health
Promotion
  • Biological Hazards of M. Tuberculosis (TB)
    transmitted in health care facilities probably
    result from
  • Unrecognized or delayed diagnosis of pulmonary
    or laryngeal TB
  • Delayed recognition of drug resistance
  • Delayed initiation of effective therapy
  • Inadequate ventilation of TB isolation rooms
  • Lapses in TB isolation practices
  • Lack of adequate respiratory protection

20
Women and Work Hazards, Protection, and Health
Promotion
  • Chemical Hazards
  • More than 1 million paid household workers
    employed as
  • Housekeepers
  • Cleaners
  • Janitors
  • Exposed to variety of chemicals, such as
  • Solvents
  • Ammonia
  • Pesticides

21
Women and Work Hazards, Protection, and Health
Promotion
  • Chemical Hazards
  • Employed in manufacturing and office environments
    exposed to
  • Organic solvents - used to degrease machinery
    can cause
  • Skin rashes
  • Headaches
  • Dizziness
  • Bone marrow depression

22
Women and Work Hazards, Protection, and Health
Promotion
  • Chemical Hazards
  • 70,000 commercially-sold chemicals
  • Anesthetic gases
  • Antineoplastic agents
  • Solvents
  • Sterilants
  • Germicides
  • Hydrocarbons
  • Many can lead to organ system problems
  • Reproductive
  • Gastrointestinal
  • Endocrine
  • Immune

23
Women and Work Hazards, Protection, and Health
Promotion
  • Chemical Hazards
  • Disinfectants
  • 2 alkaline glutaraldehyde
  • Disinfects instruments
  • Chemical injuries or irritation
  • Allergic contact dermatitis
  • Rhinitis
  • Asthma
  • Soaps and detergents for handwashing
  • Skin irritation
  • Damage to the barrier/integrity of the skin

24
Women and Work Hazards, Protection, and Health
Promotion
  • Chemical Hazards
  • Latex
  • Increased exposure with use for universal
    precautions
  • Atopic persons have increased risk
  • Estimate prevalence from 2.9 in general hospital
    workers to 17 in selected groups

25
Women and Work Hazards, Protection, and Health
Promotion
  • Chemical Hazards
  • Antineoplastic agents
  • Carcinogens, Mutagens, Teratogens
  • Significant health hazard to nurses and
    pharmacists
  • Detectable levels in pharmacy air and patient
    rooms
  • Nurses report
  • Hair loss
  • Facial flushing
  • Depressed leukocytes
  • Lightheadedness
  • Nasal sores
  • Nausea

26
Women and Work Hazards, Protection, and Health
Promotion
  • Enviromechanical Hazards
  • Create unsafe or inadequate working conditions
    for employees which may result in injuries and
    illnesses
  • Most common and current problems women are faced
    with include musculoskeletal disorders,
    particularly low back problems, and carpel tunnel
    syndrome
  • Poor or unfitting tools to do the task
  • Lifting tasks
  • Bend and flex in sharply angular positions

27
Women and Work Hazards, Protection, and Health
Promotion
  • Enviromechanical Hazards
  • Jobs held mostly by women with musculoskeletal
    disorders
  • Assembly line workers
  • Cashiers
  • Food checkers
  • Typewriter keyboard operators

28
Women and Work Hazards, Protection, and Health
Promotion
  • Enviromechanical Hazards
  • Jobs require long standing, poor sitting posture,
    and sometimes awkward positions
  • Create a postural load - results in back pain,
    muscle stress, and general body fatigue
  • Sitting at a desk for long periods
  • Blood pooling and edema in the lower extremities

29
Women and Work Hazards, Protection, and Health
Promotion
  • Enviromechanical Hazards
  • Improved work conditions improve work situation
  • Properly designed chairs and work stations
  • Frequent or regular breaks
  • Back injuries
  • 3rd most commonly reported injury
  • Most lost work days
  • Most prevalent type of injury in nursing
  • Several contributory factors include
  • Age
  • Gender
  • Length of employment
  • Heavy or multiple lifts
  • Posture and physical activity
  • Previous back injury

30
Women and Work Hazards, Protection, and Health
Promotion
  • Enviromechanical Hazards
  • More women in construction over past two decades
    in U.S.
  • Women in construction face 5 safety and health
    issues
  • Reproductive hazards
  • Ergonomic concerns
  • Lack of adequate sanitary facilities
  • Poor-fitting personal protective equipment
    clothing
  • Lack of proper health, safety, and skills
    training

31
Women and Work Hazards, Protection, and Health
Promotion
  • Enviromechanical Hazards
  • Women recommend
  • Tools, materials, and equipment should be
    available in sizes and designs for women
  • As back injuries are a major concern for women,
    safe lifting techniques should be encouraged for
    those with less upper-body strength than average
    male construction workers

32
Women and Work Hazards, Protection, and Health
Promotion
  • Physical Hazards
  • Primarily in jobs that are radiation-related
  • Ionizing radiation
  • Kills the cell directly (causes burns, hair loss)
  • Alters the genetic material of the cell (causes
    cancer or reproductive damage)
  • Associated with diagnostic processes
  • X-ray
  • Fluoroscopy
  • Angiography
  • Therapeutic nuclear medicine interventions, such
    as radioisotope implants

33
Women and Work Hazards, Protection, and Health
Promotion
  • Physical Hazards
  • Ionizing radiation
  • Dose of radiation depends on time, distance,
    shielding
  • Greatest dangers to exposed workers from
  • Scatter - small amount deflected or reflected
    from beam
  • Unexpected exposure - in undefined radiation
    area or because the equipment is not well
    maintained

34
Women and Work Hazards, Protection, and Health
Promotion
  • Physical Hazards
  • Ionizing radiation
  • Radiation workers at risk need careful monitoring
  • Diagnostic radiology (x-ray, fluoroscopy, and
    angiography for diagnostic purposes, dental
    radiography, and computerized axial tomography
    (CAT) scanners)
  • Therapeutic radiology in nuclear medicine for
    diagnostic and therapeutic procedures
  • Radio-pharmaceutical laboratories are potentially
    at risk

35
Women and Work Hazards, Protection, and Health
Promotion
  • Psychosocial Hazards
  • Common in the work environment
  • NIOSH Job stress - harmful physical and
    emotional responses that occur when the
    requirements of the job do not match the
    capabilities, resources, or needs of the worker

36
Women and Work Hazards, Protection, and Health
Promotion
  • Psychosocial Hazards
  • Occupational stress may be a particular problem
    for women
  • More employed women than men reported high
    levels of stress and stress-related illnesses
  • 60 of women surveyed - job stress was their 1
    problem

37
Women and Work Hazards, Protection, and Health
Promotion
  • Psychosocial Hazards
  • Stress manifests both physiological and
    psychological symptoms
  • Persistent unrelieved stress
  • Reduces productivity
  • Increases accidents
  • Absenteeism
  • Leads to maladaptive behaviors, such as substance
    abuse
  • Nearly everyone agrees that job stress results
    from the interaction of the worker and the
    conditions of work

38
Women and Work Hazards, Protection, and Health
Promotion
  • Psychosocial Hazards
  • Stressors can lead to injuries, health status
    effects, reduced worker productivity, and can
    ultimately affect quality of care
  • Organizational
  • Environmental
  • Situational
  • Personal
  • Technological
  • Professional

39
Women and Work Hazards, Protection, and Health
Promotion
  • Psychosocial Hazards
  • Organizational
  • Factors related to policy and operational
    controls such as lack of shared decision-making,
    role ambiguity, ineffective organizational
    leadership, inadequate resources, lack of
    opportunity for challenge or growth, job safety,
    and poor economic and professional incentives.

40
Women and Work Hazards, Protection, and Health
Promotion
  • Psychosocial Hazards
  • Environmental
  • Factors concerned with the quality of the work
    such as the design of the work station,
    ventilation, smoking/passive smoking, noise,
    lighting, hygiene, clutter, and shiftwork.

41
Women and Work Hazards, Protection, and Health
Promotion
  • Psychosocial Hazards
  • Situational
  • Factors related to conditions of the job such as
    workload, conflicts with managers and co-workers,
    job satisfaction, unreasonable expectations, and
    tight schedules.

42
Women and Work Hazards, Protection, and Health
Promotion
  • Psychosocial Hazards
  • Personal
  • Factors such as demographics, (e.g., age, gender)
    motivation, health status, personality, (e.g.,
    passive, aggressive) coping and communication
    skills, and multiple role performance.

43
Women and Work Hazards, Protection, and Health
Promotion
  • Psychosocial Hazards
  • Technological
  • Factors related to advances in technology which
    result in rapid changes in work processes or
    equipment without adequate training, interacting
    with computers and work depersonalization, and
    lack of knowledge to handle sophisticated
    technology.

44
Women and Work Hazards, Protection, and Health
Promotion
  • Psychosocial Hazards
  • Professional
  • Factors concerned with knowledge and skills
    acquisition, role preparation, the practice area,
    and professionalism.

45
Women and Work Hazards, Protection, and Health
Promotion
  • Psychosocial Hazards
  • Violence in the workplace
  • Adds to both physical psychological stress
  • Major public health problem
  • In USA
  • 2 million workplace assaults occur annually
  • Homicide - 3rd leading cause of occupational
    death
  • Homicide - 2nd leading cause of occupational
    fatality for women

46
Women and Work Hazards, Protection, and Health
Promotion
  • Psychosocial Hazards
  • Violence in the workplace
  • Convenience store clerks taxicab drivers are at
    greatest risk of homicide
  • Health care social service workers (mostly
    women) have highest incidence of injuries from
    workplace assaults

47
Women and Work Hazards, Protection, and Health
Promotion
  • Reproductive Hazards
  • Major concern to many working women
  • Disrupt the menstrual cycle and affect the course
    of pregnancy or development of embryo/fetus.
  • Many chemicals including
  • Pharmaceuticals
  • Anesthetic gases
  • Heavy metals
  • Pesticides
  • Organic solvents

48
Women and Work Hazards, Protection, and Health
Promotion
  • Reproductive Hazards
  • Many women may not know when they first become
    pregnant and thereby remain at risk to potential
    exposure.
  • The adverse reproductive effects of some
    chemicals have been known for centuries
  • Lead was recognized as a hazard in ancient Rome
  • Over 100 years ago, lead-exposed women in pottery
    industry in Europe were at increased risk of
    sterility, miscarriage, stillbirth, and infant
    death in the neonatal period.
  • Studies of lead exposure at the turn of the
    century prompted several European governments to
    prohibit women from working with lead

49
Women and Work Hazards, Protection, and Health
Promotion
  • Reproductive Hazards
  • An increasing number of pregnant women work
  • About 75 of all women who work are in
    childbearing years placing them at risk for
    reproductive toxicity
  • Biological, chemical, and physical agents in the
    work environment represent clear hazards to
    reproductive health

50
Women and Work Hazards, Protection, and Health
Promotion
  • Reproductive Hazards
  • Workplace substances that affect female workers
    and their pregnancies can also harm their
    families
  • Without knowing it, workers bring home harmful
    substances that can affect the health of other
    family members both adults and children
  • Lead brought home from the workplace on skin,
    hair, clothes, shoes, tool box, or car can cause
    lead poisoning in family members, especially
    young children
  • Most knowledge about reproductive toxins comes
    from animal lab studies

51
Women and Work Hazards, Protection, and Health
Promotion
  • Health Promotion
  • Health promotion health protection strategies
    can be implemented to
  • help educate women about potential risk on the
    job
  • implement methods to alleviate or minimize risks
  • Preplacement periodic examinations can be
    offered to
  • obtain baseline health status data
  • make appropriate recommendations for job
    assignments
  • provide monitoring and surveillance for women who
    may be at greater risk (e.g., pregnant)

52
Women and Work Hazards, Protection, and Health
Promotion
  • Health Promotion
  • Education - extremely important in worker health
    and safety program
  • The more an employee knows about specific
    workplace hazards the more effective they can be
    with helping to minimize workplace health risks.

53
Women and Work Hazards, Protection, and Health
Promotion
  • Health Promotion
  • All employees should know
  • the general hazards of the workplace,
  • the specific hazards related to their particular
    job
  • exposure to toxic substances
  • implications for reproductive health
  • measures for protective work practices
  • Preconception and prenatal education and
    counseling should be offered

54
Women and Work Hazards, Protection, and Health
Promotion
  • Health Promotion
  • Recognizing many jobs are stressful, employee
    assistance and counseling programs should be
    provided for workers at risk
  • Programs should specify
  • Signs and symptoms of stress
  • Stress management techniques
  • Crisis intervention
  • Referral services for long term counseling

55
Women and Work Hazards, Protection, and Health
Promotion
  • Health Promotion
  • Any health programs offered should be designed to
    meet the needs of the target work group while at
    the same time containing costs for both the
    employee and employer

56
Women and Work Hazards, Protection, and Health
Promotion
  • Improving the Health of Women in the Workforce
  • At a 1998 conference in Canada, Improving the
    Health of Women in the Workforce, the following
    recommendations were made which cut across
    boundaries in womens health in the workplace
  • Risks in womens traditional jobs should be
    identified and prevention programs should be
    established for such hazards as repetitive
    movements, prolonged standing and for conditions
    that may potentiate exposures such as level of
    job control, supervisor support, flexibility in
    working scheduling, etc.

57
Women and Work Hazards, Protection, and Health
Promotion
  • Improving the Health of Women in the Workforce
  • Women are often exposed to threats of physical
    violence and workplaces do not always deal with
    them adequately. Workplace stress may arise from
    a combination of small factors that add up to an
    unbearable burden, with high costs for health
    care and income replacement. Personnel cuts may
    make women who are confronted by needs of
    clients, patients, and students feel obliged to
    work ever harder to fill the gaps, but with fewer
    results.

58
Women and Work Hazards, Protection, and Health
Promotion
  • Improving the Health of Women in the Workforce
  • Research and prevention strategies should be
    developed to document and counter the effects of
    sexual and psychological harassment, demanding
    (rigid, unpredictable) work schedules, workplace
    aggression, and violence.

59
Women and Work Hazards, Protection, and Health
Promotion
  • Improving the Health of Women in the Workforce
  • Women are exposed to chemicals in many
    situations
  • In agriculture and manufacturing as well as in
    service professions such as hairdressing,
    cleaning, laboratory work and health care, to
    name just a few.
  • Exposures can be multiple and complex, and can
    effect mental and physical health.
  • All chemical substances and mixtures should be
    considered as hazardous until proven otherwise.
  • Exposure to chemical substances should be reduced
    at the source through workplace design and
    engineering.
  • Controls and protective clothing should be also
    be provided.

60
Women and Work Hazards, Protection, and Health
Promotion
  • Improving the Health of Women in the Workforce
  • There is a growing trend toward non-standard
    hours, shiftwork, mandatory overtime, and
    contract work. These conditions pose difficulties
    for women workers, particularly those with family
    responsibilities.

61
Women and Work Hazards, Protection, and Health
Promotion
  • Improving the Health of Women in the Workforce
  • Occupational health prevention programs should
    address risks to male and female reproduction,
    including male and female fertility.
  • Programs should be developed to protect the
    health of pregnant women exposed to working
    conditions and the health of the fetuses, as well
    as to protect nursing women and their babies.
  • Working conditions in womens jobs that pose a
    risk for them, their fetuses, or nursing infants
    in general (and in varying degrees) pose a risk
    for all workers.
  • Prevention programs should address these risks.

62
Women and Work Hazards, Protection, and Health
Promotion
  • In Summary
  • Occupational health hazards to women are
    ubiquitous and can cause serious problems for the
    worker and the family
  • Strategies to aid in the health promotion and
    protection of all workers must be of paramount
    importance in the eyes of legislators, policy
    makers, program planners, health care providers,
    and the workers themselves if we are to improve
    the health of women workers
  • It is vital that all aspects of womens health be
    considered when engaging in health promotion and
    protection. Collaborative efforts to achieve this
    goal are a necessity

63
Women and Work Hazards, Protection, and Health
Promotion
  • Merci beaucoup !
  • Dr. Bonnie Rogers
  • rogersb_at_email.unc.edu
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