Group Head of Environment, Health and Safety, Arriva

April 6, 2021

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women in health & safety

Does the equality maxim of ‘gender neutrality’ put women at greater health and safety risk?

Lorenzo Visentin, Group Head of Environment, Health and Safety at Arriva explores the gender sensitive approach to risk, delving into some historic and more recent case study examples.

Occupational health & safety risks for women are underestimated and span biological, physical, psychological and social risks. Many physical occupational risks such as cancer, musculoskeletal disorder and heart disease are higher among women workers. However as there is a naive belief that gender-neutral policies support equality, has there been a delay in identifying women-relevant health & safety issues? Gender sensitive risk reduction must become the new norm as women live longer than men in contemporary industrialised societies, but still have higher rates of morbidity and health service use than men do. “Longer and sicker” – not a great advert for increasing numbers of women in work or retaining them.

There is a measurable difference in risk exposure of men and women, even in the case of equal job title across their exposures to toxic chemicals, ergonomic demands, risk of accidents and psychological stressors. Balance this against the differences in education, socialisation and upbringing that may lead to differences in the way workers manage their illnesses, their perception of risk and the propensity to take sick leave or seek treatment – and there is a real risk of consequential loss or injury for women workers that is different and greater to that of male workers.

Three quarters of all employed women are in teaching, health, clerical or sales and service jobs and are disproportionately represented in lower status, lower paid jobs. This quickly develops into the misperception that “women’s jobs” are by definition low risk. In reality, the risks may simply be different, and in particular, the health risks longer term.

Even where there have been inroads into male dominated fields (such as medicine and law), women are still predominantly confined either to lower level positions or to female sub-specialties such as paediatrics or family law. This gets worse when you consider working in private homes. In Europe, the 1989 framework directive didn’t initially exclude domestic workers. It was the Council of Ministers that took the initiative to exclude it when adopting its common position. For the ministers of employment, it seemed obvious, a mark of common sense, housework wasn’t ‘real’ work.

OSH professionals have a challenge to establish a climate of gender sensitive workplace precautions to maximise the protection offered to all workers but, to women workers in particular, in an HR-led context where gender neutrality is king [sic]. Of course, this shift in approach is set within the challenging context of male dominated research, masculine workforces and workplaces. It is no longer sufficient to add women workers to theories developed for, by and about male workers.

Three quarters of all employed women are in teaching, health, clerical or sales and service jobs and are disproportionately represented in lower status, lower paid jobs.

Skirts and a long wooden stick

British Army Northern Ireland Soldiers on Patrol taking part in a search duty in Belfast Military soldier uniform beret weapons

B4HBX7 British Army Northern Ireland Soldiers on patrol taking part in a search duty in Belfast.

There are many great examples of this bias, and to help you understand the point, let me offer two. In the UK in the 1970’s there was a long running domestic terrorism crisis in Northern Ireland, called “the Troubles”. The army was deployed to the streets and in a display of gender equality, female soldiers were deployed. To ‘protect’ women soldiers they initially patrolled with their male colleagues but, unarmed and in skirts in the now incredible belief that the terrorists would not fire on an unarmed woman. The point of the skirt was to create a feminine silhouette in low light and darkness. Of course, this was very quickly refined – by arming the women, with a long wooden stick.

Coming more up to date, while some people select their car based on colour and the quality of the stereo, I suspect safety professionals may take more than a passing look at the NCAP rating (a European New Car Assessment Programme), and in particular the seat belt safety tests. The use of crash test dummies has been in existence for years, but they were typically male crash test dummies, with heavier upper bodies and slimmer hips than a woman. Following protest, NCAP realised this put women at greater risk and developed female crash test dummies with lighter upper body weight distribution and wider hips; and used this to test seatbelt safety – but only in the passenger seat. Women apparently didn’t drive!

Dangerous substances

Turning to the occupational context and why OSH professionals need to review their approach to risk assessment. Let’s look first at dangerous substances. In vivo human studies (for pharmaceuticals as well as to establish occupational exposure limits) prefer male test subjects for no reason other than men do not have a menstrual cycle. As the hormone variability of this normal process threatens the stability of any test results, it is easier to use male participants rather than adjust for it. This matters because, broadly speaking, at the population level, women have more body fat than men. For example, in the 20-39 age bracket, men have a typical body fat range of 8-20% and women of the same age 22-33%, starting above the high limit in men.

Why is this important to the control of substances with health risks? Many substances are fat soluble, therefore more likely to be found in higher concentration in women than men, retained for longer with the risk of more health damaging effects as a result. Fat soluble toxins include heavy metals such as lead, mercury, a number of pesticides, plastics, not to mention the active ingredient in cannabis.

Many substances are fat soluble, therefore more likely to be found in higher concentration in women than men, retained for longer with the risk of more health damaging effects as a result.


female PPE

Image credit: Prospect

It isn’t limited to the purely biological. It is also physical. Again, talking at the population level, women tend to be smaller than men, which leads to challenges in personal protective equipment from safety boot fit to high visibility clothing arm and leg length, shape and overall size. Having a gender sensitive approach will drive manufacturers to develop a range of more suitable sizes and shapes – not offer a range of ‘women’s’ safety shoes that have had pink laces added. Of course, if you extend this logically, it will also improve protection for the smaller man.

This is no more important area of personal protective equipment than the body armour worn by police personnel, as it can be literally lifesaving. Here, the single shape body armour has had grave consequences. A TUC report entitled, Personal protective Equipment and women, highlights that, in 1997 a women police officer was stabbed and killed while using a hydraulic ram to enter a flat. She had removed her body armour because it was too difficult to use the ram while wearing it. Two years later a woman police officer disclosed she had to have breast reduction surgery because of the health effects of wearing her body armour. After the case was reported another 700 officers in the same force came forward to complain about the vest.

Very conscious of this risk, many police services have moved to contoured body armour that reduces this risk – indeed offers greater comfort that then improves compliance in wearing – including that of larger male officers. Here we have to think of unintended consequences, there is some emerging evidence that to permit the contour there is now a larger gap at the armpit, which increases the risk of knife attacks being successful.

Social roles, unpaid domestic work and role conflict

As women do most unpaid domestic work, the health effects of this can be often treated as a simple confounding variable. The refusal to give recognition to the musculoskeletal disorders of women workers is excused by the suspicion that their domestic activities may be the main cause of their physical condition (how many times have you done that when looking at managing sickness absence?).

This ‘unpaid shift’ (childcare, elder care, homemaker) leaves women with less possibilities to unwind and relax outside their paid job and therefore less able to find opportunities for relaxation. This ‘second shift’ leaves employed women workers competing for limited amounts of time, physical energy and psychological resources.

We’ve got to remember though that women who work only as homemakers suffer far worse health than women who combine work in the professional and domestic spheres; paid work allows greater socialisation, substantial financial independence and is a major contributor to self-esteem. Women at work do however face problems with reconciling the role conflict between paid and unpaid work, other role expectations, threatened male colleagues, work overload, blocked promotion and expectations to be wonder-women – and these problems appear to be increasing.



Image credit: ABC News

In stress research, like in many other research areas, male domination of populations is common and has been blamed on tradition, convenience, comparability between studies and – again – the assumed influence of women’s biological rhythms (menstrual cycle and the effects of the menopause) on the measurement variables. This “ignoring phenomenon” is not new in the history of occupationally related disease of women.

So this is going to be a big challenge when planning organisational interventions for women workers, organisations must prioritise prevention programmes that promote and facilitate a gender sensitive approach in the context of an OHSMS and employment system made in a male-dominated workforce, with a regulatory approach that has traditionally been to apply the same standards to men and women. The United Kingdom (UK) health and safety minister ‘admitted this approach may be inadequate for many women in the labour market today’ but Regulations remains gender neutral.

Gender should be included in risk assessment after making positive commitment to female worker safety and not assuming what the hazards are and who is at risk, as well as including commitment to gender mainstreaming and linking OSH into any workplace equality plans and actions.

Broadly speaking, those people with high feminine trait (predominantly but not exclusively women) prefer a tend or befriend coping strategy over the more widely accepted fight or flight approach.

Since women are more likely to use social support as a stress coping strategy, with resultant better levels of psychological wellbeing and job satisfaction than men, this “tend or befriend” strategy should be developed as a cornerstone of organisational involvement in the development of workplace women workers’ stress management techniques, rather than the more masculine interventions playing to “fight or flight” management.

Consider though the resistance to completing any stress risk assessment in many organisations (exemplified by the opposition in the UK by the Confederation of British Industry during the HSE’s consultation period to their proposed legal regulation of workplace stress). This was so effective that there has only been the development of the good practice ‘Stress Management Standards’ and not any law. In this climate with lack of attention to organisational preventative stress management, is encouraging gender-oriented stress management programmes, a step too far, or at least, too early?

Mainstreaming gender into risk assessment

Approaching the issue of gender sensitivity in health & safety has to be done carefully to avoid misunderstandings. What it is not is gender neutrality. The right approach for organisational women worker protection (and indeed this holds for national approaches to the framework for occupational psychological health too), is to mainstream the gender dimension into risk assessment and preventative measures so as to take account of the specific characteristics of women in terms of health and safety at work.

Organisational interventions then, should approach the workplace as a social context in which men and women interact with each other, their environment and the demands made of them by superiors, peers and subordinates as well as their families and social networks outside of work. Strong social norms pull women inexorably back to roles of homemaker and mother, while pushing men into the role of breadwinner. Organisations that ignore these strong variables in their strategies for maintaining occupational psychological wellbeing do so at their peril.

Watch, A roundtable event hosted by Laura Aucott, Associate Director at HSE Recruitment, and HSE Leaders Connect in conjunction with Arriva Group, on 19 October 2021.

We’d love to hear your thoughts on some of the issues raised by Lorenzo, please place them in the comments below…

Lorenzo gave a presentation on this subject, entitled ‘sex, Sticks, Shooters and Stress: How gender influences physical, chemical and psychosocial safety’, at a Women in Health & Safety event in 2019. Click here to find out more about the Women in Health & Safety Network.

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3 years ago

This whole article talks about ‘gender’, when it actually means ‘sex’, which is incorrect and potentially problematic. They are two very different things with different meanings and should not be conflated, sex being biology which is fixed and gender being a construct which can change. From a risk assessment point of view it is potentially dangerous to substitute gender for sex, as people can choose to change their gender but it is impossible to change sex, which means any risk assessments wholly based on gender could be dangerously incorrect. If a transgender man, anatomically a woman, was treated as their… Read more »

Last edited 3 years ago by Will
Ronnie Weir
Ronnie Weir
3 years ago

Giving an example of gender bias from fifty years ago is a little out of date. Women can and do now fight alongside men and are armed with more than a skirt and a stick. There are issues though where women are expected to wear high heels at work and these are known contributors to ill health and skeletal disorders in women particularly those in office and hospitality sectors. Women often fear complaining about these uniform requirements despite the stress this must cause.

3 years ago

A really interesting article and illustrates there is still progress to be made I think

Diane Thomason
Diane Thomason
3 years ago

Great article! There’s a data-based approach to this issue in Caroline Criado Perez’ book: