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BY:
SARATU GARBA ABDULLAHI
MSc. NURSING 2nd YEAR
In 1973, WHO defined the Scope and Extent of Occupational Health
Programmes as follows:
• To identify and bring under control at the workplace all chemical,
physical, mechanical, biological and psychological agents that are
known to be or suspected to be hazardous.
• To ensure that physical and mental demands imposed on people at
work by their respective jobs are properly matched with their
individual technical, physiological and psychological capabilities,
needs and limitations.
• To provide effective measures to protect those who are
especially vulnerable to adverse working conditions and also to
raise their level of resistance.
• To discover and improve work situations that may contribute to
the ill health of workers in order to ensure that burden of
general illness in different occupational groups is not increased
over the community level.
.
• To educate management and workers to fulfil their
responsibilities relevant to health protection and promotion.
• To carry out in plant health programmes, dealing with man’s
total health, which will assist public health authorities to raise
the level of community health.
It is a fact that all women work. They perform dual roles of
production and reproduction. Their work goes unrecognized
because they do a variety of jobs daily which does not fit into any
specific ‘occupation’. Most of them are involved in arduous
household work. Although women work for longer hours and
contribute substantially to family income, they are not perceived
as workers by either the women themselves or data collecting
agencies and the government.
To understand the issue of occupational health problems of
women, it is necessary to make a detailed study of the women’s
work in terms of the actual activity undertaken, the hours of work
and the extent of remuneration received.
• The so-called housewife is already doing a single shift. If a woman
also works outside home, she is consistently working a double shift.
When children or family members are ill, she does three shifts day
after day. On an average, women work much longer hours than men.
According to International Labour Organization (ILO), 2/3rd of the
working hours around the world are worked by women because of
the combination of various roles in the workplace, in the family and
in the society. Most often, the women’s work remains invisible but it
contributes a major portion to the world economy.
The pattern of employment of women is very different among
different countries: In developed countries, most of the women
are employed in white collar jobs or as semiskilled operatives in
manufacturing industries. In USA in 1975, there were 37 million
women workers (46.3% of all women) and in 1995 this figure is
around 60%. In India on the other hand, according to 1981
census, workforce participation by females was barely 15% (main
workers) as against 51.6% amongst males.
• According to the 1991 census, the participation of female workers has
increased to 16.03 % (main workers) In addition, 6.24% of females have
been shown as marginal workers and the remaining women (305.2 million)
are shown as a non working population (Indian Labor Statistics, 1994,
Labour Bureau, Ministry of Labour, Shimla (1996). The 1991 census also
shows that of these 16.03% main women workers, 80.8% are employed in
agriculture, 3.5 % in house hold industries, 4% in other industries, 0.3% in
mining and quarrying, 0.6 % as construction workers and only 10.8% in
other services.
• However, there is gross underestimation of women’s work in
this data. Almost 30-40% of non-working women are actually
marginal workers. A large number of these marginal women
workers are engaged in occupations in order to supplement
family income in various ways such as, collection of firewood
and cow dung, maintenance of kitchen gardens, tailoring,
weaving and teaching. Moreover inadequate attention has been
paid to ‘unpaid family labour’ and household work.
• In India, most of the working women are employed in the
unorganized sector, which includes agricultural labourers, workers in
traditional village and cottage industries, migrants to the cities in
domestic service, day labourers, street vendors,etc.In agriculture, the
most important occupation in developing countries, women play an
important role in agricultural production, animal husbandry and other
related activities such as storage and marketing of produce, food
processing etc. Apart from these activities, they spend almost 10-12
hours per day doing household chores.
Even in countries like Sweden, which is looked upon as a role
model in nearly all aspects of the well-being of mankind, Monica
Boethius, who heads the Swedish Work Environment Fund’s
equality programme, writes: “Despite decades of campaigning for
equality, women still earn less than men, have less chance of
promotion, often given work not up to their qualifications and are
more exposed to health
hazards than men.”
• Population: In developing and overpopulated countries like
India, poor working women are at a great disadvantage as due
to availability of excess labour, there is always job insecurity.
Introduction of newer technologies often adversely affects
unskilled women workers who are the first to suffer loss of job.
• Poverty, illiteracy, malnutrition and infectious diseases:
Women workers of many developing countries are caught in
the vicious cycle of low productivity, low income,
undernutrition and infectious diseases leading to lower work
capacity. Low literacy level, poor sanitation and lack of public
amenities further contribute to ill health.
• Sociocultural beliefs: In many communities in India birth of a girl
child is unwelcome and women submit to multiple pregnancies till a
male child is born. This adversely affects the health of the mother
and reduces her working capacity besides posing the extra load of
caring for a large family. The status of women in a society is largely
affected by its cultural beliefs. In India, obedience to and dependence
on men (father, husband and son) is considered traditional and
scared. This often culminates in the girl child getting minimum
nutrition, poor educaton and poor access to health care facilities.
All factors mentioned above have a direct or indirect
bearing on the occupational health of women. In India, it is not
considered appropriate for women to work outside home for
wages but past few decades have seen more and more women
working outside home for economic necessities.
• Basically hazards posed by physical, chemical and biological agents
in work place are similar for male and female workers but the
following factors have to be remembered for women workers.
• Women on an average, have a smaller stature and have less physical
strength; their vital capacity is 11% less; their hemoglobin is app.
20% less; their skin area is larger as compared to circulating volume;
they have larger body fat content. They have lower heat tolerance
and greater cold tolerance.
Woman’s unique reproductive function exposes her unborn child
to workplace hazards. Women shoulder additional burden of
house hold work, care of children and social responsibilities.
• Occupational stress is one of the major problems from a
gender perspective. Studies from developed countries show
that sources of stress in women’s lives are more diverse and
diffuse than those experienced by men. A number of factors
cause stress among working women. These include:
a. Multiple overlapping roles as housewives, mothers and
workers especially when such roles are physically and mentally
demanding with little satisfaction, monetary gain or social
rewards;
b.Types of job repetitive and monotonous jobs with little control
over work pace and methods, piece rate system and job
insecurity all lead to stress;
a. Sexual harassment: This is often faced by women in almost all
types of occupations except when they occupy top level jobs. It
is widely believed that employers show a preference for
women only when they are prepared to accept lower wages, are
expected to be more docile and submissive;
b.Shift work: In certain occupations, such as telephone operators
who do different shifts including night shifts, interference with
family responsibilities causes lot of stress.
• The heavy manual labour performed by malnourished women
often under subhuman working and living conditions, cause a
number of health problems of which musculoskeletal problems
are one of the commonest problems of women in unorganized
sector.. Repetitive trauma is often the cause of a variety of
musculoskeletal and neurologic disorders in women.
Many chemicals pose hazards to the embryo especially during
organogenesis. This has led to restriction on the employment of
women in various hazardous processes under various legislation
(e.g. Factories act,1984.)Exposure to volatile organic solvents,
dusts and pesticides and VDT (Video display terminal)
nonionizing radiation has been found to be associated with
increased risk of infertility in women. This could be due to
interference with ovulation, fertilization or implantation.
• Acute poisonings: The Institute has started a Poison
Information Centre with the technical collaboration of IPCS
(International Programme on Chemical Safety). For the past 5
years, nearly 800 acute poisoning cases have been referred to
this centre physicians.
The commonest type of acute poisoning reported in 70% of cases
has been pesticide poisoning. So far 64% cases were males and
33% were females, with the largest number of poisonings
occuring between 18-25 yrs in both sexes. The lesser number of
poisonings reported in females may be due to poor accessibility
of women to health care facilities.
• in plastic scrap cleaners: Poor women often carry out washing of
plastic bags and containers contaminated with a variety of chemicals
used in dye industry which is one of the major industries in
Ahmedabad region. Dermal absorption of these chemicals results in
acute methemoglobinemia requiring hospitalization. Many such
cases have been reported to NIOH Poison Centre and investigations
have revealed these chemicals to be p-chloroaniline, p-
nitrochlorobenzene (PNCB), o-tolidine, p-anisidine, nitrobezene etc.
• This has been reported in a number of studies conducted by
NIOH. During the process of tobacco cultivation, many
agricultural women laboures have reported GTS (Green
Tobacco Sickness) due to dermal absorption of nicotine
manifesting as headache nausea, vomiting, giddiness associated
with high levels of nicotine and its metabolite cotinine in urine
of these women.
Even though occupational health problems of women have been
considered a thrust area for research in India, most of the studies
carried out in the field of Occupational Health have not
specifically focussed on women workers per se. In most of the
studies, women have been included in the study as a part of the
total sample.
• Detailed studies have been carried out in many occupations
involving exposure to silica dust. Among these, a high
prevalence of silicosis in both males and female workers was
found in slate-pencil workers and Agate workers. In the surface
coal mines, the prevalence of silicosis was less.
WHO has identified three basic principles for the development of an
occupational health service.
• It must be ensured that occupational health services are provided
through the existing national health services by a process of
integration.
• The service must provide for the total health of the workers and if
necessary their families. The primary health care approach must be
the chosen system for the delivery of such services.
• 3. The occupational health problems of working women,
especially those in the unorganized sector are a matter of
urgent concern. There is also a definite need to develop a
database on occupational health of women in developing
countries. For primary health care approach to delivery of
occupational health, it is essential to create awareness among
the health personnel, NGO’s and Womens organizations. It is
very important to understand that chronic occupational diseases
are only preventable but rarely curable. Even though, in
developing countries, health priorities focus more on infectious
diseases, improving the health of workers (especially women )
will contribute tremendously to national growth and economy.

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Women and occupational Health

  • 2. In 1973, WHO defined the Scope and Extent of Occupational Health Programmes as follows: • To identify and bring under control at the workplace all chemical, physical, mechanical, biological and psychological agents that are known to be or suspected to be hazardous. • To ensure that physical and mental demands imposed on people at work by their respective jobs are properly matched with their individual technical, physiological and psychological capabilities, needs and limitations.
  • 3. • To provide effective measures to protect those who are especially vulnerable to adverse working conditions and also to raise their level of resistance. • To discover and improve work situations that may contribute to the ill health of workers in order to ensure that burden of general illness in different occupational groups is not increased over the community level. .
  • 4. • To educate management and workers to fulfil their responsibilities relevant to health protection and promotion. • To carry out in plant health programmes, dealing with man’s total health, which will assist public health authorities to raise the level of community health.
  • 5. It is a fact that all women work. They perform dual roles of production and reproduction. Their work goes unrecognized because they do a variety of jobs daily which does not fit into any specific ‘occupation’. Most of them are involved in arduous household work. Although women work for longer hours and contribute substantially to family income, they are not perceived as workers by either the women themselves or data collecting agencies and the government.
  • 6. To understand the issue of occupational health problems of women, it is necessary to make a detailed study of the women’s work in terms of the actual activity undertaken, the hours of work and the extent of remuneration received.
  • 7. • The so-called housewife is already doing a single shift. If a woman also works outside home, she is consistently working a double shift. When children or family members are ill, she does three shifts day after day. On an average, women work much longer hours than men. According to International Labour Organization (ILO), 2/3rd of the working hours around the world are worked by women because of the combination of various roles in the workplace, in the family and in the society. Most often, the women’s work remains invisible but it contributes a major portion to the world economy.
  • 8. The pattern of employment of women is very different among different countries: In developed countries, most of the women are employed in white collar jobs or as semiskilled operatives in manufacturing industries. In USA in 1975, there were 37 million women workers (46.3% of all women) and in 1995 this figure is around 60%. In India on the other hand, according to 1981 census, workforce participation by females was barely 15% (main workers) as against 51.6% amongst males.
  • 9. • According to the 1991 census, the participation of female workers has increased to 16.03 % (main workers) In addition, 6.24% of females have been shown as marginal workers and the remaining women (305.2 million) are shown as a non working population (Indian Labor Statistics, 1994, Labour Bureau, Ministry of Labour, Shimla (1996). The 1991 census also shows that of these 16.03% main women workers, 80.8% are employed in agriculture, 3.5 % in house hold industries, 4% in other industries, 0.3% in mining and quarrying, 0.6 % as construction workers and only 10.8% in other services.
  • 10. • However, there is gross underestimation of women’s work in this data. Almost 30-40% of non-working women are actually marginal workers. A large number of these marginal women workers are engaged in occupations in order to supplement family income in various ways such as, collection of firewood and cow dung, maintenance of kitchen gardens, tailoring, weaving and teaching. Moreover inadequate attention has been paid to ‘unpaid family labour’ and household work.
  • 11. • In India, most of the working women are employed in the unorganized sector, which includes agricultural labourers, workers in traditional village and cottage industries, migrants to the cities in domestic service, day labourers, street vendors,etc.In agriculture, the most important occupation in developing countries, women play an important role in agricultural production, animal husbandry and other related activities such as storage and marketing of produce, food processing etc. Apart from these activities, they spend almost 10-12 hours per day doing household chores.
  • 12. Even in countries like Sweden, which is looked upon as a role model in nearly all aspects of the well-being of mankind, Monica Boethius, who heads the Swedish Work Environment Fund’s equality programme, writes: “Despite decades of campaigning for equality, women still earn less than men, have less chance of promotion, often given work not up to their qualifications and are more exposed to health hazards than men.”
  • 13. • Population: In developing and overpopulated countries like India, poor working women are at a great disadvantage as due to availability of excess labour, there is always job insecurity. Introduction of newer technologies often adversely affects unskilled women workers who are the first to suffer loss of job.
  • 14. • Poverty, illiteracy, malnutrition and infectious diseases: Women workers of many developing countries are caught in the vicious cycle of low productivity, low income, undernutrition and infectious diseases leading to lower work capacity. Low literacy level, poor sanitation and lack of public amenities further contribute to ill health.
  • 15. • Sociocultural beliefs: In many communities in India birth of a girl child is unwelcome and women submit to multiple pregnancies till a male child is born. This adversely affects the health of the mother and reduces her working capacity besides posing the extra load of caring for a large family. The status of women in a society is largely affected by its cultural beliefs. In India, obedience to and dependence on men (father, husband and son) is considered traditional and scared. This often culminates in the girl child getting minimum nutrition, poor educaton and poor access to health care facilities.
  • 16. All factors mentioned above have a direct or indirect bearing on the occupational health of women. In India, it is not considered appropriate for women to work outside home for wages but past few decades have seen more and more women working outside home for economic necessities.
  • 17. • Basically hazards posed by physical, chemical and biological agents in work place are similar for male and female workers but the following factors have to be remembered for women workers. • Women on an average, have a smaller stature and have less physical strength; their vital capacity is 11% less; their hemoglobin is app. 20% less; their skin area is larger as compared to circulating volume; they have larger body fat content. They have lower heat tolerance and greater cold tolerance.
  • 18. Woman’s unique reproductive function exposes her unborn child to workplace hazards. Women shoulder additional burden of house hold work, care of children and social responsibilities. • Occupational stress is one of the major problems from a gender perspective. Studies from developed countries show that sources of stress in women’s lives are more diverse and diffuse than those experienced by men. A number of factors cause stress among working women. These include:
  • 19. a. Multiple overlapping roles as housewives, mothers and workers especially when such roles are physically and mentally demanding with little satisfaction, monetary gain or social rewards; b.Types of job repetitive and monotonous jobs with little control over work pace and methods, piece rate system and job insecurity all lead to stress;
  • 20. a. Sexual harassment: This is often faced by women in almost all types of occupations except when they occupy top level jobs. It is widely believed that employers show a preference for women only when they are prepared to accept lower wages, are expected to be more docile and submissive; b.Shift work: In certain occupations, such as telephone operators who do different shifts including night shifts, interference with family responsibilities causes lot of stress.
  • 21. • The heavy manual labour performed by malnourished women often under subhuman working and living conditions, cause a number of health problems of which musculoskeletal problems are one of the commonest problems of women in unorganized sector.. Repetitive trauma is often the cause of a variety of musculoskeletal and neurologic disorders in women.
  • 22. Many chemicals pose hazards to the embryo especially during organogenesis. This has led to restriction on the employment of women in various hazardous processes under various legislation (e.g. Factories act,1984.)Exposure to volatile organic solvents, dusts and pesticides and VDT (Video display terminal) nonionizing radiation has been found to be associated with increased risk of infertility in women. This could be due to interference with ovulation, fertilization or implantation.
  • 23. • Acute poisonings: The Institute has started a Poison Information Centre with the technical collaboration of IPCS (International Programme on Chemical Safety). For the past 5 years, nearly 800 acute poisoning cases have been referred to this centre physicians.
  • 24. The commonest type of acute poisoning reported in 70% of cases has been pesticide poisoning. So far 64% cases were males and 33% were females, with the largest number of poisonings occuring between 18-25 yrs in both sexes. The lesser number of poisonings reported in females may be due to poor accessibility of women to health care facilities.
  • 25. • in plastic scrap cleaners: Poor women often carry out washing of plastic bags and containers contaminated with a variety of chemicals used in dye industry which is one of the major industries in Ahmedabad region. Dermal absorption of these chemicals results in acute methemoglobinemia requiring hospitalization. Many such cases have been reported to NIOH Poison Centre and investigations have revealed these chemicals to be p-chloroaniline, p- nitrochlorobenzene (PNCB), o-tolidine, p-anisidine, nitrobezene etc.
  • 26. • This has been reported in a number of studies conducted by NIOH. During the process of tobacco cultivation, many agricultural women laboures have reported GTS (Green Tobacco Sickness) due to dermal absorption of nicotine manifesting as headache nausea, vomiting, giddiness associated with high levels of nicotine and its metabolite cotinine in urine of these women.
  • 27. Even though occupational health problems of women have been considered a thrust area for research in India, most of the studies carried out in the field of Occupational Health have not specifically focussed on women workers per se. In most of the studies, women have been included in the study as a part of the total sample.
  • 28. • Detailed studies have been carried out in many occupations involving exposure to silica dust. Among these, a high prevalence of silicosis in both males and female workers was found in slate-pencil workers and Agate workers. In the surface coal mines, the prevalence of silicosis was less.
  • 29. WHO has identified three basic principles for the development of an occupational health service. • It must be ensured that occupational health services are provided through the existing national health services by a process of integration. • The service must provide for the total health of the workers and if necessary their families. The primary health care approach must be the chosen system for the delivery of such services.
  • 30. • 3. The occupational health problems of working women, especially those in the unorganized sector are a matter of urgent concern. There is also a definite need to develop a database on occupational health of women in developing countries. For primary health care approach to delivery of occupational health, it is essential to create awareness among the health personnel, NGO’s and Womens organizations. It is very important to understand that chronic occupational diseases are only preventable but rarely curable. Even though, in developing countries, health priorities focus more on infectious diseases, improving the health of workers (especially women ) will contribute tremendously to national growth and economy.