Women's position has much improved in recent years in many parts of the world. Yet effective action must be taken by decision-makers and political leaders everywhere to ensure adequate employment opportunities for women, along with equal pay and full social participation. To achieve this, greater gender sensitivity is needed in employment and all related socio-economic and development policies.
For huge numbers of poor women, everything they do is "work". We need to recognise this by adopting a broader official definition of work - one which includes both waged and unwaged activities. This will help to acknowledge women's major non-monetary contributions to national economies. It will also broaden the range of activities in which we might expect to find work-related health risks.
UN estimates in 1995 showed that women's unpaid domestic labour accounted for 40% of GNP worldwide. It also found that in developing countries, up to 66% of women's work is excluded from national accounting mechanisms.
Today, traditional patterns of life are changing, and the demand for paid work is escalating everywhere. Labour force profiles are changing along with social roles. Women are now entering the labour force in increasing numbers, although often with less education and fewer skills than men. Conversely, male employment figures have shrunk or remained static.
This may seem advantageous to women. However, many of the jobs they can do are concentrated in the informal sector. This provides flexibility and helps women to juggle their multiple roles. But benefits in the form of paid leave, maternity leave, social security, or health insurance are usually lacking. Female-headed households, or families where male members are unemployed, can be further disadvantaged for this reason.
Today, women increasingly take on tasks traditionally performed by men, either from choice or necessity, although often with lower recompense or recognition. Reasons may be positive or negative. The positive may include improved education and skills. The negative may be linked with shortages of men in society due to out-migration or civil conflict, which increases women's responsibilities and workload.
Other social and development issues may compound the problems of working women. Illiteracy, for example, increases risks for cleaners and domestic workers exposed to toxic agents and solvents, as they cannot read warnings and adapt their use of the products accordingly. And it is increasingly clear that a frequent cause of ill health, discomfort and inconvenience to women workers is the unsuitable ergonomic design of the tools, equipment, and workstations they use. These continue, in the main, to be designed around male norms and are not adapted to women's physiology.
It is becoming clearer that we must closely scrutinise the health risks of jobs which women perform in large numbers. Pioneering research on work intensity has shown that women's jobs thought to be relatively undemanding, and therefore safe, may in fact share features of work classified as "heavy" and usually done by men. An example is the repetitive, high-speed piecework done by women, in factories or at home; over time, these jobs can lead to severe musculo-skeletal disorders and disability, as well as high stress levels. This perception of work as demanding or undemanding can affect women's health-seeking behaviour, disease outcomes, patterns of compensation for disability, and psychological wellbeing.
A broader understanding of occupational risk factors for women is critical, as they enter the labour force in today's increasingly interdependent world. Globalisation has strong implications for women's work and health.
This can be seen in the steep rise in female employment in export industries based in developing countries. Relying predominantly on young, female, low-paid labour, these industries present both benefits and drawbacks. Women have the benefit of formal sector work and a measure of independence, but salaries are low and health and safety regulations often deficient. Such jobs may also carry specific risks. In the flower industry and the microelectronics industry, for example, there are risks of exposure to toxic chemicals. In the burgeoning garment industry worldwide, there are risks of respiratory diseases and musculo-skeletal problems are widespread. These industries must be made safer for women if the benefits are to outweigh the drawbacks.
Fortunately, our view of work-related health risks is starting to change. The traditional focus on illness, accidents and injury related to formal sector work (often men's work) is giving ground to a new approach. This calls for the development of comprehensive methods which take into account all activities carried out at home or at work. With these, we can more effectively study the multiple tasks which cumulatively contribute to women's health problems. This is important if we are to gain a better understanding of health risks incurred in the informal sector, where legislation or regulation is minimal.
No health-and-safety measures in the workplace can be effective, however, if we do not make rapid improvements in social policies and services to support women's participation in the labour force. This in turn will require stronger representation and participation of women in decision-making relating to such policies.
Gro Harlem Brundtland, MD, MPH
Director-General
World Health Organization
Asian-Pacific Newsletter 2/1999 p.27-28