My State:
February 28, 2014
Women at work. Women at risk.

Safety and health challenges, plus solutions you need to know

Look at the desk or workstation next to yours. Chances are good that its occupant is a woman. Women make up 47 percent of the total U.S. labor force, and between now and 2018, women are projected to account for 51 percent of the increase in total labor force growth.

During the economic downturn, women lost nearly three million jobs, while men lost more than six million jobs. The reason is that women tend to be employed in sectors like health care and education, which suffered less than male-dominated fields like construction and manufacturing.

Women at all ages and stages are present in huge numbers in the workforce. What are the unique safety and health challenges they face? Are you adequately protecting them? This Compliance Report focuses on two industries, construction and health care, with tips and insights on risks women face in a variety of other occupations.

What are the issues?

While men continue to outnumber women in the workforce, that ratio is shifting. According the Centers for Disease Control and Prevention (CDC), the percentage of women working has steadily increased from 34 percent in the 1950s to about 58 percent today. The percentage of men working has been decreasing during the same period, from 84 percent in the 1950s to only 71 percent today.

The CDC notes that women are marrying later, earning higher educational degrees, delaying childbirth, and having fewer children than in the past. And more women choose to continue working while balancing traditional parenting duties.

Not surprisingly, the safety and health challenges women face are different from those men experience. Women have more work-related cases of carpal tunnel syndrome, tendonitis, respiratory disease, infectious and parasitic disease, and anxiety and stress disorders.

The CDC says social, economic, and cultural factors also put women at risk for injury and illness. For example, women are more likely than men to do contingent, part-time, temporary, or contract work. Contingent workers tend to have lower income and fewer benefits than those in traditional job arrangements.

Notes the CDC, “Like all workers in insecure jobs, women may fear that bringing up a safety issue could result in job loss or more difficult work situations. They may also be less likely to report a work-related injury.” Immigrant women are a particularly at-risk group.

Other challenges include gender discrimination and sexist treatment in the workplace, which can affect physical and mental health. Sexual harassment can lead to anxiety, depression, insomnia, nausea, headaches, and other symptoms. Balancing work and family duties is a cause of additional stress, especially when women retain primary responsibility for child and elder care. The collision of family and work demands—and the resulting stress—can lead to poor appetite, lack of sleep, elevated blood pressure, fatigue, and greater susceptibility to infection, as well as mental health problems like burnout and depression.

Women in construction: Building a safe workplace

Although only nine percent of U.S. construction workers are women, that translates to 800,000 women in the field. Safety for those 800,000 women took an important step forward last summer when OSHA signed an alliance with the National Association of Women in Construction (NAWIC). The alliance focuses on musculoskeletal and sanitation hazards and issues related to poorly fitting personal protective equipment (PPE).

During the two-year alliance, OSHA and NAWIC will work together on training programs, fact sheets, and other resources. At the time the alliance was announced (August 2013), OSHA launched its new Women in Construction Web page. You can find it at

OSHA administrator David Michaels explained that the alliance will focus on “innovative solutions to improve the safety, health, and working conditions for women in the construction trades and retain female workers during a critical time of job shortages in this industry.”

Up close and personal

The issues addressed by the alliance are quite familiar to Patricia Stagno. She is the founder of Powerskills for Life, LLC (, a training and consulting services provider. Stagno, a Navy veteran, is an authorized OSHA Outreach Training Instructor and Certified Utility Safety Professional. Her business is headquartered in New Hampshire but serves clients across the United States.

One of the most persistent issues facing females in construction and other industries is the fact that PPE is made primarily for men and therefore does not properly fit many women. The result goes beyond discomfort—when PPE does not fit properly, it does not adequately protect the wearer.

“For example, if you have a fall protection harness that doesn’t fit properly, you can severely cut yourself or literally fall right out of it,” warns Stagno. Some smaller men face the same risk. The problem is worse for less common items. In the electrical field, where she spends much of her time, voltage-rated rubber gloves for women do not exist.

Stagno is not overly optimistic about changes in the availability of women’s PPE. She acknowledges that part of the issue is the small number of women demanding some of the more specialized gear. While there are some improvements in availability and women’s sizes, those garments tend to be more costly.

Another hot issue for women in the building trades is chemical exposure. “Everybody is becoming more sensitized to chemicals because of the environment, the foods we’re eating, and other factors.” Stagno says that in addition to cancer, respiratory issues, and other health conditions, women also need to be concerned about reproductive hazards. One exposure that’s becoming more common is diesel particulates and fumes. These affect women more than in the past because women are more active in flagging and road construction work.

For many employers, ensuring that women are protected on the job is not a high priority, says Stagno. Having spent her share of time in manholes wielding heavy tools, Stagno is confident that women can do any job that needs to be done, but not necessarily in the same way men do it. “We may have to use ‘work-smarter, not harder’ techniques.”

She has helped some women expand their future potential in the construction field by instructing female prisoners. Stagno regularly teaches OSHA 10-hour construction safety courses. The 10-hour card is required to work in construction in many New England states. Although many of the women she teaches may not have worked in construction in the past, getting the OSHA card helps focus them on post-prison employment. Entering the job market with a solid foundation in safety adds even more value.

Straight from the hip

Stagno generously shares her thoughts and advice on the subject of women’s safety.

  • When it comes to safety, women tend to be a bit more cautious and proactive. A man on a ladder who needs to reach a place to the right or left will stretch to get there. But with a shorter wingspan, a different center of gravity, and a greater sense of caution, a woman in the same situation will typically get down and move the ladder—as she should.
  • Women are good learners and are generally attentive during safety training.
  • It’s usually easier for a woman to correct a man who is working unsafely than for her to correct another woman.
  • Female workers are resilient, which can sometimes be a disadvantage. If they get injured, they often don’t want to make a scene or show weakness. Women will often tough it out, only going to the doctor when they absolutely must.

Stagno has broken through the barriers and stereotypes, but she occasionally uses them to her advantage. For example, after 20 years of looking, she’s finally found an electrically rated hard hat…in pink! She loves wearing it on a job site because it attracts attention. “Workers will say, ‘Here comes Peppermint Patty with the pink hard hat.’ They may laugh, but they quickly put on their safety glasses when they see me coming!”

Women in health care: Prescription for protection

Health care is the fastest growing sector of the U.S. economy. Women make up nearly 80 percent of the healthcare workforce of 18 million. Workers in this demanding field face many job hazards, including needlestick injuries, back injuries, latex allergies, workplace violence, and stress.

Healthcare workers continue to experience rates of injuries and illnesses that are among the highest of any industry. In recognition of the problem, OSHA recently launched a Web page ( dedicated to reducing these incidents.

Cynthia Groves is a member of the board of directors of the American Association of Occupational Health Nurses (AAOHN) and has worked as a registered nurse for 27 years. She currently directs an occupational health program for Beloit (Wisconsin) Health System. It serves 1,200 businesses in the Wisconsin area, including its own employees.

Ergonomics has been a persistent problem in health care, notes Groves. “People don’t come with handles, so they’re difficult to move,” she quips. The issue is complicated, because in a hospital setting, nurses and other care providers want to deliver prompt care. For a worker, the choice is to conduct a solo lift or patient transfer (good customer service), or make the patient wait while you find help (good ergonomics).


According to the CDC, 75 percent of women in the workforce are of reproductive age, and over half the children born in the United States are born to working mothers. When a woman is pregnant, exposures at work can affect the developing baby. Even low levels of exposure to chemicals and other compounds that may not be harmful to the mother could harm the unborn baby.

Reproductive hazards are defined by OSHA as substances or agents that may affect the reproductive health of women or men or the ability of couples to have healthy children. Hazards may be chemical, physical, or biological. Examples are lead (chemical), radiation (physical), and certain viruses (biological).

Workers are exposed to these hazards by inhalation, skin contact, and ingestion. Health effects can include infertility, miscarriage, birth defects, and developmental disorders in children.

The problem extends beyond the employee and the unborn child to the family. This occurs when hazards are carried home on skin, hair, clothes, shoes, tools, or in a vehicle. The means for reducing hazards that cannot be removed are engineering controls, proper work practices, and good hygiene.

The National Institute for Occupational Safety and Health (NIOSH) National Occupational Research Agenda Statement on Reproductive Hazards states: “While more than 1,000 workplace chemicals have shown reproductive effects in animals, most have not been studied in humans. In addition, most of the four million other chemical mixtures in commercial use remain untested. Physical and biological agents in the workplace that may affect fertility and pregnancy outcomes are practically unstudied. The inadequacy of current knowledge coupled with the ever-growing variety of workplace exposures pose a potentially serious public health problem.”

OSHA has standards specific to chemicals, including lead; 1, 2-Dibromo-3 chloropropane (DBCP); and ethylene oxide; all known to have an adverse effect on the reproductive system. NIOSH has conducted a variety of studies among nurses, cosmetologists, agriculture workers, flight attendants, and others to learn more about the relationship between reproductive health hazards and the work environment.

Learn more about the issue on OSHA’s Reproductive Hazards Web page at

Case in point

Beloit Health System has taken a hard look at the intertwined issues of worker and patient safety. One strategy is patient safety and employee safety committees. Ergonomics is addressed during orientation, and employees participate in annual training on safe lifting practices.

These and other approaches have contributed to a significant drop in ergonomic injuries. One successful technique was to ensure availability and proper use of devices that help workers lift patients more safely. Some of these devices are deceptively simple. For example, all rooms at Beloit Health System hospitals are now equipped with a gait belt. This is a sturdy woven belt with a buckle on one end.

The gait belt is placed around the patient’s waist for safe transfer from one position to another, such as from standing to sitting or while helping patients with balance problems to walk. Providing gait belts in every patient room has greatly increased compliance and, as a result, helped reduce injuries for both patients and caregivers.

Another best practice at Beloit Health System is regular employee injury review meetings. Participants, including the affected employee and manager, discuss how the injury occurred, how it might have been prevented, and any other safety issues on the unit.

Reducing needlestick exposures is another top concern. As a result of injury review meetings, it became clear that a number of nurses using a particular brand of insulin syringe had all been stuck. Beloit safety staff met with the syringe manufacturer to discuss the problem. The manufacturer acknowledged that the syringes, which were designed to prevent needlesticks, were malfunctioning. They went back to the drawing board to perfect the safety cap intended to prevent contact with the needle.

Communication was also behind successful resolution of the problem of slips and trips on wet, icy surfaces. Groves says the organization took a hard look at where these injuries were occurring. The grounds crew used injury data that pinpointed the location of the slips and falls to make decisions about salting and plowing priorities. The result was a significant drop in snow- and ice-related injuries.

As for inside slips and trips, the focus is on proper footwear. The subject is covered in a Beloit Health System dress code policy and through regular e-mail reminders. The messages are often simple, such as “slow down and pay attention to your surroundings.” Employees are reminded that wet floor signs mean what they say. Groves says employees often assume the signs have been up for hours and that the floors are dry, which is not a safe assumption.

Reducing hospital-based infections is another priority for all healthcare employees. Beloit enjoys a very low infection rate. One successful tactic is regular hand-washing observations in every department. The results of these observations are shared with the quality management department. Groves adds, “About a year ago we launched a campaign featuring buttons worn by employees that say, ‘It’s OK to ask.’” The purpose of the buttons is to let patients know they are free to ask a staff member if he or she has washed before providing care.

Age and attitude

As for the tendency of women to tough it out, Groves agrees with Patricia Stagno. Women in health care have a strong sense of duty and commitment to their patients. Says Groves, “Women will put off and tolerate a lot of aches and pains, whether they’re aggravated by an activity at home or at work. They just keep trooping on, assuming they can pop a couple of ibuprofen and be fine.”

This selfless attitude is addressed during orientation. Beloit employees are encouraged to manage issues as they come up rather than wait for the need for intervention or time off. Whether the issue is lifting a patient or an emotional problem, it’s important for nurses and other healthcare providers to know when to ask for help.

Groves says this issue is especially important with the average age of registered nurses now in the low 40s. Older nurses bring a great deal of experience to the job, but it can take longer for them to recover from an injury. It’s important for supervisors, especially younger ones, to recognize this and to manage expectations.

Doing more

The full entrance of women into the workforce is about more than numbers. It’s also about ensuring that the work they do is safe and free from harm. Consider a specialized audit at your place of business to assess how well you’re providing for women in areas like PPE, chemical hazards, stress, and ergonomics.

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