We Can Do It: Protecting Women Workers

Sixty years after Rosie the Riveter, some employers are still coming to terms with the fact that there are special occupational safety and health issues for women.

Perhaps one of the most powerful iconic images of the 20th Century is the poster of Rosie the Riveter, who symbolized all the women who entered the work force during WWII. These women became the backbone of the U.S. manufacturing industry after millions of men enlisted in the armed forces.

They entered a workplace that was created for men. The machinery was sized to fit the length of men's arms and legs; the clothing was sized to fit men's bodies; and the personal protective equipment was sized to fit men's heads, hands and feet.

Sixty years later, some employers are still coming to terms with the fact that there are special occupational safety and health issues for women.

In the following articles, Linda Tapp, Lyn Penniman and Belinda Thielen discuss safety and health hazards women face in the manufacturing, healthcare and laundry industries and what can be done to make those industries safer for women workers in particular and all workers in general.

In her article, Tapp points out that many workplaces are still sized to fit men, even though as many as 30 percent of the workers are women. Safety issues related to the use of PPE are particularly challenging.

The Occupational Safety and Health Administration takes its role of protecting workers very seriously, explains Penniman. The agency has created tools and guidances to identify hazards and controls to improve workplace safety for women.

In the laundry industry, where the majority of employees are women, workers are taking steps to protect themselves from serious ergonomic, chemical and health hazards, says Thielen.

Nearly half of the estimated 100 million working people over the age of 16 in this country are women. By educating ourselves about the occupational safety and health challenges facing women workers, we can help make the workplace safer for all workers.

Sandy Smith, managing editor

Making Manufacturing a Safe Work Environment for Women Workers

Although workplace rules and regulations apply equally to all workers, women are still not be as well-protected as their male counterparts.

In the United States, women make up almost half the work force, but in manufacturing, that number drops to 30 percent. Most machinery, workplace equipment and tools were designed for men.

This was not something done deliberately but is due to the fact that most published anthropometric data is based on the body measurements of American men. Obviously, this data does not cover today's entire work force. By using this data, engineers and designers may be inadvertently designing tools, equipment and personal protective equipment (PPE) that are too large for many workers.

When machinery is too large, smaller female employees may have increased reach distances or have to use platforms or stools to easily reach controls. Additionally, the majority of workplace hand tools are designed for men. In response, several new companies have begun specifically designing hand tools that are lighter, have smaller handles and are easier overall for women to use. The smaller design helps smaller workers and those with less upper body strength to have better control of their tools and thus less of a chance for accidents to occur.

PPE

With PPE, some manufacturers offer small sizes in gloves, safety shoes, respirators and safety glasses, although it is not very common to find these smaller sizes in many manufacturing environments. Unfortunately, too many companies still believe that "one-size-fits-all" and PPE is only ordered in one or two sizes.

PPE that is too large can cause problems. Glasses that are too big can slide off and may impair vision. Goggles may not seal properly, which can allow chemicals and airborne hazards to get into the eyes. Respirators that are too big will not prevent the wearer from inhaling contaminants. Gloves that are too large can get caught or stuck in equipment or cause tools or materials to be dropped more easily. The "one-size-fits-all" approach is not only particularly hazardous to women but against OSHA regulations as well.

Pregnant Workers

While the smaller size of many women causes PPE to fit improperly, the increased size of pregnant women causes other problems. A growing abdomen creates new ergonomic concerns. The increased reach distance required of a woman with a very large belly affects many activities, including lifting and assembly line work, by causing additional arm and shoulder strain. While the pregnant woman may know the importance of holding heavy items close to her body during lifting, her new belly causes her to hold items further from the spine. In addition to placing increased force on her lower back, she is stressing muscles and ligaments already stretched beyond their normal limits and already weakened by pregnancy hormones a dangerous situation.

Pregnant workers also have less of a tolerance to excessive heat and may experience altered balance that can lead to fainting or falling at work. It is wise to limit the amount of excessively hot work the pregnant woman is exposed to particularly if the work also involves full body PPE as well as any work at heights. If at all possible, work done on platforms or ladders should be avoided since the center of gravity is now shifted forward, making it easier for the pregnant worker to lose her balance.

The above concerns related to pregnant women are problems experienced later in the pregnancy, such as during the last trimester. There are different concerns that employers should be aware of during the beginning of the pregnancy and these can sometimes be more challenging. Very often, a female worker will keep the pregnancy secret until at least the 12th week. Unfortunately, some chemical exposures have their most dangerous effects on the fetus during these early weeks. If the safety and medical departments are not aware the pregnancy exists, it is unlikely additional precautions will be taken.

In some industries, a woman may fear losing her job or being transferred to a lower-paying position if she reports being pregnant, so she may keep her condition quiet as long as she can. For this reason, it is important for safety and health departments to take proactive steps to encourage all employees to report pregnancies as soon as possible and to have a program in place to address workplace hazards that may now be a concern.

As the number of working women continues to grow, the percentage of women in manufacturing will also increase. Women and pregnant women in manufacturing can also be provided with a safe work environment with a little forethought, education and planning.

Linda Tapp, ALCM, CSP, is president of Crown Safety LLC in Cherry Hill, N.J. She currently serves as administrator for the American Society of Safety Engineers' Consultants Practice Specialty (CPS) group. Tapp has over 15 years of experience in occupational safety, health and ergonomics. She is a frequent writer, speaker and trainer in various workplace safety topics including pregnant worker management programs. She received her BS in Biology from Drexel University and an MS in Environmental Health from Temple University.

Using the Right "Tools" to Protect Women Workers

OSHA doesn't differentiate between the genders, but there are occupational health issues that particularly impact women.

by Lyn Penniman, MPH

"To ensure safe and healthful working conditions for working men and women." This was the mission of the Occupational Safety and Health Act of 1970 when it was enacted by Congress, and is still its mission today.

To accomplish its goal, the federal Occupational Safety and Health Administration (OSHA) uses a variety of tools, among them enforcement of standards and regulations, training in safety and health topics, distribution of training grants externally, special emphasis programs, hazard bulletins, and other outreach and guidance products and activities. Additionally, states that operate their own occupational safety and health programs can develop their own areas of special emphasis to meet the requirement that their programs be at least as protective as the federal program.

When it comes to protecting workers, the agency typically doesn't differentiate between the genders. Its regulations apply to all workplaces (and all workers) covered in the scope of the standard. The agency took this approach with its lead standard (29 CFR 1910.1025) and 1, 3 Butadiene (29 CFR 1910.1051), for which adverse reproductive outcomes were a concern. Ensuring protection for sub-populations that may be more sensitive than the working population as a whole is ensured not by implementation of exclusionary policies, but by making the workplace safe for all workers. This approach was upheld in the courts (Supreme Court, International Union, United Automobile, Aerospace & Agricultural Implement Workers of America, UAW v. Johnson Controls Inc., 111 S. Ct. 1196, 55 EPD 40,605 (1991)).

Health Care Industry Hazards

There are, however, occupational health issues that have particular applications to women's health because a large portion of the work force to which they apply is comprised of women.

The health care industry, where 92 percent of the 4.3 million nurses and nursing aides in the United States are female, is the best example of this. Occupational hazards encountered by employees in the health care industry include ergonomic hazards, such as patient handling and lifting; potential chemical and drug exposures such as glutaraldehyde, inhaled anesthetic agents (e.g., nitrous oxide), cytotoxic drugs (e.g., antineoplastic agents); and biological hazards including bloodborne pathogens, among others.

In addition to OSHA's bloodborne pathogen and hazard communication standards, a number of guidance tools either recently completed or in development by the agency address hazards found in health care. In March of this year, OSHA published its "Guidelines for Nursing Homes: Ergonomics for the Prevention of Musculoskeletal Disorders." The guidelines focus on practical recommendations for employers to reduce the number and severity of workplace injuries by using methods found to be successful in the nursing home environment.

The guidelines are the result of extensive collaboration with stakeholders. (The agency has proposed ergonomic guidelines that will affect large numbers of women in two other unrelated industries retail grocery stores and poultry processing.)

Inhaled anesthetic agents, which include two different classes of chemicals nitrous oxide and halogenated agents are another concern. Workplace exposures to anesthetic gases occur in hospital-based and stand-alone operating rooms, recovery rooms, dental operatories and veterinary facilities. Several summaries of the epidemiologic studies of exposure to N2O and reviews of the topic generally including animal and retrospective studies (Purdham, 1986; Kestenberg, 1988; and NIOSH, 1994) have been published. They report a consistent excess of spontaneous abortion in exposed women. Other summaries of the epidemiologic studies do not establish a cause-effect relationship (Buring et al., 1985; Tannenbaum and Goldberg, 1985). Evidence for congenital abnormalities is less strongly associated with exposure. Halogenated agents are used with and without N2O and have been linked to reproductive problems in women and (less consistently) developmental defects in their offspring

Exposure to ethylene oxide is covered under OSHA's standard 1910.1047. In addition to regulatory requirements, OSHA provides further guidance on engineering, work practice and administrative controls that help reduce these exposures in "Anesthetic Gases: Guidelines for Workplace Exposures." A fact sheet (OSHA, 1995) lists exposure hazards, including reproductive hazards, with safety measures and controls.

Glutaraldehyde is a high-level disinfectant used in a variety of health care settings, including units where endoscopy and dialysis are performed. Health care workers exposed to glutaraldehyde report a variety of exposure-related symptoms, occupational asthma being the most serious. Guidance materials on best practices for use of glutaraldehyde in various operations in health care are currently undergoing agency review and will be available soon.

For hazards in hospitals, OSHA's hospital e-tool, found on the Web at www.osha.gov/SLTC/healthcarefacilities/index.html, offers a graphical menu to identify hazards and controls found in the hospital and healthcare industry.

The ability to use a broad variety of tools provides OSHA with flexibility in ensuring safe and healthful working conditions for working women and men. For many women, work is challenging, but need not be harmful to their health.

Lyn Penniman has been a health scientist with OSHA since 1988. Prior to joining OSHA, she served for more than 20 years as a public health nurse in both Vermont and Alaska. She earned her master of Public Health degree in the Department of Environmental Health, at Johns Hopkins University School of Hygiene and Public Health just before joining OSHA.

Laundry Workers: Cleaning Up an Industry

Women make up the majority of workers in the laundry industry and they face a number of serious hazards in these hot, exhausting jobs.

by Belinda Thielen

Each day, laundry workers manually sort hundreds of pounds of dirty linens from hotels, hospitals, restaurants and other workplaces. Across the U.S., laundry workers are joining UNITE, the union that represents 40,000 laundry workers, as a way to make their jobs safer.

Workers have to take great care because mixed in with the linens, they encounter broken glass, blood, scalpels, knives and adult diapers. Syringes pose a particularly serious threat. A laundry worker in Phoenix recalls: "When I first started working in the laundry, I was stuck with a needle that was about two inches long. It went deep into my palm. I pulled the needle out and showed it to my supervisor who wrote a report and gave me some ice to put on my hand so I could keep working. After work, they sent me to the doctor where I was given six different shots. They checked my blood every month for six months."

Although protective clothing offers some defense from exposure to contamination, it can exacerbate another common and serious problem in commercial laundries. The combination of heat and humidity can reach life-threatening levels. UNITE recently documented a Heat Index of 130 F in an Arizona laundry, a level determined by the National Weather Service to present extreme danger and a high likelihood of heat stroke.

And there's more. Other health and safety concerns include burns, allergic reactions to residual wash chemicals, cumulative trauma disorders and injuries from poorly guarded and poorly maintained equipment. The hazards can be especially dangerous for pregnant women.

Making Changes

Growing numbers of laundry workers are joining unions to improve their working conditions and make their jobs safer. UNITE negotiates contracts that encourage a high level of worker parti-

cipation in workplace health and safety. UNITE members are developing plans of action to address key problems in their plants. One worker describes the plan at her shop: "Our first request is for safety training that applies to laundry work. It is hard to understand how the videos they show us about factory safety apply to the work we do.

"After that, we are asking to have everyone trained about the chemicals they use here," she added. "Many of the women get rashes from handling the damp sheets that come from the wash area. We think there may be chemicals that have not been rinsed out of the sheets."

The next step, she said, will be to ask the company to ensure that everyone who works in the soil sort area is offered the hepatitis B vaccinations, including workers who fill in as substitutes.

Safety Committees

Through contract negotiations, UNITE establishes labor-management health and safety committees that provide workers with a venue to offer suggestions and a mechanism for finding out specific information about their work. UNITE also provides worker representatives with education materials and trainings on laundry issues, such as hepatitis B.

The union is developing innovative ways to educate members, like health and safety comics and a train-the-trainer program that avoids lecture-style teaching and encourages group problem solving. When all else fails, the union works with members to develop accurate, detailed OSHA complaints.

Workplace health and safety is an important part of winning respect on the job, and many commercial laundry workers are finding that union representation offers the most direct and effective way to clean up the industry.

As one UNITE member explains: "I always had dreams of becoming a nurse but that was impossible because of the money it would have cost. I love working in a laundry because it gives me a chance to help sick people even though I am not a nurse. Maybe someday people will see that this too is important work and that we deserve decent wages, benefits and working conditions."

Belinda Thielen is a health and safety educator in the Laundry Division of UNITE. She has an MS in Environmental and Occupational Health Sciences from the University of Illinois at Chicago School of Public Health. She is also a journeyman machine repair machinist.

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