Employment trends and their impact on women’s OSH

This article describes the situation of women on the European labour markets and the resulting consequences for occupational safety and health (OSH). Relevant European statistics provide an overview of female employment trends in Europe. The article includes an analysis of hazards and risks inherent in female-dominated work. There is a special focus on OSH risk factors among women of different ages.

Labour market participation

Female labour market participation has increased over the last few years, but the employment rate of men (aged 15–64) remains higher. In 2012, the EU average employment rate was 69.6% for men and 58.5% for women. While the employment rate of men decreased slightly compared to the rate in 2002 (70.3%), the women’s rate increased by about 4.2% compared to in 2002, when the rate was 54.3% (see Table 1 below).

One major reason for the gender employment gap is still the fact that women are more likely to be involved in childcare and elderly care. For more information in relation to family care work, please see this separate article. Women with small children have the lowest employment rates, and the gender gap remains large – on average around 17% across the EU ^[3]. Another reason is that young women spend longer in education than men.

In the group of employed persons aged 25 to 49, the employment rate varied in 2011 from about 58% in Greece and Italy to over 80% in Sweden and Slovenia. The women’s employment rate in this group has increased in almost all European Member States during the last 20 years ^[8]. However, 30% of employed women in 2011 were working part-time compared to 6% of men ^[9].

At 41.7%, the average EU employment rate for older women (aged 50–64) in 2012 is less than for those in middle age (ages 25–49), for whom the average employment rate is 71.2%. However, the employment rate of older women has increased during the last few years in almost all European Member States. The greatest increase has been observed in Germany, Slovakia and the Netherlands, where it increased by more than 20 percentage points. The highest employment rates of older women in 2012 were found in Nordic countries (Sweden: 69.6%, Finland: 59.7%, Estonia: 61.2%). The lowest rate was reported by Malta, at 15.8%) ^[10].

Part-time work

To compare working times across different groups of workers, it is beneficial to use full-time equivalents, as this unit takes into account the ratio of the hours worked by a part-time worker to the hours worked by a full-time worker. This is important because many more women work part-time than men. This is why in full-time equivalents, women’s employment rate is lower than the general employment rate. At 53.5%, the women’s equivalent rate is about 20% lower than the general female employment rate. This means that the total number of hours worked by women in Europe is 20% lower than the total number of hours worked by men. This is due to the fact that many women work in part-time employment. In 2012, 31.9% (EU average) of women were working part-time compared to 8.4% of men. The proportion of women working part-time was especially high in the Netherlands, where 76.9% of all employed women and a high proportion of men (24.9%) were working part-time, but there were also high proportions of women working part-time in Germany (45% part-time working women and 9.1% part-time working men) and Austria (44.4% part-time working women and 7.8% part-time working men) ^[11]. Data from 2011 shows that 32% of women in the European Union were working part-time and that, on average, 46% of them were working part-time due to family responsibilities. The percentage of men working part-time is much lower: only 8% of men do so and only 12% of those do so because of family responsibilities ^[12]. The average women’s part-time employment rate in the EU27 increased from 28.7% in 2000 to 32.1% in 2012, with the lowest rate (2.5%) in Bulgaria and the highest rate (76.9%) in the Netherlands ^[13]. The increase in part-time employment in Europe over the past two decades has led to an increase in the general women’s employment rate ^[14] [link to other Gender Introduction article]. In general, it can be stated that the proportion of women working part-time is much lower in the eastern European countries than in the “old" Member States. In most of the eastern European countries, the proportion of women working part-time is below 10%, while it is around 30% or more in the “old" Member States. Comparison of the different age groups shows that the highest proportion of women working part-time – 39.8% in 2012 – can be found among young female workers (aged 15–24) ^[15]. As mentioned above, this is due to the fact that young women remain in education and work part-time to supplement their income. Over the last few years, part-time work has also increased significantly among young men (15–24 years). Compared to 16.1% of young men working part-time in 2002, the proportion increased to 18.8% in 2007 and 23.6% in 2012. For both genders this development is partly due to the financial crisis in Europe ^[16].

Part-time work may have positive and negative effects. Besides the negative effects – that it might reduce career opportunities and lead to lower pensions – the scarcity of opportunities to work part-time (as can be observed in Bulgaria, Slovakia and Hungary) could be seen as an obstacle to ensuring work-life balance for both women and men. Family commitments are also the major reason for women engaging in part-time work in most of the Member States ^[17]. Part-time working women often have to face higher risks to their occupational safety and health because they tend to have fewer training opportunities and less control over their work. Their opportunities to participate in the company’s decision-making processes are more limited and they have less access to OSH preventive services ^[18]. While parenthood is leading to a decrease in women’s employment, men with children are more likely to work; this applies to both part-time and full-time employment ^[19]. This reflects the traditionally unequal sharing of family responsibilities, as well as a lack of childcare support ^[20].

Pay gap

The gender pay gap is defined as the difference between men’s and woman’s income. According to the data collected in 2011, women in the European Union earned on average 16% less per hour than men. The average of 16% has remained constant over the last 10 years. This data is for the so-called ‘unadjusted gender pay gap’, as it does not take into account all of the factors that have an impact on the gender pay gap, such as differences in education, labour market experience, hours worked, type of job, etc. In 2011, the gender pay gap varied across Europe by about 25 percentage points. The widest gender pay gap was found in Estonia (27.2%), followed by Austria (23.9%) ^[21].

The reasons for the gender pay gap are very complex. Of course, instances still occur of women being paid less for the same job than their male colleagues, but there are also other reasons that lead to unequal payment. Competences that are necessary for typically female jobs such as caring, sensitivity and compassion (e.g. for nurses) are often deemed to be female characteristics and therefore part of a woman’s character. It seems that these skills that are considered as female characteristics are not evaluated as professional skills that have to be learned, supported and trained. Women’s part-time work might also lead to fewer career opportunities, less-qualified work than when working full-time and, therefore, lower pay. Unfortunately, young women often work in jobs that are below their competences, and also accept less well-paid jobs, due to traditions and gender roles and with the aim of increasing their chances of employment ^[22]. The average gender pay gap in the European Union is lowest among young workers and increases with age ^[23]. This reflects the lack of career development but also the lower salaries in typically female jobs. Last, but not least, the lower pensions received by women are influenced by the gender pay gap – as well as by other factors such as part time work, family leave and unpaid family care work. In 2011, 23% of women aged 65 and over were at risk of poverty, compared to 17% of men ^[24].

Women in leadership positions – Vertical segregation

Vertical segregation describes the gender-related difference in female and male rates of employment in leadership positions. Compared to the overall female employment rate and taking into account that women tend to achieve better school-leaving qualifications than men – 34% of working women have some form of tertiary level education compared to 28% of men ^[1] – it is surprising that the female rate of employment in leadership positions is still very low in Europe. Less than a third of business leaders are women, and many large enterprises still have no women on their management board ^[26]. The lack of career opportunities leads to less motivation, which has an impact on mental health and might lead to mental illness in the longer term. The latest data shows that the average yearly increase in the proportion of women involved in leadership in the EU has been greater over the last three years compared to the period between 2003 and 2007: ‘Since 2010 […] the share of women on management boards has risen by 4.8 percentage points (pp) at an average rate of 1.9 pp/year, almost four times the rate of progress from 2003 to 2010 (0.5 pp/year)’ ^[27]. The most successful developments since 2010 have been achieved by countries where binding legislation has already been adopted, such as France (increase of + 14.4 pp to reach 26.8%), the Netherlands (+8.7 pp to reach 23.6%) and Italy (+8.4 pp to reach 12.9%) ^[28]. It is presumed that these developments also reflect EU-wide discussions based on the European Strategy for Equality between Women and Men (2010–2015) ^[29], which are addressing, among other issues, the under-representation of women in decision-making positions and the share of women on management boards.

Obviously, the introduction of a quota can be very effective for supporting gender equality in leadership, as shown by the introduction of a quota for gender parity in the boardroom in Norway in 2006. As a direct consequence of the quota legislation, the representation of women on the management boards of Norwegian large companies has risen from 22% in 2004 to 42% in 2009 ^[30]. Further information can be found in this separate article.

Female dominated occupations – Horizontal segregation

Besides the before mentioned vertical segregation, the term horizontal segregation describes the fact that more women and/or men undertake specific types of jobs. According to the ILO report from 2010, ‘there is still a segregation of women in sectors which are characterised by low pay, long hours and often informal working arrangements’. The report further mentions that women’s work brings fewer gains (‘monetarily, socially and structurally’) than typical male work ^[31]. Although female activity is increasing, the concentration of female activity remains high in a few sectors and is rather increasing than falling. The sector in which the most women work, and in which female activity is steadily increasing, is the health and social sector. The retail sector is ranked second for both women and the general population. It is followed by education as the third-ranked sector among women. This sector replaced manufacturing during the financial crisis. Public administration is placed fifth. A decrease in female employment can be observed in the sectors of agriculture and manufacturing ^[32].

In concrete terms, about 70.1% of employed persons in the EU in 2012 were working in the service sector. About 39.6% were working in market services and 30.5% in non-market services. The proportion of women working in the non-market sector was much higher (38.8%) than the percentage of men (18.6%). According to the OECD definition, non-market services are defined as (4 NACE-CLIO) branches covering general public services; non-market services of education and research provided by general government and private non-profit institutions; non-market services of health provided by general government and private non-profit institutions; and domestic services and other non-market services ^[33]. In the same year, 24.9% of the working population in the EU were working in industry (including construction).This is obviously still a male-dominated area, as about 35.5% of men were recorded as working in this sector in the EU against only 12.5% of women. The proportion of men and women working as skilled manual workers in the EU also differs widely: 36.3% of all employed men and 8.7% of all employed women ^[34]. For further information on women in male dominated professions see [Women at work: An introduction].

While women occupied 59% of the newly created jobs, these gains were concentrated in the lowest pay group and in the second-highest pay group out of five occupational categories. In the newer Member States, men and women benefited equally from employment growth in terms of newly created positions, but women’s employment growth was focused on well-paid jobs. Contrary to the situation in the old MS, women’s employment is also more evenly distributed across occupations in these countries. As the latest EU-OSHA report states, women are more likely than men to suffer from multiple discrimination in the workplace, which may also result from segregation and the limited career and development opportunities that women have at work ^[35]. Hazards and risks of female dominated work are further explained in section 2.

Migrant women’s working lives

One definition of migrants refers to migrants as persons having a foreign country of birth. In contrast to those who are born in the EU but have foreign-born parents or grandparents, migrants born outside the EU are also called third-country migrants. Most of the female migrants in Europe are third-country migrants ^[36]. The term migrant also refers to persons that migrate from one EU Member State to another. While the proportion of men moving from one Member State to another was much higher than that for women (125:100), immigration from third countries was more balanced between men and women (108:100). However, the gender composition of third-country migrants varies between the EU Member States ^[37]. The share of working migrant women differs between the so-called ‘old’ migrant-receiving countries and ‘new’ migrant-receiving countries. In the study by Rubin et al, countries such as Belgium, France, Luxembourg, the Netherlands and the UK are considered to be ‘old’ migrant-receiving countries. ‘New’ migrant-receiving countries include the southern European countries such as Greece, Portugal and Spain. Migrant women’s labour market participation is higher in the ‘new’ migrant-receiving countries than in the ‘old’ receiving countries. This finding is influenced by the age of the migrants. Young migrants are more likely to participate in the European labour market and live in the ‘new’ migrant-receiving countries. This is one explanation for why migrant women’s labour market participation is higher compared to native women’s labour market participation in ‘new’ migrant-receiving countries. In these countries, initial labour market participation deficits decrease with the time migrant women spend living in the country. Despite the differences between the countries, the overall employment rate of female third-country migrants is lower than that of natives on average ^[38]. Eurostat data shows that in 2008 the employment rate of female foreign citizens was lower, at 59%, than that of native women, at 73%. There are exceptions in Member States such as Cyprus, Hungary, Portugal, Spain and Estonia, where the employment rate of third-country immigrants slightly exceeds that of female nationals ^[39].

Migrant women’s labour market participation is correlated to motherhood. Migrants with children under the age of 5 are less likely to participate in the labour market than native-born women. This fact is highly significant because birth rates among third-country migrant women are higher than among native women ^[40] The authors use the term ‘double disadvantage’ for migrant women because they are both women and migrants. The high prevalence of involuntary part-time work and short-term working arrangements among migrant women is also considered a disadvantage ^[41]. Migrant female workers are concentrated in low-skilled occupations in sectors such as domestic work, catering, hotels and restaurants, agriculture and sex industries ^[42]. The sectoral distribution of female migrants is one reason why they are over-represented in part-time work. Part-time jobs or other types of non-standard contracts are common in some service sectors, in particular in countries such as Austria, Belgium, Germany, the Netherlands, Norway and the United Kingdom ^[43]. In many cases, women are overqualified for their jobs and are forced to work in the informal labour market ^[44]. Most of them work in household services, including cleaning and care for children and the elderly. Working in the informal labour market is associated with higher job insecurity and vulnerability. Migrant female workers who have a non-standard contract or who work in the informal labour market are at a higher risk of poverty or social exclusion ^[45].

Highly skilled migrant women represent a minority among migrant workers, although the number of highly skilled female migrants has increased and European demand is still not satisfied. The difficulties of recognition of foreign degrees contribute to this effect. Research from Great Britain shows that highly skilled female migrants are to a large extent employed in the health-care sector. In Great Britain, the number of female migrant nurses rose by 49,000, or by about 92%, between 1997 and 2004 ^[46]

Negative health and safety outcomes for migrant workers, such as stress, are often caused by racial discrimination in combination with gender discrimination. Migrant female workers seem to be at a high risk of bullying and harassment. There are findings indicating that migrant nurses are subject to racial harassment by work colleagues or patients. Nurses are at a higher risk of developing MSDs than their native colleagues and are especially affected by accidents that might lead to MSDs. The overall higher accident rates among migrant workers are linked to poor on-the job training, language problems, and poor communication and little access to preventive services and advice ^[47]. Migrant domestic workers were more likely to report having been psychologically abused. Migrant workers in the cleaning sector reported incidents of sexual harassment by supervisors. They also have to deal with greater chemical risks because of a lack of training, consultation and personal protective equipment (PPE) or because of poor-quality PPE ^[48].

On a general level, it has been observed that the occurrence of work-related health problems in employed persons increased between 1999 and 2007 from 4.6% to 7.0% ^[49]. However, a more detailed analysis will show that the differences between female and male working lives result in a difference between the hazards and risks that women and men are exposed to. The risk factors lead to different OSH outcomes amongst working women ^[50]. This section describes the prevalence, trends and nature of exposure to occupational risk factors such as dangerous substances, violence and harassment, psychosocial risks, musculoskeletal disorders and accidents for working women.

Exposure to dangerous substances

Existing exposure limits for dangerous substances were established for the protection of all workers. Many of these limits were based on a predominantly male working population and on laboratory tests ^[51]. Although questions regarding the effects of occupational exposures on women are not new, female exposure to dangerous substances remains under-assessed ^[52], ^[53]. Research is needed to explore women’s exposure to dangerous substances as a result of infectious materials and handling chemical substances that are predominantly used in female-dominated sectors such as the health-care and home care sector and other service sectors like cleaning, hairdressing and cosmetology, and new occupations in waste management, as well as for women working in male-dominated professions ^[54]. Further research must consider the effect of occupational background on certain diseases, for instance on certain cancers that are frequent among women. Furthermore, additional research is needed on reproductive health ^[55]. Many chemicals that are used in the workplace have not been evaluated with regard to reproductive toxicity. Their influence on hormonal effects, menstruation and the menopause must be analysed ^[56].

Female exposure is particularly important in certain sectors in which chemical substances are used and where women represent the majority of the workforce. The agricultural sector remains a relevant employer for women. Chemical substances are used in pesticides and other agro-chemicals ^[57]. Another sector with a high share of female workers and involving daily use of dangerous substances is the cleaning sector ^[58]. Workers in other branches of the service sector, health care, hairdressing and cosmetology may also be subject to higher exposure levels in their work. The waste-management sector is also associated with exposure to dangerous substances ^[59]. Women make up a large proportion of the workforce in all of these sectors. Any exposure depends on the type of products used and on the conditions under which they are used. In order to reduce women’s exposure to dangerous substances, it is essential to apply gender-sensitive risk assessment and professional risk-management measures [hierarchy of prevention measures] ^[60], as required by EU legislation (Framework Directive 89/391/EEC).

Violence and harassment

Third-party violence occurs in particular sectors such as health care, social work, education, transport, public administration, defence and retail. Workers have direct contact with clients in these sectors, which have a high share of female workers. This is why it is suggested that women are victims of third-party violence more often than men. Another possible reason is the status of jobs that women do, which are often perceived as lower than the ones that men do (see the subchapter on “Accidents" below). Violence is increasing in some occupations such as teaching, in which women make up 70% of the profession. There are no findings that indicate that women or other groups might be at particular risk of harassment. Harassment occurs mostly in a ‘top down’ manner and is indirectly supported or hindered by workplace cultures and climates. Harassment and bullying against women originate not only from men but also from other women. Although unwanted sexual attention is rare, female workers reported three times more sexual harassment than male workers. Young women under the age of 30, women in white-collar occupations and women with fixed-term contracts or undertaking temporary agency work are especially at risk ^[61]. Third-party violence can have physical and psychological consequences, such as fear, anxiety and post-traumatic stress disorder (PTSD). Harassment can result in long-term sick leave, displacement and even suicide. It also has an indirect effect on families and friends ^[62].

Psychosocial risks

Changes in work lead to a change in working demands and therefore also to a change in related stresses and strains. Work intensity has increased as a result of new technologies and the increase in service-sector work. Higher absenteeism and early retirement rates due to mental health problems are the consequences of increased work intensity. Major factors influencing women’s mental health include the effects of vertical and horizontal segregation, as well as the fact that women are still largely responsible for family care and struggle to balance this with working life (nearly half of part-time working women still work part-time because of family care (see 1.2)). Vertical and horizontal segregation leads to an over-representation of women in low-paid jobs, lower status, and therefore less autonomy. One effect of lower pay is poverty, which may lead to chronic stress, as demonstrated by numerous scientific researchers ^[1].

A lower level of autonomy and fewer opportunities to organise work in an appropriate way, e.g. flexible working time opportunities, may lead to an imbalance between work and private life. Particularly those women who work in the care or service sector in a “typically female job" such as nursing that requires a high level of emotional work often have a very low level of autonomy. This may lead to greater emotional dissonance because their actions cannot be in accordance with their own emotions and values ^[64], ^[65].

Musculoskeletal disorders (MSDs)

Women’s risk of developing MSDs may be underestimated. Although research has reached different conclusions, the assumption still prevails that only men suffer from MSDs because of lifting and carrying heavy loads. A definition of MSDs is provided by the WHO ^[66] and further explained in the OSH-Wiki article on MSDs. Results from the European Labour Force Survey 2007 show that 59% of employed women reported musculoskeletal problems as their main work-related health problem (compared to 62% of men) ^[67].

The European Occupational Disease Statistics (EODS) underlined research findings indicating that MSDs have become an important issue for female workers. Women not only lift and move heavy loads in the health-care sector when lifting and moving people, but also have to face the consequences of frequent standing at work. Prolonged standing is a characteristic of work in the health-care sector, hotels and catering, education, retail and cleaning, all of which have a high proportion of female workers ^[68]. MSDs are also caused by prolonged sitting and VDU work. MSDs emerging from static work, prolonged standing and prolonged sitting affect women more than they do men. One reason for the higher prevalence of symptoms among women is that more women than men work in administrative occupations such as the public service and office jobs ^[69]. Women’s occupational disorders, such as MSDs, remain underdiagnosed. To improve recognition of MSDs that affect women, there is a need for further research on disorders that are caused by prolonged standing, prolonged sitting or static work and on any other kinds of risks that relate to women’s work ^{[70] [71]}.

Research should also focus on MSDs among young workers. Young workers are overexposed to most of the MSD risk factors. In some Member States, the rates of MSDs among young workers are increasing. This is because they work in sectors such as the service sector, low-skilled manufacturing and construction, where they are exposed to high levels of MSD risk factors. Prevention measures are needed that take into account the specific conditions facing young workers ^[72], ^[73]. Known risk factors for MSDs include carrying and moving heavy loads, prolonged standing, repetitive work and painful/tiring positions. However, psychosocial, physical, ergonomic and organisational factors also play an important role in MSDs because MSDs usually have multifactorial causes ^[74]. According to the LFS ad hoc module 2007, the overall occurrence of musculoskeletal problems increased from 2.5% in 1999 to 4% in 2007. This increase was observed in all sectors. The sectors ‘hotels and restaurants’ and ‘other community, social and service activities’ were among those with the greatest increase in the occurrence of musculoskeletal problems and with a high proportion of female workers ^[75].

Accidents

Female occupational accident rates are lower than male accident rates. Among other reasons, this is due to the distribution of female and male workers within different sectors. It is also because many women do not work full-time, so they are exposed to the risk of accident for fewer hours per day. If women and men are compared on a full-time equivalent basis, there is a smaller difference in accident rates between women and men [4]. In contrast to the slight decrease observed in the LFS survey in the occurrence of accidents among men between 1999 and 2007 (4.4% to 4.1%), no decrease in accidents was found among women (2.4% in both years). This can be explained by considering the prevalence of accidents in different sectors. The decrease in accident rate was especially high in male-dominated sectors such as mining, quarrying and construction. Research has not found any relation between age and the percentage of female accidents. However, figures show that the male accident rate declines with age. These research findings may be explained by greater risk-taking behaviour amongst young men. The size of this gender gap decreases over time ^[76].

Most accidents reported in the LFS survey among female workers were caused by slips, trips or falls or were linked to stress and violence. Women’s accidents are related to the sectors in which they work. The high proportion of women in public administration, education, health care and other services accounts for accidents involving office equipment, personal and sports equipment, weapons, domestic appliances, living organisms and human beings ^[77]. Female accident rates were highest in sectors such as ‘agriculture, hunting and forestry’, ‘hotels and restaurants’ and ‘health and social work’ ^[78]. Occupational accidents of female workers can be also linked to Musculoskeletal Disorder risk factors such as carrying or moving people, for example in the health-care sector ^[79]. Women’s commuting accidents depend on different modes of travel and different family obligations; more research is needed to better explore this area.

The sectors in which women are typically employed depend strongly on their age. Therefore, women of different ages are exposed to different OSH risk factors. On average, more young women work in hospitality and retail than older women. Older women tend more to work in health care and education ^[80]. In addition to the age distribution of women across certain jobs, women of different ages react differently to certain working environments, working conditions and tasks. At different stages of life, women require distinctive measures to protect their physical and mental health. OSH risk factors vary between women of different ages, but age-related research into women’s OSH is limited. An exception can only be made for pregnant women. Pregnant women are at a stage of life that necessitates specific provisions, which are also determined by legislation. In order to analyse specific OSH risk factors for women at different ages, it is important to differentiate between the sectors they work in. Young women (aged 15–24) tend to work in sectors such as retail, health and social work, hotels and restaurants, and catering. The top occupation for women working in the retail sector is that of a shop salesperson and demonstrator. In many cases, this occupation requires prolonged standing or sitting. Prolonged sitting and standing are considered to be risk factors for MSDs ^[81]. Another risk factor for MSDs stems from women’s occupation in the health and social care sector, where many women work as domestic helpers, personal care workers ^[82]. Nurses, in particular, are required to move patients. Handling patients is also a risk factor for MSDs. However, working in the health-care sector is associated with a wide range of risk factors such as exposure to biological agents and chemical substances, physical risks and psychological risks, which may occur as a result of violence or shift work ^[83]. Working conditions in HORECA such as for crop and animal producers are often characterised by irregular working hours, low pay and a large proportion of temporary employment. OSH risk factors range from heavy workloads, prolonged standing and static postures that could lead to MSDs, to customer contact that might lead to psychosocial stress, harassment and violence, and to evening and weekend working hours that might affect work life balance. Monotonous work might also have a negative effect on workers’ health ^[84]. It can be stated that young people lack skills, training and physical or psychological maturity, and often are not aware of their rights and the employers’ duties, or lack the confidence to complain ^[85]. OSH education should start at a very young age, and the transition from school to work must be accompanied by education on relevant OSH risks and corresponding prevention measures ^[86]. Action at an early stage of working life is crucial because that is when young women develop their work orientation and future health risks can be avoided. It is important to facilitate the reconciliation of paid work and family commitments in order to support the work orientation of young women and their decision regarding the extent to which and under what conditions they want to participate in the labour market. Greater difficulties for young women to find an adequate job add to their willingness to accept worse conditions.

Women between the ages of 25 and 49 tend to work in sectors like health care and social work, retail, education and increasingly in real estate, renting and business activities. Middle-aged women in the health-care and retail sectors must face the same OSH risks as their younger colleagues in these sectors, who have the same occupations. In the education sector, there is a particular risk of MSDs for those who work with children that results from lifting children. Another MSD risk factor in the education sector is prolonged standing and sitting while working on a computer in an office. Women working in the education sector have no choice but to experience work-related stress as a consequence of organisational problems, violence or bullying. Women working in education are at a higher risk of violence and harassment because of the direct and frequent conflict situations they face, including dealing with pupils and their parents ^[87].

The largest proportion of older women aged 50–64 work in the health-care sector, followed by the education and retail sectors. As mentioned above, working in the health-care and retail sectors is associated with a higher risk of developing MSDs.

Women’s risk factors for MSDs, such as carrying or moving heavy loads or working in tiring or painful positions, remain more or less at the same level up to the age of 60. The data indicates that older female workers do not have many opportunities to avoid physical strains and to adjust their workplace according to their reduced physical abilities ^[88]. Older women [ageing workers] therefore need specific OSH measures to protect their health and to maintain their ability and willingness to work. A study from UK based on a large-scale survey of women’s experiences of working through menopausal transition in the UK states that menopausal symptoms can cause problems at work. The reported problems were ‘poor concentration, tiredness, poor memory, feeling low/depressed and lowered confidence’. Coping with problems caused by the menopausal transition is regarded as difficult, particularly with regard to coping with hot flushes. The study presented four major areas of support at the organisational level for women affected by menopausal symptoms: awareness among managers; flexibility in working hours and arrangements; access to information and support at work; attention to workplace temperature and ventilation ^[89]. Although these suggestions hint at a more open discussion of problems relating to menopause, this topic is still perceived as an individual problem in many European countries, and the essential support of employers is lacking.

To address women of different ages and meet their requirements, it is necessary for any kind of prevention or intervention measures to be based on their specific needs. Measures must be group-specific and tailored in order to achieve the greatest effect. Consultation of female workers of different age groups with different occupations in different sectors is needed with regard to gender sensitive risk assessment. Further information on gender and OSH policy and practice can be found in this separate article and in the EU-OSHA publications on this topic ^{[90] [91] [92] [93]}.