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Citation: Bolghanabadi, S.; Haghighi,
A.; Jahangiri, M. Insights into
Women’s Occupational Health and
Safety: A Decade in Review of
Primary Data Studies. Safety 2024,10,
47. https://doi.org/10.3390/
safety10020047
Academic Editor: Raphael Grzebieta
Received: 23 March 2024
Revised: 20 May 2024
Accepted: 24 May 2024
Published: 27 May 2024
Copyright: © 2024 by the authors.
Licensee MDPI, Basel, Switzerland.
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Attribution (CC BY) license (https://
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4.0/).
safety
Review
Insights into Women’s Occupational Health and Safety:
A Decade in Review of Primary Data Studies
Somayeh Bolghanabadi 1, Aida Haghighi 2, * and Mehdi Jahangiri 3, *
1Student Research Committee, Department of Occupational Health, School of Health, Shiraz University of
Medical Sciences, Shiraz 7153675541, Iran; bolghanabadis@gmail.com
2
School of Occupational and Public Health, Faculty of Community Services, Toronto Metropolitan University,
350 Victoria Street, Toronto, ON M5B 2K3, Canada
3Department of Occupational Health, School of Health, Shiraz University of Medical Sciences,
Shiraz 7153675541, Iran
*Correspondence: aida.haghighi@torontomu.ca (A.H.); jahangiri_m@sums.ac.ir (M.J.)
Abstract: Women play integral roles across various sectors, including mining. Moreover, they often
form a majority in certain sectors, such as healthcare and education. Biological (sex) and social
(gender) differences can influence how hazards are assessed and controlled for women at work.
Therefore, because of the importance of women’s occupational health and safety (OHS), this study
reviews and analyzes OHS-related research studies to explore (i) the attention given to women’s
OHS; (ii) the specific occupations studied; and (iii) the primary OHS issues and challenges faced by
women. Following PRISMA guidelines, the study examined articles from 2010–2021, selecting 62
that utilized primary data, with all or part of their participants being female. The results indicate
that the included studies examined women’s OHS in specific occupations. These include healthcare
workers, farm and forestry workers, office staff, teachers, firefighters, police officers, nail technicians,
workers in the clothing industry, and general industrial workers. The trend of publishing articles
on women’s OHS has been growing, with most studies focusing on healthcare and agriculture. The
USA and South Korea are leading in publications in the field of women’s OHS, while the USA,
Australia, and the Netherlands have the highest collaboration rates. Key findings reveal that the most
common OHS issues faced by women in various occupations include stress, fatigue, musculoskeletal
disorders and pain, sleep disorders, long working hours, depression and anxiety, workplace violence,
and allergies and skin problems. Many of these issues are related to mental health. Specific issues
based on the nature of the work vary; for example, teachers experience voice disorders, while
farmers face digestive problems. This study contributes theoretically by enhancing understanding of
women’s OHS, serving as a foundation for further research, and providing practical guidance for
employers and policymakers seeking to implement effective strategies for guaranteeing women’s
OHS across sectors.
Keywords: occupational health and safety (OHS); women’s health; women’s safety; working women;
female workers; literature review; gender differences
1. Introduction
According to the charter of the International Labor Organization (ILO), all people of the
world, irrespective of race, belief and gender, have the right to material and spiritual welfare
with freedom and respect, as well as to economic security and equality of ownership [
1
].
In 1948, the United Nations (UN) in the Universal Declaration of Human Rights provided
equal rights to men and women. It called for the equality of women’s rights in various
economic and social areas, such as employment, job promotion, education and choice of
profession [
2
]. However, after 1950, although women’s employment rates had increased
worldwide, women had not reached the desired socio-economic position in their working
and private lives and were still subject to inequality (e.g., gender pay gap) [3].
Safety 2024,10, 47. https://doi.org/10.3390/safety10020047 https://www.mdpi.com/journal/safety
Safety 2024,10, 47 2 of 33
Women face risks due to the multiple roles they play in family and society, the different
physiological periods they experience, such as puberty, menstruation, pregnancy, child-
birth and menopause, and their susceptibility to poverty, hunger, malnutrition, increased
workloads and gender discrimination, all of which increase their health risks [
4
]. Health is
related to all aspects of primary human rights [
5
]. The world’s health systems are increas-
ingly shifting their goals from providing health care to creating a healthy society [
6
]. The
general health indicators, such as welfare, have been replaced by limited and inadequate in-
dices, such as mortality [
7
]. According to the World Health Organization (WHO) definition,
well-being, physical, and social welfare are not just the lack of illness or organ defect [
8
].
The health and well-being of women, who constitute half of society, is not only recognized
as a human right, the impact it has on family health and community is also becoming
increasingly important [
9
,
10
]. According to the UN, women’s health is one indicator of a
country’s level of development [
11
]. Countries cannot achieve thorough and sustainable
development unless they take both halves of the population into consideration [
12
]. In
recent decades, as a result of extraordinary efforts, women’s role in labor and income
earning has increased [
13
]. More women work regularly, although their job opportunities
are still limited based on gender [
14
]. The ILO has identified three main problems related to
the work life of women: lack of social protection and access to decent work opportunities;
challenges in balancing work and family responsibilities; and workplace discrimination
and inequality [15,16].
Today, a considerable number of women are employed in the agriculture industry.
Women produce half of the world’s food [
7
]. In the meantime, exposure to pesticides,
which are an inevitable component in agricultural production, can be a threatening factor
for women who hold farming jobs [
17
]. Estimations indicate that worldwide, 0.3 million
workers in the agricultural sector lose their lives due to exposure to pesticides. Women
are exposed to these toxins because protection measures are not respected [
18
]. Pesticide
exposure has been linked to breast cancer in postmenopausal women as well as to aborted
and not fully developed babies [19].
Women’s and men’s bodies have distinct physiological and anatomical differences,
including in their skeletal structure, body fat composition, respiratory system [
20
–
23
].
Therefore, although working in the same conditions as men, women can experience dif-
ferent outcomes. Among the inherent differences that can influence these consequences
are differences in body size and physical strength. Women, due to having less physical
strength, are more likely to experience higher levels of muscular strain and may face greater
physical discomfort when using personal protective equipment (PPE) [
23
,
24
]. Most PPE is
designed for male workers and does not consider the dimensions and body size of women,
leading to inadequate protection [
25
]. Women are vulnerable when exposed to chemicals
in the following specific ways: The absorption of cadmium via the gastrointestinal tract
poses more danger to women than to men, especially during menstruation and for women
who have low iron storage and protein intake [
26
]. Also, the chemical substances absorbed
in women’s bodies are dispersed more rapidly because of their smaller body mass, which
is dependent on a more vigorous blood circulation system, causing faster substance release
in the tissues [
27
]. The renal system in women is slower than in men, which leads to
slower excretion of toxic substances through the urine [
28
]. Women’s bodies have more
adipose tissue than men, which causes toxic substances to be absorbed, accumulated, and
retained in the body. Studies on the rate of women’s exposure in the workplace to per-
chloroethylene, the primary solvent in cleaners, reveal the relevance of this substance to
cervical cancer [
29
]. Further studies show that similar risk factors may increase women’s
probability of developing bladder cancer and kidney problems [
30
]. In Chinese women, the
prevalence of breast cancer was observed in laboratory technicians, telephone operators
and telegraph operators, leather and fur workers, and glass workers [
31
]. In Norway, the
incidence of ovarian cancer was high in women working in the paper industry [
32
]. In
Russia, mortality due to gastric cancer and esophageal cancer is reported in women in the
printing industry [33].
Safety 2024,10, 47 3 of 33
Work conditions, regarding ergonomics, work speed, heavy load management, and
use of PPE, have been designed for the size and physical strength of the average male
worker, despite the increasing participation of female workers in many fields. The high cost
of appropriate interventions is still a barrier to improving women’s work environments and
OHS. The use of PPE not designed appropriately for the physical size of women workers
leads to musculoskeletal disorders (MSDs), especially during pregnancy. Additionally, the
efficacy of some PPE, such as respirators, gloves and boots, is reduced when not suited for
women’s physical dimensions [
34
,
35
]. Various studies have shown that employed women
tend to be more vulnerable to carpal tunnel syndrome, burns, wounds and fractures, as
well as to MSDs, than men [36].
As mentioned above, the role women play in the working environment is undeniable.
Due to their physical and physiological characteristics, they experience different outcomes
when exposed to hazards in the workplace. Therefore, they encounter distinct health and
safety challenges that must be considered to prevent injuries and illnesses and provide
a healthy and safe workplace. In this regard, the focus of this paper is on reviewing and
analyzing OHS-related research studies that used primary data, with all or part of their
participants from the female population, to address the following research questions. It is
worth noting that the studies using primary data were investigated because primary data
are collected directly from the source [
37
] (female population) and provides deeper, more
accurate, and reliable knowledge [38].
•
Research Question 1. How much attention did research studies draw to women’s health
and safety in workplaces between 2010 and 2021?
•
Research Question 2. In which occupations within specific sectors have research stud-
ies primarily concentrated on the female population, examining women’s OHS in
those occupations?
•
Research Question 3. Based on previous research studies, what are the primary OHS
challenges or issues that women face in the occupations identified from Research
Question 2?
2. Materials and Methods
This review was conducted using the Preferred Reporting Items for Systematic Re-
views and Meta-Analyses (PRISMA) guidelines. It provides a quantitative assessment of
findings and a synthesis of information from previously published studies.
2.1. Search Strategy
This review was conducted with a systematic search of articles published in PubMed,
Scopus and Web of Science (WOS) during the period of 2010–2021. Title and abstract
searches were implemented in all of these electronic databases. Three sets of keywords
were used in the search strategy: safety (occupational injury); health (occupational disease;
occupational illness; job analysis; industrial health; employee health; industrial hygiene);
and woman. The Boolean logic operators including “AND” and “OR” were applied to
combine the keywords [39].
Then, the search results were entered into the EndNote version 20 software, and duplicate
articles were automatically deleted. After removing duplicates, 1315 articles remained.
Safety 2024,10, 47 4 of 33
2.2. Selection of Studies
Two researchers independently reviewed articles. The following inclusion and exclu-
sion criteria were considered to determine the eligibility of studies:
i.
Only English-language articles were included. Therefore, articles in languages other
than English were excluded.
ii. Only articles with full-text availability were included.
iii.
Review articles, editorials, letters to the editor, articles presented at seminars and
conferences, reports and books were excluded.
iv.
Only articles that used primary data, with all or part of their participants from the
female population, were included.
v.
Studies that included both women and men in their research but presented results in a
generalized manner were excluded from the study because the focus of this review is
on women’s OHS. Therefore, studies that did not present results focused on women
were excluded. It is worth noting that this review does not intend to compare the OHS
challenges faced by men and women. Instead, its focus is specifically on women.
vi.
Studies that were unrelated to the human population (e.g., animal population)
were excluded.
To determine which articles were within the research subject area, the article titles and
abstracts were reviewed. After confirming that the year and subject matter were within the
scope of this review, the articles were examined more closely. Additionally, the reference
lists of articles were reviewed; however, no additional studies were added to this review.
2.3. Quality Assessment of Articles
The researchers assessed the quality of the all the articles using the quality assessment
checklist provided by the Joanna Briggs Institute (JBI). The JBI checklist evaluates ten
criteria for qualitative studies through critical appraisal questions and provides an overall
appraisal decision at the end [40].
2.4. Screening Process
The initial search for studies was performed by two researchers who also indepen-
dently carried out data extraction and a quality control evaluation. In the case of any
inconsistency, the two researchers had a discussion to reach a consensus and make a
final decision.
As previously mentioned (Section 2.1), 1315 studies were found after searching the
databases. After completing three phases of checking (duplicate checking; title and abstract
checking; full-text checking), 62 articles were entered into the final analysis stage. Addi-
tionally, these 62 articles were assessed using the JBI tools, and all of them met the criteria
for inclusion in this review. Furthermore, as previously mentioned in Section 2.2, the lists
of references of the included articles were reviewed to add related studies. However, no
studies were added. Figure 1depicts the PRISMA-based flowchart of the studies included
in this review.
Safety 2024,10, 47 5 of 33
1
Figure 1. PRISMA-based flowchart of the studies included in the review.
3. Results
3.1. Preliminary Results Based on the Literature
Considering the studies included in this review, Figure 2shows the trend of publishing
these types of articles (i.e., OHS-related studies that used primary data, with all or part of
their participants from the female population, and results focused on the female population)
during the studied years. As shown, after 2017, there is an increasing trend of studies into
women’s OHS.
Between 2010 and 2021, 33 countries published papers on women’s OHS. Figure 3
illustrates the distribution of publications by country.
Through the current study, the ten most productive countries were identified, with a
total of 46 published papers. The USA and South Korea are considered the most effective
countries with 10 and 7 publications, respectively. China (People’s Republic of China)
has an average of 46 citations per document but is ranked sixth among the ten most
productive countries. Table 1shows the number of documents and citations for each
country separately.
Safety 2024,10, 47 6 of 33
Safety 2024, 10, x FOR PEER REVIEW 6 of 33
Figure 2. The number of articles published in the field of women’s OHS during the period of 2010–
2021.
Figure 3. Distribution of publications by countries.
0123456789101112
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
year
Number of Articles
Figure 2. The number of articles published in the field of women’s OHS during the period of
2010–2021.
Safety 2024, 10, x FOR PEER REVIEW 6 of 33
Figure 2. The number of articles published in the field of women’s OHS during the period of 2010–
2021.
Figure 3. Distribution of publications by countries.
0123456789101112
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
year
Number of Articles
Figure 3. Distribution of publications by countries.
Safety 2024,10, 47 7 of 33
Table 1. The number of documents and citations of top 10 countries.
Country Documents Citations Average Number of Citations per Document Total Link Strength *
USA 10 290 29 6
South Korea 7 64 9.1 0
Spain 6 168 28 1
Australia 5 129 25.8 4
Canada 4 95 23.7 1
China 4 184 46 1
Netherlands 3 66 22 3
Thailand 3 52 17.3 2
Bangladesh 2 10 5 2
Iran 2 28 14 0
* The total link strength indicates the total strength of the citation links of a given country with other countries.
Furthermore, a co-authorship analysis was conducted using the VOSviewer to illus-
trate the countries’ collaboration. Figure 4depicts the cooperative network among the
various countries. A network of seven nodes was obtained based on the cooperation
analysis of countries from 2010 to 2021, with each node representing an author’s country.
In the map, the font size represents the frequency of collaboration with other countries,
each line indicates the collaboration between the countries, and the darkness of the line
represents the level of collaboration. Therefore, as shown in the map, USA, Australia, and
the Netherlands have the largest rates of cooperation, engaging more than other countries
in the field of women’s OHS. The greater the international cooperation of a country, the
greater its academic influence of that country in that field. Countries sharing the same
color were associated with similar research areas. For instance, Bangladesh, Malaysia, The
Netherlands, and South Africa were grouped in Cluster 1; Australia, England, and Thailand
in Cluster 2; Canada, United Arab Emirates, and USA in Cluster 3; Greece, Pakistan, and
China in Cluster 4; France and Wales in Cluster 5; and Mexico and Spain in Cluster 6. The
countries’ collaboration links are also displayed on the map.
Safety 2024, 10, x FOR PEER REVIEW 7 of 33
Table 1. The number of documents and citations of top 10 countries.
Country Documents Citations Average Number of Citations per Document Total Link
Strength *
USA 10 290 29 6
South Korea 7 64 9.1 0
Spain 6 168 28 1
Australia 5 129 25.8 4
Canada 4 95 23.7 1
China 4 184 46 1
Netherlands 3 66 22 3
Thailand 3 52 17.3 2
Bangladesh 2 10 5 2
Iran 2 28 14 0
*
The total link strength indicates the total strength of the citation links of a given country with other
countries.
Furthermore, a co-authorship analysis was conducted using the VOSviewer to illus-
trate the countries’ collaboration. Figure 4 depicts the cooperative network among the var-
ious countries. A network of seven nodes was obtained based on the cooperation analysis
of countries from 2010 to 2021, with each node representing an author’s country. In the
map, the font size represents the frequency of collaboration with other countries, each line
indicates the collaboration between the countries, and the darkness of the line represents
the level of collaboration. Therefore, as shown in the map, USA, Australia, and the Neth-
erlands have the largest rates of cooperation, engaging more than other countries in the
field of women’s OHS. The greater the international cooperation of a country, the greater
its academic influence of that country in that field. Countries sharing the same color were
associated with similar research areas. For instance, Bangladesh, Malaysia, The Nether-
lands, and South Africa were grouped in Cluster 1; Australia, England, and Thailand in
Cluster 2; Canada, United Arab Emirates, and USA in Cluster 3; Greece, Pakistan, and
China in Cluster 4; France and Wales in Cluster 5; and Mexico and Spain in Cluster 6. The
countries’ collaboration links are also displayed on the map.
Figure 4.
Collaboration Map of Countries Based on Co-authorship Analysis.
The 62 papers on women’s OHS were published in 39 journals. “Safety and Health at
Work” and “International Journal of Environmental Research and Public Health” had the
Figure 4. Collaboration Map of Countries Based on Co-authorship Analysis.
The 62 papers on women’s OHS were published in 39 journals. “Safety and Health at
Work” and “International Journal of Environmental Research and Public Health” had the
highest number of publications. The top 10 journals based on literature citations are listed
in Table 2.
Safety 2024,10, 47 8 of 33
Table 2. The number of documents and citations for the top 10 journals.
Journals Documents Citations Impact Factor Total Link
Strength *
Safety and Health at Work 5 59 3.5 10
International Journal of Environmental Research and
Public Health 4 84 - 28
Journal of Agromedicine 3 68 2.4 5
Occupational and Environmental Medicine 3 86 4.9 5
Annals of Work Exposures and Health 2 49 2.6 4
BMJ Open 2 18 2.9 5
Medicine 2 76 1.6 9
Scandinavian Journal of Work Environment & Health 2 62 6.3 8
African Journal of Agricultural Research 1 13 - 0
Anesthesia and Intensive Care 1 9 - 3
* The total link strength indicates the total strength of the citation links of a given journal with another journal.
Additionally, Figure 5represents a cluster density map of co-occurring keywords
mapped using VOSviewer. Sixteen major keyword clusters were identified based on the
correlation of keywords. Such cluster density maps are created based on the weight and
number of surrounding elements for each item. As the density of the representative cluster
increases, the frequency of keyword co-occurrence also increases. The minimum threshold
for the co-occurrence of keywords was set at five. By analyzing the co-occurrence of key-
words, a total of 422 keywords were identified, of which 16 met this threshold. Table 3lists
the ten most frequently occurring keywords along with their total link strengths. In terms
of search terms, “health”, “safety” and “stress” were the most frequently used keywords.
Table 3. The top 10 co-occurring keywords.
Keyword Occurrence Total Link Strength *
Health 14 31
Safety 13 30
Stress 11 26
Gender 11 17
Women 8 20
Symptoms 8 16
Burnout 8 15
Management 6 15
Prevalence 6 12
Depression 6 12
* The total link strength refers to the degree of a keyword co-occurrence with other keywords. In other words, this
metric indicates how frequently and strongly a given keyword appears simultaneously with other keywords in
various texts.
3.2. Results Related to Occupations in Specific Sectors as Found in the Literature
Figure 6shows the number of articles published in the field of women’s OHS focusing
on occupations during the period of 2010–2021. The majority of the included studies
(23 articles) focus on the healthcare sector. The farm and forestry sector is second with
11 articles. These results indicate that the healthcare sector received more attention from
researchers due to its significance and the various OHS issues present in this extensive
Safety 2024,10, 47 9 of 33
occupational setting. It is worth noting that the industrial sector was not ranked second
because it encompasses various sectors such as mining, construction, and transportation.
Safety 2024, 10, x FOR PEER REVIEW 9 of 33
Figure 5. Cluster density map of co-occurring keywords.
3.2. Results Related to Occupations in Specific Sectors as Found in the Literature
Figure 6 shows the number of articles published in the field of women’s OHS focus-
ing on occupations during the period of 2010–2021. The majority of the included studies
(23 articles) focus on the healthcare sector. The farm and forestry sector is second with 11
articles. These results indicate that the healthcare sector received more aention from re-
searchers due to its significance and the various OHS issues present in this extensive oc-
cupational seing. It is worth noting that the industrial sector was not ranked second be-
cause it encompasses various sectors such as mining, construction, and transportation.
Figure 5. Cluster density map of co-occurring keywords.
Safety 2024, 10, x FOR PEER REVIEW 10 of 33
Figure 6. The abundance of articles published in the field of women’s OHS focusing on occupations
during the period of 2010–2021.
In addition, Table 4 shows a full description of the characteristics (i.e., author, year,
country, occupation, type of study, target of the study, and number of women investi-
gated) for all 62 included articles.
Farm and forestry
worker, 11
Office staff, 4
Firefighter, 1
Healthcare
worker, 23
Nail technician, 2
Police officer, 3
Teacher, 4
General industrial
worker, 12
Garment industry
worker, 2
Figure 6. The abundance of articles published in the field of women’s OHS focusing on occupations
during the period of 2010–2021.
In addition, Table 4shows a full description of the characteristics (i.e., author, year,
country, occupation, type of study, target of the study, and number of women investigated)
for all 62 included articles.
Safety 2024,10, 47 10 of 33
Table 4. Summary of the included articles.
Row Author Year Occupation Type of Study Target of the Study Number of Women
Investigated
1 Teeraphun Kaewdok [34] 2021 Farm and forestry
workers Cross-Sectional Risk identification of MSDs among farmers 284
2 Ramirez-Moreno [41] 2021 Healthcare workers Cross-Sectional Possible effects of the mask on new headaches
during the COVID-19 pandemic 244
3Alessia
Abderhalden-Zellweger [42]2021 Office staff Qualitative Maternity support at work, work-match strategies,
and pregnancy 202
4 Alak Paul [43] 2021 Farm and
forestry workers NIP * Tobacco’s effect on farm workers’ health 48
5 J Ahn [44] 2021 General industrial
workers Cross-Sectional Study on the effect of long working hours
with infertility 5909
6 Fattori A [45] 2021 Healthcare workers Observational Systematic study of mental health in health workers 353
7 M Faghihi [46] 2021 Healthcare workers Qualitative
Explaining the components of workplace violence
against nurses from the perspective of working
women in hospital
21
8 AM Stelnicki [47] 2021 Healthcare workers NIP Prevalence of mental disorders among nurses 4067
9 A Aiswarya [48] 2021 Garment industry
workers Cross-Sectional
Identification of occupational health problems,
assessment of nutrition specifications and
anthropometric changes, comparison of sleeping
hours of working women, and evaluation of job
stress levels before and during COVID-19 quarantine
in female weavers
100
10 Uymaz Pelin [49] 2021 Healthcare workers Descriptive Frequency of exposure to occupational accidents 83
11 Jenny V. Dang [50] 2021 Nail technicians Qualitative Assessing and promoting nail technicians’ health 23
12 Poursadeqiyan Mohsen [51] 2020 Healthcare workers Cross-Sectional
Determining the relationship between safety climate
and nurses’ job fatigue 82
13 Chae Young Hong [52] 2020 Farm and forestry
workers Cross-Sectional
Relationship between meniscus tear and
occupational risk factors in the
agricultural profession
248
Safety 2024,10, 47 11 of 33
Table 4. Cont.
Row Author Year Occupation Type of Study Target of the Study Number of Women
Investigated
14 Bani-Issa Wegdan [53] 2020 Healthcare workers Cross-Sectional
Stress assessment among healthcare workers
(HCWs) using cortisol level measurements, mental
stress, and sleep quality
335
15 Liu Yujie [54] 2020 Healthcare workers Cross-Sectional Evaluation of risk factors related to violence in
the workplace 847
16 Harthi Moussa [55] 2020 Healthcare workers Cross-Sectional Estimating prevalence and potential factors
associated with workplace violence 215
17 RN Carleton [56] 2020 Police officers Cross-Sectional Review of mental disorders 451
18 H Chun [57] 2020 General industrial
workers Cross-Sectional Investigating the critical factors of mental problems
and the occurrence of depression 5173
19 SB Vilella [58] 2020 Teachers Descriptive Job satisfaction levels, fatigue, and burnout
in teachers 102
20 M Boström [59] 2020 Teachers Cross-Sectional
Describing how teachers experience health in the
workplace, the social and safety climate, and
socio-psychological health at work
387
21 Y Lagrosen [60] 2020 Teachers NIP Review of gender differences in the field of quality
management experience and workplace health 183
22 Sujin Lee [61] 2019 Farm and forestry
workers NIP Evaluation of hearing disorders in farmers 1121
23 Memon Qurat Ul Ain [18] 2019 Farm and
forestry workers NIP
Study of the problem related to the health of harvest
workers in the face of pesticides and the necessity of
using PPE
260
24 Watkins Emily R [35] 2019 Firefighters NIP
Identification of female fire fighters’ health problems
840
25 Claudia C.Ma [62] 2019 Police officers NIP Analysis of the relationship between stress, sleep
quality, and incidence of occupational accidents 100
26 Villar Rocio [63] 2019 Healthcare workers Cohort
Investigating the relationship between workplace
risk factors during pregnancy and absence
from work
428
Safety 2024,10, 47 12 of 33
Table 4. Cont.
Row Author Year Occupation Type of Study Target of the Study Number of Women
Investigated
27 Rocha Luiz Junior [64] 2019 Healthcare workers Cross-Sectional
Identifying factors related to the prevalence of
burnout and job satisfaction among emergency
personnel and special care staff
33
28 Gander Philippa [65] 2019 Healthcare workers NIP Investigating the increase in risk and fatigue
of nurses 2813
29 Gu Bo [66] 2019 Healthcare workers Cross-Sectional The relationship between job stress and cognitive
symptoms of nurses 2795
30 Jin Young Seo [67] 2019 Nail technicians Cross-Sectional
Determining the similarities and differences in
health effects, safety concerns, and the use of health
services among immigrant women
148
31 Akhter Sadika [68] 2019 Garment industry
workers NIP Study of violence and social norms in
garment workers 56
32 J Ahn [69] 2019 General industrial
workers Cross-Sectional Assessment of physical and mental health problems
of workers 11,023
33 Pornpimol Kongtip [70] 2018 Farm and
forestry workers Cross-Sectional
Comparison of population statistics, working
conditions, health of individuals, and the health
behaviors in different agricultural workers
255
34 Park Jungsun [71] 2018 Office staff NIP Identification of work-related MSDs 2248
35 Oliveira AM de [72] 2018 Healthcare workers Cross-Sectional
Investigating the relationship between individual
and occupational aspects of hospital staff with job
satisfaction, burnout, and depressive symptoms
213
36 Karien Stuetzle [73] 2018 Healthcare workers NIP Determining sources and effects of job fatigue 115
37 Azimi Hanifeh [74] 2018 Healthcare workers Cross-Sectional Determining the status of intensive care unit (ICU)
nurses’ protection against radiation 91
38 Starc Jasmina [75] 2018 Healthcare workers Descriptive
Determining the leading causes of stress and
investigating the symptoms of stress among health
care professionals at the primary and secondary
level of health care
318
Safety 2024,10, 47 13 of 33
Table 4. Cont.
Row Author Year Occupation Type of Study Target of the Study Number of Women
Investigated
39 Tei-Tominaga Maki [76] 2018 Healthcare workers Cross-Sectional
Studying the influence of supportive environments
on occupational accidents, injury, and
mental disorders
822
40 N Cherry [77] 2018 General industrial
workers Cohort Difference between work type and health level in
welding and electrical professionals 447
41 Sunindijo Riza Yosia [78] 2017 General industrial
workers NIP Examining stress and factors influencing the
conditions of stress in construction workers 110
42 Hyocher Kim [79] 2016 Farm and forestry
workers NIP
Identifying related agricultural job injuries and
assessing the relationship between injury and
possible risk factors
7658
43 Chen Chin-Huang [80] 2016 Healthcare workers Cross-Sectional
Study on the effect of job satisfaction and stress on
anxiety, depression symptoms, and
perceived health status
159
44 A Honda [81] 2015 General industrial
workers NIP Study on the impact of factors affecting the
psychological issues of workers 366
45 Castro Marta [82] 2015 General industrial
workers NIP Investigating the factors affecting the fatigue of
airplane cabin crew 39
46 D Botha [83] 2015 General industrial
workers Descriptive Investigating the health, safety, and hygiene of
women working in mines 290
47 Allesøe Karen [84] 2015 Healthcare workers Cohort Physical activity in the workplace and ischemic
heart disease 12,093
48 Evangelos C.
Alexopoulo [85]2014 Police officers Cross-Sectional Stress perception, job satisfaction, and the
relationship between the two 45
49 Turk Meral [86] 2014 Healthcare workers NIP Relationship between organizational culture,
burnout, and the quality of care in hospital 36
50 A Honda [87] 2014 Healthcare workers NIP Investigation of stress and mental health of
elderly caregivers 367
51 Takashi TATSUSE [88] 2013 Office staff NIP Studying the relationship between job satisfaction
and health problems related to stress 570
Safety 2024,10, 47 14 of 33
Table 4. Cont.
Row Author Year Occupation Type of Study Target of the Study Number of Women
Investigated
52 Artazcoz Lucía [89] 2013 Office staff NIP Studying the relationship between long working
hours and family responsibilities 6295
53 J Berecki-Gisolf [90] 2013 General industrial
workers Cohort Exploring factors determining workplace injury
among workers 28,428
54 Kheiraoui F [91] 2012 Healthcare workers Cross-Sectional Assessing HCWs’ quality of life 185
55 E Van Houtte [92] 2012 Teachers NIP Assessment of risk factors and identification of new
risk factors in teachers 670
56 Lederer Valérie [93] 2012 General industrial
workers Cohort
Assessing the impact of individual and
psychological factors related to work and the
effective physical and organizational factors after
long-term disability
169
57 SG Herrero [94] 2012 General industrial
workers NIP Analysis of gender differences in perceived stress 5137
58 A Wirtz [95] 2012 General industrial
workers Cross-Sectional
Investigating gender differences in the impact of
long weekly working hours on occupational risk
and injury
48,099
59 Julia Blanco-Muñoz [96] 2011 Farm and
forestry workers Case-Control Description of the risk perceptions and methods
related to the use of PPE 35
60 Xujun Zhang [97] 2011 Farm and
forestry workers Cross-Sectional
The study of prevalence and risk factors of acute
poisoning with work-related pesticides
among farmers
351
61 Sezgin Ouml Zden [98] 2011 Farm and
forestry workers NIP
Identification of the working conditions and
attitudes of seasonal forestry workers regarding
accidents and work safety
47
62 Saloshni Naidoo [99] 2010 Farm and
forestry workers Cross-Sectional
Investigation of training and safety practices when
mixing and spraying pesticides, and levels of
acetylcholinesterase among farmers
803
* NIP: No information provided.
Safety 2024,10, 47 15 of 33
Additionally, Table 5illustrates the OHS challenges or issues for women identified
in the literature for each occupation within specific sectors. These challenges or issues are
discussed in Section 4. Stress, fatigue, MSDs and pain, sleep disorders, long working hours,
depression and anxiety, workplace violence, and allergies and skin problems are among
the most common OHS challenges or issues faced by women in various occupations, as
highlighted in the included studies (see Table 5).
Table 5. Matrix of OHS challenges or issues for women by occupation.
Specific Occupations
HCWs
Farm and Forestry
Workers
Office Staff
Teachers
Firefighters
Police Officers
Nail Technicians
Workers in the
Clothing Industry
General Industrial
Workers
OHS challenges or issues
Auditory and respiratory disorders ✓ ✓
Allergies and skin problems ✓ ✓ ✓
Conjunctivitis ✓
Cuts ✓
Depression and Anxiety ✓ ✓ ✓
Digestive problems ✓
Educational interventions ✓
Fatigue ✓ ✓ ✓ ✓
Gender-specific factors (e.g., menstrual health) ✓
High workload ✓
Toxic chemicals and Inhalation of fumes ✓
Ischemic heart disease ✓
Job satisfaction ✓ ✓
Job stress and job burnout ✓ ✓ ✓ ✓ ✓
Lack of sports facilities ✓
Long working hours ✓ ✓ ✓
MSDs and pain ✓ ✓ ✓ ✓ ✓ ✓
Poisoning with pesticides ✓
Poor working conditions ✓ ✓
Pregnancy considerations ✓
Rehabilitation challenges ✓
Slip, trips, and falls ✓
Sleep ✓ ✓ ✓ ✓
Strength and conditioning support ✓
Ability to meet job needs ✓
Use of PPE ✓ ✓
Voice disorder ✓
Workplace violence ✓ ✓ ✓
Safety 2024,10, 47 16 of 33
4. Discussion
4.1. OHS Challenges or Issues for Women in Specific Occupations Based on the Literature
According to Section 3.2, the included studies examined women’s OHS in specific
occupations. These included HCWs, farm and forestry workers, office staff, teach-
ers, firefighters, police officers, nail technicians, workers in the clothing industry,
and general industrial workers. Subsequently, OHS challenges or issues (Table 5)
faced by women in these occupations are discussed based on the findings of the
included studies.
4.1.1. OHS Challenges or Issues Faced by Female HCWs
One occupation mentioned in most of these studies devoted to the OHS of women is
that of HCWs, particularly in relation to organizational culture, burnout, job satisfaction,
and stress appraisal. The results indicated that the following issues or challenges endanger
the health and safety of female HCWs:
•
Female HCWs are at high risk of job stress and job burnout, both of which can lead to
less effective nursing care and psychological problems (11 studies);
•
Three studies conducted between 2010 and 2021 considered workplace violence as a
factor affecting the health level of female HCWs. Overall, the results showed that
female HCWs were exposed to varying degrees of verbal, organizational, sexual, and
physical violence;
•
Another factor affecting HCWs health is fatigue due to high workload, long hours of
work, and stress. Among the studies conducted in the field of fatigue, two were found
in this case;
•
Sleep is an essential factor that plays an important role in health. Sleep, as a physiolog-
ical mechanism of the body, can restore lost power and eliminate fatigue caused by
activity. Sleep disturbances can lead to physical and mental problems and a decrease
in performance. One case study related to the sleep health of women working in the
healthcare sector showed the results of sleep disturbances in working women;
•Two studies investigated the use of PPE related to reduced employee health levels;
•HCWs are at risk of ischemic heart disease (one study).
Table 6shows a summary of included studies related to each of these issues or challenges.
According to the findings, the OHS challenges or issues faced by women in the
healthcare sector seriously affect mental health. Various factors contribute to stress, fatigue,
and sleep disorders, including the nature of work in this occupational setting, exposure to
mortality, staffing shortages, work pressure, and physically demanding tasks. Workplace
violence is also a significant OHS issue among HCWs, having an adverse effect on their
mental health. Risk factors associated with violence include working in community-based
settings and working with unstable individuals. Consequently, HCWs experience violence
from organizational threats, patients, and patients’ relatives. Therefore, mental health is
crucial in the healthcare sector, and relevant risk factors should be eliminated to improve
mental health among HCWs.
Safety 2024,10, 47 17 of 33
Table 6. A summary of studies related to each of the OHS issues or challenges faced by female HCWs.
Issues or
Challenges Author A Summary of Studies
Job stress
and job
burnout
Rocha et al. [64]
- It investigated burnout and job satisfaction in emergency and intensive care workers in a public hospital. Of these, women comprised 60% of
the participants.
-
The results showed that workers suffer from frustration and cross-hierarchical relationships, and that more than 50% of them want to quit their jobs.
Turk et al. [86]
-
It revealed that HCWs face work stress arising from different sources. In most health and treatment centers, the stressors related to work, the content
of work and the health care system, and gender discrimination are evident.
-
The results showed that in women’s health centers, women, as nurses, play a supportive role, and they are expected to tend to the affective emotional
needs of colleagues and patients.
Starc [75]
- It classified stressors into three categories:
i. extreme stressors (including psychological and physical abuse, exposure to death, employee shortage, and a high number of patients)
ii. medium stressors (including exposure to infection, night shift, working conditions, and salary)
iii. low stressors (including staff–manager relationships, lack of resources, administrative work, and lack of education).
- The existence of stressful conditions on female nurses has shown its effects: reduced concentration, low motivation in work, less involvement with
patients, failure to perform tasks, low involvement with colleagues, and irrational decisions.
Fattori et al. [45]
- It studied the mental health of hospital employees during the COVID-19 pandemic.
-
The average general health scores for women were low, and in the examination of perceived stress, the average score was 23: 25% had high stress; the
average anxiety level was 7, and 25% of female hospital workers reported high anxiety levels.
Oliveira et al. [72]-
It stated that 12% of women had job burnout syndrome and 25% had symptoms of depression; personal and occupational factors were associated with
job satisfaction, burnout syndrome, and depressive symptoms.
Chen et al. [80]
- It concluded that the mean of job stress was high for female HCWs.
- The highest scores were for job control, psychological needs, physical intentions, supervisor support, and colleague support.
- Women under the age of 34 had higher job stress and more psychological demands than other age groups.
- The mean stress score in surgery and emergency departments was more elevated than in others, as were the levels of depression.
Tominaga [76]
- It conducted a study on a group of nurses with a statistical population of 93% female.
- The results showed that 6% had experienced occupational accidents and 7% had severe psychological problems.
- There was a significant relationship between mental health problems and the ethical climate in the work environment.
- The results also indicated that the experience of accidents or work-related injuries was correlated with the employees’ work environment.
Honda et al. [87]
- It examined the mental health status of employees who were caring for elderly relatives.
- The results demonstrated that of those who were women, 82% had low mental health levels.
-
The prevalence of depression in women was twice that of men. Poor health, poor sleep quality, and dissatisfaction with daily life was shown to have a
significant relationship with mental health of women.
Safety 2024,10, 47 18 of 33
Table 6. Cont.
Issues or
Challenges Author A Summary of Studies
Job stress
and job
burnout
Stelnicki et al. [47]
- This research was conducted on “nurses working in a community where 95% of the female population had been investigated for potential stressors
including potentially psychologically traumatic events (PPTEs)”.
- The results suggested that exposure to stressful situations can be associated with mental disorders such as anxiety, depression, generalized anxiety
disorder, and alcohol consumption disorder.
-
Also, according to female nurses, the worst and most distressing PPTEs were physical aggression, child mortality, death of a person after trying very
hard to save his or her life, and sexual assault.
Gu et al. [66]
- It studied a 97% female population with a mean age of 31 years and found that most nurses (68%) had high levels of job stress.
-
Workload and time pressure were correlated with anxiety, depression, and sleep quality, and patient care and interaction were correlated with anxiety
and physical symptoms.
-
Depression, anxiety, sleep quality, and physical symptoms were influenced by environmental problems and the existence of meaningful relationships.
Additionally, interpersonal relationships and management problems had a significant relationship with anxiety, depression, and physical symptoms.
- Overall, female nurses experienced high levels of job stress.
Bani-Issa et al. [53]
-
This investigation into the level of internal stress and sleep quality in female health workers showed that 36% had a disorder in their morning cortisol
level and 14% in their bedtime cortisol level, and 57% had perceived moderate levels of stress.
- The most common reported symptoms were heart rate, back and neck pain, and poor sleep quality, which was reported by 60% of the women
in the study.
- Significant relationships were found between working night shifts or shifts with a duration of more than eight hours and a disturbance in cortisol
levels (p< 0.05).
Workplace
violence
Liu et al. [54]
- The authors perceived that within the previous 12 months, 4% of women working in a hospital had been physically assaulted and 42% had
experienced psychological violence.
- Psychological violence was the most prevalent (48%) with verbal abuse (46%) being the second most common.
Harthi et al. [55]
- It studied violence against women in the hospital emergency department.
- The results showed high rates of sexual violence (29%), followed by verbal violence (28%), as well as bullying and racial discrimination.
- Overall, 21% of women experienced some degree of violence at work.
Faghihi et al. [46]
- Violence components against nurses in Iran were categorized as being related to organizational threats or interpersonal relationships.
- Organizational threats included massive and illogical shifts, forced shifts, forced recruitment in hospital wards, lack of knowledge of women’s
problems, lack of facilities, and lack of support from managers.
- Interpersonal relationships included hidden violence against female nurses in the workplace, physical violence by the patient and the patient’s
relatives, verbal violence by the patient and the patient’s relatives, and verbal violence by staff and divisional management.
- According to that study, female nurses were abused by the system unconsciously, demonstrating a need for more investigation and organization.
Safety 2024,10, 47 19 of 33
Table 6. Cont.
Issues or
Challenges Author A Summary of Studies
Fatigue
Poursadeqiyan
et al. [51]
-
A study conducted into nurses’ job fatigue and occupational fatigue found that 32% of female nurses had low job satisfaction; the mean fatigue score
was 96.7.
- The job fatigue subscales that occurred most frequently were, in descending order, lack of energy, sleepiness, lack of motivation, and physical effort.
- Fatigue scores and subscales were higher for female nurses who had low satisfaction than for others.
Stuetzle et al. [73]
- It showed that anesthesiologists need a high level of steady mental concentration, which increases fatigue, but fatigue is accepted or often ignored,
and this can affect job performance and patient safety.
-
In that study, 90% of fatigue causes were identified as fatigue factors during long working hours, 73% as mental and physical pressure at work, and
50% as personal and family desires.
Sleep Gander et al. [65]
-
It studied the sleep of nurses and showed that over the previous six months, 38% of female nurses had experienced sleep problems, 34% had severe
sleepiness, and 31% had made clinical errors due to fatigue.
- Furthermore, 65% reported that over the previous year they had fallen asleep while driving.
- That study found a significant relationship between gender and medical error as well as a significant relationship between nursing experience and
clinical error, falling asleep behind the wheel, and drowsiness.
The use
of PPE
Ramirez-Moreno
et al. [41]
- During the COVID-19 pandemic, a study of hospital staff demonstrated that the effect of masks on the occurrence of new headaches is unknown.
-
The results demonstrated that 65% of female employees who used masks experienced headaches. The relationship between the use of masks and the
occurrence of headaches was significant.
Azimi et al. [74]
- It investigated nurses’ awareness of PPE against workplace radiation.
-
Among the women surveyed, 98% had not participated in radiation protection training sessions and 76% believed that the periodic examinations in
the hospital were not mandatory.
-
The results showed that 62.7% had weak knowledge about PPE against radiation, 37.3% had moderate knowledge, and 100% had poor performance.
Ischemic
heart
disease
Allesøe et al. [84]
- In the cohort study of nurses caring for women over age 45, the age of participants with high physical activity was 52 years.
- Of those who took part in severe physical activity, 5% were at risk of ischemic heart disease.
- Among female nurses performing hard work, those who performed a high volume of physical activity were about 40% more at risk of developing
ischemic heart disease than those who performed moderate physical activity. As a result of increased physical activity, the risk of heart disease in
female nurses is high.
Safety 2024,10, 47 20 of 33
The included studies, based on the defined inclusion and exclusion criteria, predomi-
nantly focused on the female HCWs’ occupational health issues. Based on the obtained
findings, the existing research based on primary data and focused on safety issues among
female HCWs is limited. However, it is obvious that existing occupational health issues
can endanger the safety of HCWs and lead to injuries and fatalities. Stress, fatigue, and
sleep disturbances are factors affecting health that ultimately lead to accidents, a decreased
quality of life, and increased disease. Uymaz et al. [
49
] investigated the accidents experi-
enced by HCWs. Of the participants, 44% and 34% experienced accidents and near misses,
respectively. A meaningful relationship was found between gender and the occurrence
of occupational accidents (p< 0.05). To investigate the quality of life of HCWs, Kheiraoui
et al. [
91
] studied a population of 57% women with an average age of 39 years. In that study,
the general health score of women was 68, and the mean score of physical performance
was 92.6. Vitality received the lowest score with an average of 57, and mental health
received a mean score of 67. A meaningful relationship was found between gender and
vitality, body pain, social function, and mental health (p= 0.005). Additionally, results
from Villar et al. [
63
] into work conditions and absenteeism during pregnancy in HCWs
showed that the following risk factors caused an increase in absences during pregnancy:
biological factors (58% absence), ergonomics (54%), and safety factors (42%), followed by
psychological factors (34%) and physical and chemical factors (6%).
4.1.2. OHS Challenges or Issues Faced by Female Farm and Forestry Workers
Second to HCWs, female agricultural workers were among the most studied (11 arti-
cles). In the studies on the health and safety of women working in the agriculture sector,
poisoning with pesticides was the most frequent OHS issue. Pesticides are regarded world-
wide as the most effective, fastest and cheapest method of pest control. According to
documented statistics, the rate of poisoning with pesticides in developing countries is
13 times higher than in developed countries [
100
]. In fact, employees in the agriculture
sector are directly and indirectly dealing with agricultural toxins in a variety of ways that
can have both positive and negative effects on their health.
In addition, according to the analysis of the health and safety risk factors of female
farm and forestry workers presented in the included studies, the next categories of
frequency were, MSDs, auditory and respiratory disorders, and other issues (e.g., slips, trips,
and falls, the use of PPE and cuts). It is worth noting that products cultivated on farms
can sometimes have adverse effects on women’s health. For example, Paul et al. [
43
]
investigated the impact tobacco exposure has on female farm workers. Table 7shows
a summary of included studies related to each of these issues or challenges faced by
female farm and forestry workers.
As mentioned above, pesticide poisoning and MSDs were identified as the most
frequent OHS issues among women in the farm and forestry sector. Protecting female
workers in this sector involves precisely identifying and eliminating the contributing
factors to pesticide poisoning and MSDs. For example, the factors contributing to pesticide
poisoning include poor pesticide safety training, inadequate training on the proper use
of PPE, and insufficient hygiene measures. The factors contributing to MSDs are related
to the nature of the work and include high volumes of physical activity, prolonged static
postures, and heavy load handling (e.g., large animal handling).
Safety 2024,10, 47 21 of 33
Table 7. A summary of studies related to each of the OHS issues or challenges faced by female farm and forestry workers.
Issues or
Challenges Author A Summary of Studies
Poisoning with
pesticides
Blanco et al. [96]
- It found that 20% of women were exposed to pesticides and had a low understanding of the correct use of PPE.
- Furthermore, the hygiene measures taken were insufficient for protection.
- Many (42%) kept agricultural products at home, creating a significant source of exposure to toxins for themselves and their family members.
- It shows the need to develop preventive programs to educate workers on how to reduce the risks caused by pesticides.
Naidoo et al. [99]- It showed that only 16% of the farm workers who carried out the spraying had passed training courses on working with pesticides.
- Among the women who used PPE, 56.7% read the label on poisons while mixing, and 54.9% did so while spraying.
Zhang et al. [97]- This study found that 13% of women suffer from poisoning, and that this was more prevalent in areas that were poorer and without training.
- Pesticide safety training, safe application methods, and behavioral prevention can be effective in reducing the risk of pesticide poisoning.
Kongtip et al. [70]- It found that the prevalence of allergies, nasal congestion, and wheezing among farm workers who worked in rice fields was high due to high
contact with pesticides.
MSDs
Kaewdok et al. [34]
- The findings indicated that the women’s risk of MSDs is 2.52 times higher than that of men.
- This discrepancy can be due to high levels of physical activity, use of improper working tools, exposure to long-term static posture, and lifting
heavy loads. These discomforts increase with age, as women’s body strength declines and they experience menopause.
- Consequently, dealing with ergonomic issues and promoting the safety awareness of occupational risk factors among employed women in
agriculture is essential.
Hong [52]
-
It confirmed that female sex, old age, long work shifts, and long-term squatting at work are occupational injury factors that cause meniscus tears
and ultimately have a direct relationship with arthritis.
-
It also showed that 60.1% of female farmers had a meniscus tear, which underscores the importance of preventive programs and early diagnosis of
knee arthritis.
Sezgin et al. [98]- Women working in the forestry sector experienced pain in the lower back, numbness in the arms and legs, and feeling cold in the legs.
Auditory and
respiratory
disorders
Lee et al. [61]
-
The prevalence of hearing loss in farm workers is 19.6% higher than in the general population, and this hearing loss was observed in both female
and male farm workers.
- This study can be a step toward protecting the hearing health of farm workers.
Sezgin et al. [98]- Women working in the forestry sector experienced bronchitis.
Safety 2024,10, 47 22 of 33
Table 7. Cont.
Issues or
Challenges Author A Summary of Studies
Others (e.g.,
slips, trips, and
falls, PPE
and cut)
Kongtip et al. [70]
- Loud noises, slippery surfaces, and vibrating equipment create dangerous working conditions for rice growers, whereas the prevalence of these
working conditions is lowest among flower growers.
- Vegetable farm workers have reported pain relief in the knee region.
- The flower and vegetable farm workers correctly used PPE.
Sezgin et al. [98]
- It reported health problems in women working in forestry. The most frequent tasks (in decreasing order) were in the loading, storage, peeling,
crushing, site cleaning and charcoal sections, in which it was more common for women to be hit by a stick while throwing (66.7%), followed by
slips, falls, and collisions with cut pieces (22%).
- According to the investigations and evaluations, 56.8% of accidents were due to excessive fatigue, 52.3% to lack of attention, 34% to insufficient
training and knowledge, 9.1% to unfavorable weather conditions, and 6.8% to lack of PPE.
- The suggestions made to prevent accidents include taking more care, better working conditions, salary increases, training, and frequent
control activities.
Memon et al. [18]
- It investigated female workers’ use of PPE during cotton harvest. The results showed a low use of PPE: 12% used personal protective clothing,
11% used gloves, and 55% did not use any PPE.
-
Among women working in cotton harvesting, 27.3% experienced diseases and health problems, including eye damage (14.2%), headache (16.6%),
stomachache (20.4%) and fever (21.5%).
-
Young women used PPE more often than older women, and among those surveyed, the percentage of workers who used PPE was higher among
those with more work experience.
Kim et al. [79]
-
A study of occupational injuries in farm workers showed that the prevalence of accidents in female farm workers was 2.9%. This can be attributed
to aging, farm ownership, nocturnal work experience, and work speed.
- The increase in risk due to aging cannot be solved by education.
Paul et al. [43]
- It investigated the impact of female farm workers’ exposure to tobacco. The reported health problems included nausea, vomiting, body pain,
headaches, digestive problems, and skin turning a blackish color.
- Failure to use any protective and safety measures exposes the farmers to higher risks.
- The tobacco planting control policy is one of the measures reported to reduce health problems in this area.
Safety 2024,10, 47 23 of 33
4.1.3. OHS Challenges or Issues Faced by Female Office Staff
The administrative work environment is composed of physical, psychological and
social stimuli, each of which can be considered a cause of fatigue. These sources of stress
and pressure can undermine physical health, mental health, and performance, and can
reduce the health levels of women in administrative staff jobs [
101
]. Another important
issue that women face is pregnancy. This is one of the most sensitive and vital periods of a
woman’s life [
102
], during which she experiences changes due to hormonal, psychological,
and physical factors [
103
]. Another problem office workers face is long working hours.
According to European Union reports, poor health outcomes are associated with long
working hours, which can be due to lack of social welfare, family responsibilities, and being
the breadwinner. The last issue found, based on the literature, is MSDs.
Four studies focused on the OHS of women working in administration. Table 8presents
a summary of included studies related to each of the OHS issues or challenges faced by
female office staff.
Table 8. A summary of included studies related to each of the OHS issues or challenges faced by
female office staff.
Issues or
Challenges Author A Summary of Studies
Stress, fatigue,
and sleep
Tatsuse and
Sekine [88]
- A study in Japan stated that the mean score of mental performance of the women was
47.5; 30% had poor performance, 18.3% had extreme fatigue, and 30% reported
sleep disorders.
- In addition, job stress variables were significantly associated with job dissatisfaction.
Pregnancy
considerations
Abderhalden-
Zellweger
et al. [42]
- Findings indicated that the organizations appear to implement procedures to protect
pregnant women that are also in compliance with the Women’s Protection Act.
-
However, it is necessary to consider more safety measures because some women, when
faced with low and insufficient protection levels, modify the way they work in order to
reconcile work and pregnancy, which may ultimately affect their health.
Long working
hours
Artazcoz
et al. [89]-
In eastern European countries, women worked long hours, causing a low health status.
MSDs Park
et al. [71]
- It investigated MSDs in Korea. Of the sectors studied, more women were employed in
wholesale and retail trade, health and social work activities, hotels and restaurants,
education and training.
-
More than 50% of the women in these jobs suffered from MSDs, and women working in
the hotel and restaurant sector were exposed to more than three ergonomic risk factors.
- The results indicated that sex-specific instructions should be compiled and published
for different work sectors to prevent work-related MSDs.
4.1.4. OHS Challenges or Issues Faced by Female Firefighters
Firefighters in rescue activities are subject to intense psychological pressure. The
main occupational risk factors among women working in fire departments are time (20 h
per week), stress in the workplace, violence in the workplace, strenuous physical activ-
ity, exposure to noise and chemicals, and working with men for prolonged amounts of
time [104,105]
. Watkins et al. [
35
] studied the health of women, finding that 49% of working
women in North America complained of back injuries, 51% of lower limb injuries, and 45%
of heat-related illnesses. A significant number (39%) of women considered the menstrual
cycle and menopause as a factor affecting their work; 36% were worried about their ability
to meet their job needs in the future; 50% reported “strength and conditioning support”;
and 21% cited lack of sports facilities as their problem. The availability of PPE for women
in the United Kingdom was 66%, compared to 42% in other groups.
Safety 2024,10, 47 24 of 33
4.1.5. OHS Challenges or Issues Faced by Female Police Officers
Police officers experience high levels of stress, anxiety and stimulation. Their profes-
sion is described as one of the most stressful jobs in the world because physical threats in
the operational area are very high. Alexopoulos et al. [
85
] revealed that, 84% of female
officers were more or less satisfied with their jobs, and only 35% were satisfied with their
salaries. Most (78%) of the women described their health status as good to excellent, and
5% had a poor health status. In that study, significant relationships were found between
physical disorders, stress, insomnia and depression. Ma et al. [
62
] sought to evaluate stress
and sleep quality. The results indicated that female police officers have high stress levels.
Only 13% of female police officers worked at night; 3% used “sleep medicine”, and 48% had
a high workload. Female police officers reported a significant rating score for physical and
psychological danger, averaging 48.9 (
±
25.1). Carleton et al. [
56
] assessed mental disorders
in correctional staff. The findings indicated that screening results for mental disorders
in female officers were 59.4% positive and that mental disorders occurred more often in
women than in men.
4.1.6. OHS Challenges or Issues Faced by Female Teachers
Among the articles reviewed in this study, four looked at the safety and health of
women working in education. One of the problems found based on the literature was
fatigue. Another issue was stress due to workplace violence. Among other threatening fac-
tors for teachers is voice disorder, for which they experience an increased risk due to the
prolonged use of their voice. The prevalence of vocal diseases is between 11% and 81%.
These voice problems may lead to a reduced quality of teaching and an increased personal
and emotional burden on teachers [
92
]. Table 9presents a summary of the included studies
related to each of the OHS issues or challenges faced by female teachers.
Table 9. A summary of included studies related to each of the OHS issues or challenges faced by
female teachers.
Issues or
Challenges Author A Summary of Studies
Fatigue
and job
satisfaction
Vilella
et al. [58]
- The authors conducted a study on a community of teachers, of which 82% were women.
- The results related to fatigue and job satisfaction showed that teachers who worked in the
morning and afternoon suffered from physical and mental fatigue, their mood changes
tended to worsen, they had lower job satisfaction, and their fatigue increased at the end of
their shift.
Boström
et al. [59]
- Of the teachers studied, 81% were women who reported reasonably good general health.
- The mean fatigue score was high. Teachers reported high fatigue, high work speed, high
emotional needs, and poor mental health and safety.
Workplace
violence
Lagrosen
et al. [60]
-
Despite the desirable status of quality management, women reported their perceived stress:
12% were subjected to sexual harassment, 11% were exposed to bullying, and only 3.5%
experienced physical violence.
- A meaningful relationship was found between sexual harassment and physical violence
and sex.
Voice
disorder
Van Houtte
et al. [92]
-
It advocated that one occupational hazard of teaching is the risk of creating voice disorders,
which has a prevalence in teachers of 51%, with female teachers being at more risk than
their male colleagues.
- Factors found to contribute to teachers’ voice impairment include the presence of
temperature changes (62%), screens (58%), poor ventilation (64%), and carpeting (54%) in
the classroom.
- After correcting for age and sex risk factors, a family history of voice disorders, a large
number of students in the class, repeated temperature changes in the classroom, and noise
were found to be the factors that aggravated voice disorders in teachers.
Safety 2024,10, 47 25 of 33
4.1.7. OHS Challenges or Issues Faced by Female Nail Technicians
Nail technicians are very vulnerable to occupational hazards, as they are exposed to
toluene and formaldehyde. In addition to causing skin problems, allergies and asthma,
these chemicals are carcinogenic (present a risk of cancer). Additionally, prolonged sitting,
improper posture, and MSDs can cause neck pain and back pain [
106
]. Two studies were
conducted in the field of the safety and health of women working in nail salons. Dang
et al. [
50
] aimed to investigate the level of health and safety of employees and to raise
health and safety awareness among nail technicians. Three important factors affecting the
health of nail technicians were identified: work-related stress factors such as the lack of
policies and regulations, the lack of formal training, and insufficient knowledge; exposure
risks in the workplace that include inhaling fumes from manufacturing materials and nail
products as well as poor ergonomics; and the need for interventions at the individual and
organizational levels, such as for a new educational policy. Furthermore, Seo et al. [
67
]
studied female nail technicians and found that 46% of them were concerned about their
health and reported complications such as stress (46%), pain (38%), allergies (35%), skin
problems (35%) and MSDs (34%). Preventing these health symptoms would require, as
priorities, the implementation of new ventilation regulations against long-term exposure
to toxic chemicals, changes to public health policy, and staff training with an emphasis on
increasing the use of PPE.
4.1.8. OHS Challenges or Issues Faced by Female Workers in the Clothing Industry
Two studies into the OHS of workers in the apparel sector highlighted the factors
that threaten women’s health in this profession. Akhter et al. [
68
] investigated violence
against women working in the garment industry and demonstrated a high incidence of
verbal and physical abuse by supervisors who try to exert control over female workers
by yelling, insulting, and speaking harshly. The most common physical abuses included
slapping, pinching, and pushing. Disregard for the physical conditions of the workers
(lack of proper ventilation, lack of first aid boxes, high noise levels), long hours of work,
and threats to the proper rehabilitation of workers after injury and accident at work are
among the health and safety problems faced by women workers in this industry. Regarding
female weavers, Aiswarya and Bhagya [
48
] found that more than 61% had occupational
health complications. Of those, 93.4% had joint and muscle pain due to improper posture,
continuous movement of hands and feet, and long hours of sitting. The majority had pain
in the hands, arms, shoulders, and neck; 20% had respiratory problems due to the presence
of fiber dust; 11.5% suffered from skin diseases, dermatitis, and conjunctivitis due to being
part of the dyeing and spinning department; and 41% suffered from depression, with a
high prevalence of anxiety among women in this work unit.
4.1.9. OHS Challenges or Issues Faced by Female General Industrial Workers
Regarding the OHS of female workers in other industries or units, including mining,
construction, air transportation, and welding and electrical units, it was found that the
following topics were studied: safety conditions of women’s work, mental disorders, long
work hours, and PPE. Table 10 demonstrates the OHS issues faced by female workers in
each of these industries or units.
In addition to the above-mentioned industries or units, some other studies investigated
the OHS of female workers in general, rather than focusing on a specific industry. The
results of those studies are as follows:
Safety 2024,10, 47 26 of 33
Table 10. The OHS issues faced by female general industrial workers.
Industries/Units
Author A Summary of Studies
Mining
Botha and Cronjé
[83]
- It investigated the health and safety of women in the mining sector and reported the
inappropriateness of the working conditions.
- That study revealed that underground mines were in compliance with the standard
safety conditions, but that the conditions nevertheless posed a danger to women,
especially for those working night shifts.
- Indicators related to the adequacy of PPE (e.g., protective clothing, masks), changing
jobs during pregnancy, holding educational classes about AIDS, and the existence of a
rehabilitation program after an accident were scored above 2.5, which is satisfactory.
-
Although mining companies have done their best to promote health and safety in mines,
it is still one of their biggest challenges. Therefore, mining companies should make
efforts to ensure women’s continued involvement in mining activities by taking into
account risk management, gender differences, and ergonomics.
Construction Sunindijo and
Kamardeen [78]
- According to the results, the mean scores of stress and anxiety for women working in
this industry were higher than for men.
Air trans-
portation Castro et al. [82]
- It classified the factors that cause flight crew fatigue from most frequent to
least frequent.
-
These factors include flying at night, flight fatigue, lack of humidity, type of flight, lack
of rest, temperature, and workload. Complaints and discomforts reported by female
crew members are leg fatigue (82.1%), dry skin (79.5%), shin pain (69.2%), leg pain
(64.1%), back pain (56.4%), eye fatigue (53.8%), and digestive problems (53.8%).
- With age, fatigue increases and the quality of sleep decreases.
-
Due to irregular working hours and long night flights, fatigue risk management is more
important than ever for women.
Welding and
electrical
units
Cherry et al. [77]
-
The results showed that the most frequent problems reported by workers in the welding
team were depression, anxiety, sneezing, and runny nose or nasal obstruction without a
cold, while those in the electrical sector reported sneezing and a runny or stuffy nose,
anxiety, depression, and back pain, which interfered with their activities.
- In comparing the health status of women in these two professions, the prevalence of
runny nose and sneezing, debilitating shoulder pain, and depression and anxiety was
higher in the welding profession than in the electrical unit, but the amount of
debilitating back pain in the electrical unit was higher than in the welding unit.
Honda et al. [
81
] studied the mental health of Japanese workers with multiple roles
and found that women’s mental health was weaker than men’s. Married women had better
mental health than unmarried women, and those who were responsible for their families
had better mental health than those who only held a job. Chun et al. [
57
] assessed the level
of depression and found that 26.5% of women were depressed and more than 50% had
high workloads. Herrero et al. [
94
] examined stress and revealed that 22.10% of female
workers had at least three stress-related signals. Young female workers had less stress than
older female workers. Across the different age groups, women experienced more stress
than men in the same age groups. After using a Bayesian network method to analyze the
results, the factors found to most affect stress levels in women were, in descending order
of importance, “overwork” (28.51%), “tight deadlines” (23.38%), “quick work” (22.86%),
“complex tasks” (20.93%), “intellectual demanding” (19.18%), “repetitive tasks” (17.47%),
and “attention level” (15.65%).
In the study of the physical and mental problems of Korean waged workers in dif-
ferent job categories, unskilled female workers experienced the most physical and mental
problems. These were most frequently diabetes, high blood lipids, arthritis, depression,
and suicidal thoughts. The most common disease among managers and specialists was
cardiovascular disease, and among skilled female workers and after-sales service workers,
it was high blood lipids and high blood pressure [69].
Berecki-Gisolf et al. [
90
] found that 1.8% of women in Thailand had been impaired
during the previous 12 months and that women who worked more than 48 h per week,
Safety 2024,10, 47 27 of 33
and those who had a lower income, were exposed to more risk. Also, women who worked
part-time reported less victimization than women who worked full-time.
Lederer et al. [
93
] evaluated the social, physical, and organizational factors related to
women’s work. The results showed that 64% suffered a high perceived physical workload,
38% had an average level of job satisfaction, and 15% were dissatisfied. In grading job
security, the results depicted high job insecurity. Furthermore, 56.2% of the women were
not aware of the safety and health programs in their workplace. They complained of pain
in the back area (54%) and in the neck and upper extremities (35.5%). Also, the nature of
pain in MSDs was 79% from vertebral injuries and 21% from repetitive movements in work.
Ahn et al. [
44
] examined the relationship between long working hours and infertility,
and found that infertility is related to long hours of work in workers under 40 years of
age. Furthermore, Wirtz et al. [
95
] found that with increased working hours, the number of
injuries women reported increased.
4.2. Strengths Impact, and Future Research Avenues
In terms of strengths, this review covers the studies that utilized primary data, with
all or part of their participants being female. Focusing on such specific studies allowed
us to gain an understanding of the health and safety issues directly raised by the female
population in the workplace. Additionally, this approach enabled us to understand the
extent of attention that researchers have given to women’s OHS through empirical studies,
rather than relying on secondary data or theoretical and conceptual studies.
Furthermore, the detailed discussion in Section 4.1 highlights that stress, fatigue, MSDs
and pain, sleep disorders, long working hours, depression and anxiety, workplace violence,
and allergies and skin problems are the most common OHS challenges or issues faced by
women across different occupations, as indicated by the included studies. However, some of
the factors affecting women’s OHS in specific sectors may not be as relevant in other sectors.
For example, female farm and forestry workers may be at risk of pesticide poisoning; female
workers in the clothing industry may develop conjunctivitis from working in dyeing and
spinning departments; female teachers may experience voice disorders due to prolonged
voice use; and female tobacco farmers may encounter digestive problems. These findings
enable organizations, employers, and policymakers to pay more attention to women’s
physical and physiological characteristics and to implement more efficient measures and
strategies for protecting women’s health and safety in sectors with varying types of work.
Additionally, these findings will help future OHS researchers identify the most critical
research needs concerning the protection of female workers in various occupational settings.
They will also assist in identifying industry sectors that have not yet been studied.
The obtained findings also indicate avenues for future research. This study provides
insights for drawing more attention to the research topic of women’s OHS, highlighting
the OHS challenges faced by women in workplaces. The field of OHS is broad. While
this review focused on specific studies based on inclusion and exclusion criteria, future
studies should examine women’s OHS more precisely by focusing on specific issues.
This approach can help develop appropriate control measures for each specific issue to
promote women’s health and safety in the workplace. Additionally, while the obtained
findings included women’s OHS issues in several specific occupations (e.g., HCWs, farm
and forestry workers, office staff, teachers, firefighters, police officers, nail technicians,
workers in the clothing industry, and general industrial workers), several opportunities for
future studies are recommended to precisely examine women’s health and safety issues
in different occupations separately. For example, reviewing women’s risks in farm work,
healthcare, manufacturing, transportation, and construction, especially in developing
countries, could be beneficial for prevention purposes by accurately identifying the risk to
women in each industry, considering the varied nature of work in each. Additionally, this
approach allows for a precise focus on the OHS challenges faced by women in a specific
sector. It also provides an opportunity to discuss in greater detail common OHS issues, as
well as certain sector-specific factors affecting women’s OHS that may not be as relevant
Safety 2024,10, 47 28 of 33
in other sectors, such as ethical stress in the healthcare sector. Ethical issues related to
“protecting patient rights”, “autonomy and informed consent”, “organizational structures”,
and “standardization and the development of health care system” can create stress among
healthcare providers [
107
,
108
] and “a conflict between their professional and personal
ethical values” [
109
]. Consequently, the development of programs to teach ethics and the
creation of national and global strategies are essential to address ethical stress, to enhance
the provision of “quality patient care”, and to retain skilled personnel [107,110].
Since the focus of this review is on women’s OHS and not solely on the health status of
healthcare workers during the COVID-19 pandemic, some studies (e.g., pandemic-related
articles) were likely excluded. This exclusion is also due to the inclusion criteria being
limited to articles that used primary data with all or part of their participants from the
female population. Therefore, the COVID-19 pandemic is a specific topic worthy of a
targeted systematic review in future research, particularly given the substantial number of
articles published on the subject.
Finally, the majority of studies included in this review focused on women’s health
in the workplace. Therefore, future research should prioritize women’s safety to prevent
workplace injuries.
5. Conclusions
In today’s world, women play active roles in various industries. The physical and
physiological characteristics of women have an impact on their health and safety in the
workplace. These characteristics should receive the attention needed to mitigate occupa-
tional diseases and occupational injuries and to provide a healthy and safe workplace for
women. In this regard, this study aimed to review and analyze OHS-related research stud-
ies that used primary data, with all or part of their participants being female, to investigate
the status of research on women’s health and safety, as well as the OHS challenges or issues
that women face in different occupations. During the period of 2010–2021, an increasing
trend in publishing such articles in the field of women workers’ OHS could be seen. The
studies included in this review investigated women’s OHS in specific professions, such as
HCWs, farm and forestry workers, office staff, teachers, firefighters, police officers, nail
technicians, workers in the clothing industry, and general industrial workers. Most of the
studies in this area were related to women working in the healthcare sector and agricultural
industry. Some OHS issues identified in the literature, such as job stress, fatigue, MSDs and
pain, sleep, workplace violence, as well as allergies and skin problems, are common across
different occupations. However, certain OHS issues are specific to particular occupations
due to the nature of the work. For instance, female teachers may suffer from voice disorders
due to prolonged voice use, while female farmers working in tobacco planting farms may
experience digestive problems. Additionally, the findings emphasize the importance of
addressing women’s mental health across various occupational sectors.
Finally, based on the knowledge gained, limited research has been conducted on
women’s OHS. This is particularly true for the new jobs in which women are engaged, and
this has led to unsafe conditions, in which the threats to women’s health and safety remain
unknown. Appropriate and preventive control measures have not yet been suggested
to provide safer and healthier workplaces for women in various sectors. The findings of
this study shed light on women’s OHS issues and challenges. Additionally, this paper
serves as a foundation and a guideline for researchers to develop further research in this
area. Moreover, there were certain limitations in conducting this review. This study used
general keywords related to the field of women’s OHS. This review was also limited
to studies that used the primary data, with all or part of their participants being female.
Consequently, some studies might not have been included in the search, potentially limiting
the comprehensiveness of the list of OHS challenges and issues faced by women in various
industries. Therefore, further research could focus on women’s OHS issues and challenges
in each industry separately and comprehensively.
Safety 2024,10, 47 29 of 33
Author Contributions: Conceptualization, M.J., S.B. and A.H.; methodology, S.B. and M.J.; validation,
M.J. and A.H.; formal analysis, S.B. and A.H.; investigation, S.B., M.J. and A.H.; writing—original
draft preparation, S.B.; writing—review and editing, S.B., M.J. and A.H.; supervision, M.J.; project
administration, A.H. and M.J.; funding acquisition, M.J. and S.B. All authors have read and agreed to
the published version of the manuscript.
Funding: This research was supported by Shiraz University of Medical Sciences (extracted from a
doctoral dissertation, approved code of ethics: IR.SUMS.SCHEANUT.REC.1402.004).
Data Availability Statement: No new data were created or analyzed in this study. Data sharing is
not applicable to this article.
Acknowledgments: We would like to acknowledge the financial support of Shiraz University of
Medical Sciences.
Conflicts of Interest: The authors declare no conflicts of interest.
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