Women and the ageing workforce : implications for occupational safety and health.
Date: 2017-02-02
Institutions: European Agency for Safety and Health at Work
Subjects: elderly person, health policy, occupational health, occupational safety, older worker, organisation of work, participation of women, population ageing, position of women, quality of life, report, working conditions

Women and the ageing workforce – Implications for OSH 

European Agency for Safety and Health at Work 

ISSN: 1831-9351 

Women and the ageing workforce  
Implications for Occupational 
Safety and Health 
A research review 

Women and the ageing workforce – Implications for OSH  

Authors: Joanne O. Crawford, Alice Davis, Hilary Cowie and Ken Dixon (Institute of Occupational 
Medicine). 

Reviewed by Sonja Hagen Mikkelsen (COWI) and Maria Albin (Lund University). 

Edited by Robert Pederson and Alice Belin (Milieu Ltd) 

This report was commissioned by the European Agency for Safety and Health at Work (EU-OSHA). Its 
contents, including  any  opinions  and/or  conclusions  expressed,  are  those  of  the  authors  alone  and 
do  not necessarily reflect the views of EU-OSHA. 

Project management - Sarah Copsey (EU-OSHA) 

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Luxembourg: Publications Office of the European Union, 2016 

ISBN: 978-92-9240-985-2 

doi: 10.2802/082637 

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Reproduction is authorised provided the source is acknowledged. 

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Women and the ageing workforce – Implications for OSH  

Table of contents 
Abbreviations .......................................................................................................................................... 5 

Executive summary ................................................................................................................................. 7 

1 

Introduction ................................................................................................................................. 13 

1.1  The project ‘Safer and Healthier Work at Any Age’ ................................................................... 13 

1.2  Background: why be concerned about age and gender? .......................................................... 13 

1.3  Scope of the review .................................................................................................................... 15 

2 

Sex and gender differences in age-related changes ................................................................. 16 

2.1  Introduction ................................................................................................................................. 16 

2.2  Specific physiological changes in working women .................................................................... 17 

3 

Gender segregation in the labour market, OSH and sustainable work ...................................... 20 

3.1  Introduction ................................................................................................................................. 20 

3.2  Horizontal segregation ............................................................................................................... 20 

3.3  Vertical segregation.................................................................................................................... 21 

3.4  Hazards and risks in female-dominated occupations and sustainable work ............................. 22 

3.5  Differences related to employment arrangements ..................................................................... 25 

4 

Specific OSH and health issues, female workers and implications for sustainable work .......... 27 

4.1  Introduction ................................................................................................................................. 27 

4.2  MSDs .......................................................................................................................................... 27 

4.3  Psychosocial risks and health problems .................................................................................... 30 

4.4  Life-cycle  approach  to  OSH,  cumulative  exposures  and  recognition  of  risks  to  female 

workers ...................................................................................................................................... 32 

4.5  Multiple exposures, female workers and sustainable work ........................................................ 34 

4.6  Accidents, female workers and sustainable work ...................................................................... 35 

4.7  Night or shift work and sustainable work.................................................................................... 35 

4.8  Work and the menopause .......................................................................................................... 36 

4.9  Unpaid work and caring responsibilities ..................................................................................... 38 

5 

Female-dominated work and sustainable work .......................................................................... 42 

5.1  Healthcare .................................................................................................................................. 42 

5.2  Education ................................................................................................................................... 44 

5.3  Implementing measures in work predominantly carried out by women ..................................... 45 

6 

7 

‘Groups’ of female workers and sustainable work ..................................................................... 46 

Risk prevention, health promotion, OSH systems and gender and sustainable work ............... 47 

7.1  Age- and gender-sensitive risk assessments ............................................................................ 47 

7.2  Workplace health promotion and diversity ................................................................................. 49 

7.3  OSH systems, labour inspection and strategies for sustainable work ....................................... 51 

7.4  Access to support services ........................................................................................................ 53 

8 

Conclusions ................................................................................................................................ 55 

8.1  Gaps in knowledge and support ................................................................................................. 55 

8.2  Overall conclusions and possible policy implications ................................................................. 57 

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Women and the ageing workforce – Implications for OSH  

References   ......................................................................................................................................... 59 

Appendix A: Summary of findings on the ageing workforce and the implications for occupational 

safety ................................................................................................................................ 67 

Appendix B: Search protocol and selection methodology .................................................................... 80 

Appendix C: Features of good practice: summary of findings (Weyman et al., 2013).......................... 85 

List if figures and tables 
Figure 1: Gender differences in life expectancy and HLY expectancy at birth in EU Member States     

in 2010 (Marmot, 2013) ........................................................................................................ 17 

Figure 2: Percentage of workers aged 50-54 years who do not think they will be able to do the      

same job at the age of 60 (Eurofound, 2012) ....................................................................... 24 

Table 1: Employment (%) by age group and by gender for workers aged 50+, according to sector 

(Eurofound, 2012)................................................................................................................... 21 

Table 2: Employment (%) by age group and by gender for workers aged 50+, according to   

occupation (Eurofound, 2012) ................................................................................................ 22 

Table 3: Examples of hazards and risks found in female-dominated occupations (EU-OSHA, 

2013a) .................................................................................................................................... 23 

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Women and the ageing workforce – Implications for OSH  

Abbreviations 
COPD 

chronic obstructive pulmonary disease 

EU-28 

28 Member States of the European Union 

EU-OSHA 

European Agency for Safety and Health at Work 

Eurofound 

European Foundation for the Improvement of Living and Working Conditions 

ENWHP 

European Network for Workplace Health Promotion 

EWCS 

European Working Conditions Survey 

HLY 

HR 

HSE 

MSD 

NHS 

healthy life years 

human resources 

United Kingdom Health and Safety Executive 

musculoskeletal disorder 

United Kingdom National Health Service 

NIOSH 

US National Institute for Occupational Safety and Health  

OECD 

Organisation for Economic Cooperation and Development 

OSH 

PPE 

occupational safety and health 

personal protective equipment 

PRISMA 

Preferred Reporting Items for Systematic Reviews and Meta-Analyses 

RCT 

randomised controlled trial 

TAEN 

The Age and Employment Network 

TUC 

United Kingdom Trades Union Congress 

WHO 

World Health Organization 

WHP 

workplace health promotion 

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Women and the ageing workforce – Implications for OSH  

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Women and the ageing workforce – Implications for OSH  

Executive summary 
This review was carried out as part of a larger project of the European Agency for Safety and Health at 
Work (EU-OSHA), initiated by the European Parliament. The project, called ‘Safer and Healthier Work 
at Any Age’, aims to enhance the implementation of existing recommendations, the exchange of best 
practices,  and  the  further  investigation  of  possible  ways  to  improve  occupational  safety  and  health 
(OSH), and thereby improve the sustainability of work. The present review examines a number of issues 
related to gender, older female workers, OSH and sustainable work, however, it is not a comprehensive 
review. It was informed by desk-based research that reviewed existing information on these topics. It 
was also informed by a workshop on the topic organised by EU-OSHA (2015). 

  Why review the gender dimension of occupational safety and health, sustainable work and 

older workers? 

It is important to discuss how gender and age interact in relation to OSH and sustainable work, in order 
to  inform  policy,  debate  and  future  research  on  sustainable  work.  Age-related  management  that 
accounts  for  demographic  change  is  crucial  to  the  implementation  of  the  objectives  on  increasing 
employment  rates  among  women,  in  the  context  of  the  Europe  2020  Strategy.  However,  different 
measures may need to be taken to maintain and improve the OSH of older female workers. A gender-
related dimension is important, for example, with regard to addressing measures to balance work and 
care responsibilities for older workers, and addressing the impact of physical work on women in relation 
to, for example, musculoskeletal disorders (MSDs), and the impact of stress and burnout resulting from 
emotionally demanding work carried out by women. Despite a growing body of work on the separate 
domains of gender and age in the workplace, there has been limited research on the intersection of 
gender  and  age  and  OSH  in  relation  to  safety  and  health  issues  and  sustainable  workplaces. 
Nevertheless, relevant information is available from studies on gender by EU-OSHA and Eurofound. 

  Sex and gender differences in age-related changes 

A number of changes in physical ability and health are associated with ageing, and these are influenced 
by sex (that is, biological) and gender (that is, socially constructed) differences, and can affect the ability 
of older women to work. 

Women live longer than men, but they are also more likely to live longer with a chronic health condition 
or disability than men. The most obvious sex-specific age-related change is the menopause, although 
there has been very little research on the influence of the menopause on working women. Osteoarthritis 
and  osteoporosis  are  diagnosed  more  frequently  in  women  than  in  men,  and  are  age  related. 
Osteoporosis increases the risk of fractures in the workplace. Differences between men and women 
with regard  to the prevalence of chronic conditions, such as chronic obstructive  pulmonary  disease, 
have  been  observed.  These  differences  can  also  be  explained  by  differences  in  the  exposure  to 
workplace hazards. Breast cancer is far more prevalent among women; evidence is growing for a link 
between long-term shift work, particularly night work, and breast cancer. 

It is important to avoid stereotypes that relate to older workers, and older women in particular, and their 
work ability. For example, physical strength and endurance is very specific to individuals. For example, 
some  older  workers  may  be  stronger  than  their  younger  colleagues.  Likewise,  the  differences  in 
physical ability between individual women can often be greater than those between men and women. 

Declines in physical ability and health with age in women and men often do not affect work performance. 
Many chronic diseases are controllable. For example, while unpredictable in nature, various measures 
can be taken in the workplace to help those with arthritis manage their pain and fatigue. Older workers 
can also use their experience to adapt their ways of working. Simple measures can often be taken in 
the workplace to prevent early exit from work, such as equipment changes, changes in the way a task 
is  performed,  adjustments  to  working  hours  or  a  transfer  to  alternative  work  if  necessary.  Simple 
ergonomic measures to reduce workloads, for example lifting aids, have a positive impact on  young 
and old workers, the only difference being that whereas they facilitate work for younger workers, they 
often make the work possible for older workers. 

  Gender-related differences between men and women exist across the work-life course 

According to the European Working Conditions Survey, gender differences exist across the work-life 
course  and,  generally,  well-being  is  lower  for  women  than  for  men. This  gender  gap  widens  after  a 
woman  has  had  children  and  remains  wide  for  the  rest  of  the  life  course.  Vertical  and  horizontal 

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Women and the ageing workforce – Implications for OSH  

segregation in the labour market exposes women generally, and older women specifically, to different 
risks from those that men are exposed to. This affects women’s health throughout their working lives. 
Vertical gender segregation leads to a concentration of women in jobs lower down the job hierarchy; 
this  is  due  to  a  lack  of  promotion  opportunities  and  career  mobility  (EU-OSHA,  2013a).  Vertical 
segregation because of a lack of career mobility can lead to prolonged exposure to certain workplace 
hazards, such as repetitive work or work that requires awkward postures. 
Horizontal  segregation  relates  to  the  fact  that  men  and  women  tend  to  work  in  different  economic 
sectors. Older women are over-represented in the health and social work, education and other service 
sectors.  In  the  context  of  sustainable  work,  it  is  important  not  to  underestimate  the  physical  and 
emotional demands of some women’s work. Manual handling, highly repetitive and paced work, shift 
work, the risk of violence and harassment, and stress are issues that affect retention and the quality of 
the  working  life  in  many  areas  in  which  women  work.  As  for  other  areas  of  OSH,  strategies  for 
sustainable work should address the sectors and jobs in which women predominate, such as health 
care, education, and cleaning and retail work, as well as male-dominated sectors, such as construction. 
This is also important in the context of an increased risk of developing MSDs as a result of desk-based 
work; this is especially relevant for relatively low-grade administrative workers, who have less control 
and variety in their work. 

  The menopause and workplace health promotion 

Other health issues faced by women related to, for example, the menopause, remain taboos in society 
and, therefore, in the workplace. Simple measures can be taken in the workplace to address such health 
issues; for example, access to drinking water can be provided, layered clothing can be used for uniforms, 
and flexible  working can be arranged to facilitate doctor’s appointments. However, more awareness 
raising and support for workplaces is needed, including advice on non-stigmatising measures, model 
policies and risk assessment checklists. In addition, more research on workplace implications is needed. 
Similarly, there is a need for more tailored approaches to addressing the promotion of men’s health in 
the workplace, especially as different awareness-raising techniques are needed to engage men and 
women. 

  Gender-sensitive occupational safety and health strategies across the life course 

Workplace  safety  and  health  strategies  for  sustainable  working,  which  start  with  younger  workers, 
should be both age and gender sensitive. For example, a lifelong approach to sustainable work should 
encompass risk education and prevention for girls and boys in schools, and ensure that OSH education 
addresses  the  risks  associated  with  female-dominated  jobs  and  that  OSH  is  included  in  vocational 
training in typical women’s jobs. 

  Stress and musculoskeletal disorders 

Stress and MSDs can have a major impact on the sustainability of women’s work. More attention needs 
to be given to these two issues, including a focus on risk prevention in jobs predominantly carried out 
by women. For example, in the case of MSDs, more attention needs to be given to work that involves 
prolonged standing or prolonged sitting, both of which are prevalent in some jobs often carried out by 
women, such as at supermarket checkouts or office administration work. 

  Rehabilitation 

A  specific  gender  focus  also  needs  to  be  given  to  rehabilitation  from  work-related  illnesses  and  to 
ensure that programmes are accessible for women with childcare responsibilities. Non-recognition of 
the work relatedness of women’s ill health can be a barrier to women accessing rehabilitation if such 
access  is  dependent  on  having  a  recognised  occupational  health  problem.  As  an  example  of  good 
practice for rehabilitation, the French work injury insurance organisation Anact (L’agence nationale pour 
l’amélioration des conditions de travail) has promoted a guide for the rehabilitation of female workers 
after treatment for breast cancer; this was developed by associations of occupational physicians (Anact, 
2008). Breast cancer is one of the most common female cancers and affects mainly older women. 

 

Incorporating age and gender dimensions into risk assessment and strategy development 

For the promotion of sustainable work, it is important to integrate age and diversity into risk assessment, 
so that OSH strategies promote diversity through risk prevention and by tackling risks at their source. 
This  should  be  underpinned  by  key  principles  based  on  the  importance  of  collective  measures, 
consultations with employees and valuing diversity as a resource. Therefore, it is important to address 
age equality, gender equality and OSH in one policy and practice framework. 

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Women and the ageing workforce – Implications for OSH  

The close link between gender equality and sustainable work is demonstrated by an intervention that 
was employed by a French printing company. Women working in ‘finishing’ suffered from exceptionally 
high rates of MSDs. Ergonomic improvements were recommended but more had to be done to prevent 
exposure to repetitive tasks for long periods. An analysis of the length of time spent in different jobs by 
gender revealed that men were more quickly promoted from roles involving ‘finishing’ work than women, 
so  one  of  the  recommendations  included  promoting  women’s  career  path  development  and  skill 
recognition, in order to prevent women from becoming trapped long term in repetitive jobs. 

An  example  of  integrated  strategy  development  in  a  sector  dominated  by  a  female  workforce  is  the 
strategy  of  the  tripartite  Working  Longer  Group  (WLG)  of  the  National  Health  Service  (NHS)  in  the 
United Kingdom 1. This group was established to address the impact of the increase of the retirement 
age from 65 years to 68 years on the NHS workforce, which is 77 % female, with nearly two-thirds of 
nurses over the age of 40 years. The recommendations cover four main areas: data; pension options 
and  retirement  decisions;  working  arrangements  and  the  work  environment;  and  good  practice 
occupational health, safety and well-being. The audit of existing evidence found that if older workers 
are in good health and their ‘job fit’ is right, they can work as productively as their younger counterparts. 
This highlighted the importance of fully implementing sector guidelines on health and well-being at work 
to ensure that a longer working life does not adversely affect an employee’s health or ability to work 
effectively  and  safely.  Specific  recommendations  were  made  with  regard  to  developing  and 
implementing  a  risk  assessment  framework,  in  order  to  assist  organisations  in  addressing  the 
cumulative impact of working for longer. For employers, this means supporting staff with health, safety 
and well-being issues throughout their working lives to enable them to work longer. 

  Family carers 

With an ageing working population and an increase in the retirement age, more workers are likely to 
have the responsibility of caring for sick relatives. Measures for the reconciliation of work and family life 
are increasingly recognised as being important in the context of the EU 2020 Employment Strategy and 
as a driver for gender equality. Currently, 80 % of the time spent caring for people with disabilities and 
older people is provided by informal carers, and the highest proportion of this care is provided by women 
of 50 years or older. There is evidence that older men are more likely to be carers for, for example, a 
sick spouse or elderly parent, than younger men. However, current strategies aimed at carers focus on 
young women with childcare needs. 

Preconceptions regarding who may be affected by care duties should be avoided in order to develop 
appropriate reconciliation policies and practices, which are essential for promoting the employment of 
both older women and older men. Flexible working schemes and part-time policies, as have already 
been implemented for young parents, should also be considered, in order to prevent older carers, and 
especially older female workers, from exiting the workforce. As well as employment policies that allow 
the reconciliation of work and care by employees, an ageing population in Europe requires additional 
resources for the care of older and disabled people and services to promote independent living as part 
of an integrated strategy. 

  Mainstreaming diversity in national occupational safety and health strategies 

Labour  inspectorates  need  to  be  able  to  support  the  process  of  incorporating  age  and  gender 
considerations  into  sustainable  workplace  strategies  without  causing  discrimination.  To  do  this 
systematically,  diversity  should  be  mainstreamed  into  the  strategies  and  activities  of  labour 
inspectorates. One example of how to achieve this is provided by the diversity mainstreaming strategy 
implemented  by  the  Austrian  labour  inspectorate,  the  outputs  of  which  include  a  range  of  gender 
mainstreaming tools, and training and diversity checklists for inspectors to use in companies. Another 
example  is  the  research  and  advice  for  employers  on  different  areas  of  diversity  carried  out  and 
provided by the United Kingdom Health and Safety Executive. (EU-OSHA, 2014). 

1 http://www.nhsemployers.org/wlr 

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Women and the ageing workforce – Implications for OSH  

An example of an intervention in a workplace in which women predominate is given by a kindergarten 
in  Denmark,  which  introduced  a  range  of  sustainable  work  adjustments  to  retain  staff  affected  by 
repetitive movements and lifting. These adjustments specifically addressed the fact that workers had 
to  bend  frequently  and  that  the  available  furniture  was  only  apt  for  children  and  was  not  height-
adjustable. Working time adjustments, external help with lifting, and advice on working methods and 
the prevention of MSDs were facilitated through trade union and worker involvement and access to a 
municipal  health  promotion  programme,  which  included  training  for  the  kindergarten  director.  (EU-
OSHA, 2016c). 

Gaps in knowledge 

More  research  is  needed  on  the  intersection  between  age  and  gender  in  relation  to  OSH  and 
sustainable work. The following general knowledge gaps have been identified during the review: 

  Further  work  is  needed  to  improve  the  collection  of  data  on  hazards  to  which  women  are 
exposed, rather than making assumptions about work tasks and job roles, or correcting for sex 
and gender, in research studies. 

  Because of horizontal segregation in certain sectors, such as cleaning and health care, women 
can be exposed to multiple hazards; further research is needed to examine this in relation to 
age and extending the working life. 

  Further research is needed to understand why women report poorer mental health outcomes 

than men exposed to the same psychosocial risks. 

  Further  research  is  needed  to  strengthen  our  understanding  of  the  impact  of  women’s  dual 
roles of paid and domestic work on their health, especially in the context of extending working 
lives.  

  Studies need to include older women workers from different ethnic groups.  

More specific research gaps have also been identified: 

  Our understanding of the possible impact of the menopause on a woman’s working life is still 
limited  and  this  is  an  area  for  which  further  research  is  needed,  in  order  to  identify  support 
strategies for the workplace. 

  Further research is needed on the links between night work and breast cancer in women to 
increase our understanding of the potential cause mechanisms and to improve risk prevention 
strategies. 

  Further research is needed on working with painful and fatiguing conditions. 

Overall  conclusions:  taking  account  of  gender  issues  in  the  occupational  safety  and  health 
aspects of sustainable work 

In the future, it will be important to create sustainable working patterns for older workers, with a specific 
focus on older female workers, through measures that address workloads, work tasks, flexible working 
hours, the work–life balance, support in the workplace for specific gender-related health issues, and 
workforce development. Strong policy frameworks, investment and resources are crucial for supporting 
actions, at strategic and practical levels, on the complex intersection between age and gender. This 
requires consistent, coordinated actions in order to address age, gender and OSH actions related to 
risk management, the adaptation of work, and the balance of work and care responsibilities across the 
life course. In addition, more research is needed on the intersection of age and gender in relation to 
OSH and sustainable work, and more practical support for the workplace is also needed. Older female 
workers  are  a  valuable  asset  to  organisations.  It  is  important  to  counter  stereotyped  views  of  their 
abilities  and  avoid  the  double  discrimination  that  older  women  may  face  in  the  workplace.  The  key 
findings are summarised below: 

  Sex- and gender-related differences in working conditions persist throughout the working life: 
Sex- and gender-related differences between men and women influence the health issues they 
may  face,  what  jobs  they  do,  their  conditions  of  work  and  the  occupational  risks  they  face 
throughout their working lives. Therefore, a gender-specific approach is needed for sustainable 

10 

 
Women and the ageing workforce – Implications for OSH  

work strategies, and policy plans should be assessed for any possible gender-specific impacts. 

  The  cumulative  physical  and  emotional 

impacts  of  women’s  work  should  not  be 
underestimated:  Sustainable  work  strategies  need  to  focus  on  the  cumulative  impact  of  the 
exposures  women  face  throughout  their  working  lives  (a  life-course  approach)  in  particular 
sectors and jobs, including in relation to repetitive and monotonous work, prolonged standing 
and sitting, stress and emotionally demanding work, and paced and shift work. 

 

In  the  workplace,  support  for  risk  assessments  of  the  cumulative  exposure  to  hazards  that 
incorporate  the  complexities  of  age  and  gender  is  needed:  The  assessment  of  cumulative 
exposures should take into account differences related to both gender and age; for example, 
older  men  and  older  women  or  older  and  younger  women  should  be  considered  within  one 
occupation/sector. 

  Segregation  into  low-level  jobs  without  career  promotion  can  lead  to  long-term  exposure  to 
hazards:  Attention  needs  to  be  paid  to  women’s  career  development,  to  avoid  them  being 
trapped in low-level jobs resulting in long-term exposure to the same hazards. 

  The barriers to equal access to rehabilitation and vocational training need to be tackled: Women 
of  all  ages  need  equal  access  to  appropriate/adapted  rehabilitation  programmes,  and 
vocational  retraining  should  be  adapted/relevant  to  the  sectors  and  jobs  they  are  usually 
employed in. Non-recognition of the work relatedness of some health problems, and child and 
other care obligations, can be barriers to access. 

  Simple  non-stigmatising  workplace  measures  can  support  women  going  through  the 
menopause: Understanding and support for female workers during the menopause are needed; 
such  support  could  be  as  simple  as  providing  access  to  drinking  water.  More  research  and 
practical, non-stigmatising advice for the workplace in this taboo area is needed. 

  Workplace  health  promotion  strategies  need  different  approaches  for  male  and  female 

audiences. 

  Flexible work measures need to be relevant to carers of older relatives and to both men and 
women: The workplace approach to family carers needs to be adjusted away from the current 
model  that  focuses  on  women  who  care  for  children,  so  that  it  is  relevant  to  both  male  and 
female carers of older relatives. 

  Labour inspectorates need diversity strategies, and examples of such strategies exist: Labour 
inspectorates need to adopt diversity strategies in order to routinely incorporate age and gender 
issues into their work, avoid discrimination in their practices and be able to support workplaces 
effectively. 

  More  research  on  the  age/gender  intersection  is  needed:  More  research  is  needed  on  the 
intersection between gender and age in relation to OSH and sustainable work, combined with 
more practical support for the workplace. 

  Older female workers should be viewed as a valuable asset and the double discrimination that 
older  female  workers  may  face  should  be  addressed  through  awareness  raising:  Simple 
measures can often be taken in the workplace to allow women with declining health or abilities 
to continue working. Measures to reduce work demands will often benefit all workers. 

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Women and the ageing workforce – Implications for OSH  

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Women and the ageing workforce – Implications for OSH  

Introduction 

1 
1.1  The project ‘Safer and Healthier Work at Any Age’ 
This review belongs to a series of activities that have been carried out as part of a larger project of the 
European  Agency for  Safety  and Health  at Work (EU-OSHA),  initiated by  the  European  Parliament. 
The  project,  called  ‘Safer  and  Healthier  Work  at  Any  Age’,  aims  to  enhance  the  implementation  of 
existing recommendations, facilitate the exchange of best practices and encourage further investigation 
of possible  ways of improving occupational safety  and health (OSH) to  improve the sustainability  of 
work across the life course, in the context of the ageing workforce. 

The project supports the objectives of the EU Strategic Framework on Health and Safety at Work 2014-
2020 to address the ageing of the workforce, emerging risks and the prevention of work-related and 
occupational  diseases  (EC,  2014).  The  Framework  states  that  risks  affecting  particular  age  groups, 
workers  with  disabilities  and  women  deserve  particular  attention  and  require  targeted  action.  It  also 
emphasises  that  OSH  policy  can  contribute  to  promoting  equal  opportunities.  It  includes  a  specific 
action to promote the identification and exchange of good practice on ways to improve OSH conditions 
for  specific  categories  of  workers,  e.g.  older  workers,  inexperienced  younger  workers,  workers  with 
disabilities and women. 

One of the objectives of the project was to prepare a review of the implications for occupational safety 
and health of the ageing workforce (EU-OSHA, 2016a) looking at the key issues in relation to OSH and 
sustainable work in the context of an ageing workforce. This general review, the conclusions of which 
are given in Appendix A, is complemented by the present review, which examines a selection of issues 
in relation to gender, women, OSH and sustainable work in the context of the ageing workforce. 

1.2  Background: why be concerned about age and gender? 

The  number  of  women  participating  in  the  labour  market  has  increased  in  recent  decades.  The 
proportion  of  women  between  the  ages  of  20  and  64  years  who  are  employed  has  increased  from 
59.4 % in 2004 to 63.5 % in 2014 in the EU-28 (Eurostat, 2015a). In addition, the workforce is ageing. 
The employment rate of both men and women between the ages of 55 to 64 years has increased across 
the EU, from 38.4 % in 2002 to 51.8 % in 2014. When this is broken down by sex, the participation in 
work of women in this age group has increased more than that of men. Women’s participation in work 
increased from 29.1 % in 2002 to 45.2 % in 2014 (i.e. an increase of 16 percentage points), while men’s 
participation  in  work rose from 48.2 % in  2002 to 58.9 % in 2014 (i.e. an increase of a little  over 10 
percentage points) (Eurostat, 2015b). It is a target of the EU’s employment strategy (Europe 2020) to 
increase these rates further. 

At the same time, both the official and the effective ages of retirement have been increasing throughout 
Europe  for  both  men  and  women.  In  some  countries,  such  as  Greece  and  Croatia,  the  statutory 
retirement age has been set at 67 years; in other countries, such as Portugal, men and women are 
already working beyond the official retirement age (usually for financial reasons) 2. The rate of increase 
of the pensionable age for women can be steeper than that for men; for example, in some Member 
States, such as the United Kingdom, disparities in the official retirement age — with women retiring at 
an earlier age than men — have been removed. 

Increases in the pensionable age mean that men and women may be working for a longer period of 
time across their life course, which may increase their cumulative exposure to workplace hazards. It 
also means that they will work, and be exposed to workplace hazards, until an older age. Both have 
implications for the sustainability of work, and economic incentives to prolong working life are likely to 
fail  if  they  are  not  accompanied  by  measures  to  simultaneously  improve  working  conditions.  More 
broadly speaking, if work demands (physical or mental) are excessive, then early retirement may be 
used as a health-preserving measure. Changes in retirement benefits that prevent workers with limited 
economic  resources  from  retiring  may  increase  social  inequalities  in  health  (Burdof,  2015)  and  also 
gender  inequalities.  Vendramin  and  Valenduc  (2014)  also  suggest  that  women’s  more  fragmented 

2  For  more  details  on  retirement  behaviours  across  European  countries,  see  EU-OSHA  (2016b),  Analysis  report  on  EU  and 

Member States policies, strategies and programmes on population and workforce ageing 

13 

 
                                                      
Women and the ageing workforce – Implications for OSH  

careers may mean that they have to remain in work for longer (because of financial constraints and/or 
to accrue pension rights) and, consequently, this may mean that they are more likely to have to deal 
with work-impeding health problems. 

There  are  key  differences  between  men  and  women  relating  to  their  participation  in  work,  first  with 
regard  to  the  type  of  sectors  that  they  work  in  (horizontal  segregation)  and  second  in  relation  to 
opportunities for career progression within a company or sector (vertical segregation). There are also 
differences in relation to the type of employment contracts of men and women (e.g. part-time, temporary 
work, etc.). 

1.2.1  Why  review  the  gender  dimension  regarding  OSH,  sustainable 

work and the ageing workforce? 

The biological differences between men and women are often described as sex differences; for example, 
it is only women who go through the menopause, pregnancy and childbirth. Gender, on the other hand, 
refers to the socially constructed characteristics of men and women that are learned, that vary between 
different cultures and that can be changed; for example, it can be either working men or working women 
that  help  to  look  after  grandchildren  and  elderly  parents  (EU-OSHA,  2003a).  Gender  sensitivity  is 
defined as ‘the ability to perceive existing gender differences, issues and inequalities and incorporate 
these into strategies and actions’ (EU-OSHA, 2003a). 

One  of  the  conclusions  from  EU-OSHA’s  general  research  review  on  ageing  and  OSH  (EU-OSHA, 
2016a) was that, as with all areas of OSH policy, gender issues should be taken into account in relation 
to sustainable work. 

It is important to discuss how gender and age interact in relation to OSH and sustainable work in order 
to  inform  policy,  debate  and  future  research  on  sustainable  work.  Age  management  to  handle 
demographic  change  is  crucial  for  the  implementation  of  the  objectives  on  increasing  women’s 
employment rates  in the context of the  Europe  2020 strategy. However,  different measures may be 
required to maintain and improve the OSH of older female workers. Women generally, and older women 
specifically, are exposed to a number of different workplace safety and health issues, and experience 
the impacts of their dual role at work and in the home and of physiological changes with age. Therefore, 
a  gender  dimension  is  important  in,  for  example,  addressing  measures  to  balance  work  and  care 
responsibilities  for  older  workers,  addressing  the  impact  of  physical  work  on  women,  such  as 
musculoskeletal  disorders  (MSDs),  and  addressing  the  impact  of  stress  and  burnout  resulting  from 
emotionally demanding work carried out by women. 

The gender segregation described above is a persistent feature of European labour markets (Eurofound, 
2015a) and persists across working life. Gender segregation affects the hazards that women and men 
are exposed to across their working lives, in other words, it has an impact on their cumulative exposure 
to certain working conditions and hazards across their working lives. There can also be the perception 
that  women  are  engaged  in  ‘light  work’,  which  may  lead  to  the  erroneous  conclusion  that  the 
sustainability of work is less of an issue for older women than for older men. This reinforces the need 
to consider the gender dimension in OSH and age management. 

While a number of workplaces have put in place good practices to ensure that their older female workers 
can, and are willing to, remain in work for longer, the potential hazards and risks that the ageing female 
workforce is facing, and the related support needs, need to be more fully considered in policies and 
legislation related to OSH in the context of an ageing workforce. Despite a growing body of work looking 
at the domains of gender and age issues in the workplace separately, there has been limited research 
to date on the intersection of gender and age in relation to OSH issues and sustainable workplaces. 
Nevertheless, relevant information is available from previous studies on gender by EU-OSHA and the 
European Foundation for the Improvement of Living and Working Conditions (Eurofound). In a report 
on gender and OSH, EU-OSHA (2003a) concluded that older workers are not a homogeneous group 
and gender differences do exist (in OSH); that there is little specific literature on the health at work of 
older women as a group; and that policies on the ageing workforce should take account of gender. 

14 

 
 
 
Women and the ageing workforce – Implications for OSH  

1.3  Scope of the review 

This report gives an overview of some of the key issues on gender, women, OSH and sustainable work 
that have been highlighted in previous studies by EU-OSHA and Eurofound. It also takes account of 
some of the themes from the general review on OSH and the ageing workforce (EU-OSHA, 2016a) and 
considers  them  further  from  a  gender  perspective.  For  each  topic,  the  possible  issues  and  risk 
prevention measures are considered. To supplement the previous studies of EU-OSHA and Eurofound, 
the results of a literature search were also used. The methodology for the search protocol and screening 
process used for the  literature search are given in  Appendix B. In  addition, the results of a seminar 
organised by EU-OSHA on the topic of OSH and the ageing workforce (EU-OSHA, 2015) have served 
as an input to this review, in particular regarding the discussion that took place on possible policies and 
practices. 

This  report  looks  at  gender  issues  in  relation  to  OSH  and  sustainable  work  across  the  life  course. 
Eurofound (2012) defined a sustainable work system as a system in which the criteria of biocompatibility 
(whereby  work  is  adapted  to  the  functional  properties  of  the  human),  ergo-compatibility  (whereby 
efficient work strategies have been developed) and socio-compatibility (involving self-fulfilment in social 
and family life and controlling one’s life course) are reached. 

The  review  recognises  that  considering  workers  only  in  terms  of  their  chronological  age  is  overly 
simplistic, as there are significant differences between individuals in the rate and nature of the ageing 
process. A ‘life-course’ approach to OSH examines OSH risks and controls across the entire workforce, 
whatever their age, thereby accommodating individual differences while ensuring an appropriate level 
of  protection  for  all.  Adopting  a  life-course  approach  improves  risk  prevention  for  all  workers  and 
reduces  the  damage  to  workers’  health,  while  limiting  early  exit  from  work  and  improving  the 
sustainability of  work in jobs that have  high physical demands. This is key to  promoting sustainable 
work and thus to achieving longer working life and healthy retirement. 

Features of such an approach include: 

  being aware that changes made to reduce risks for older workers (e.g. by excluding them from 
the more demanding aspects of jobs) might increase the risks for the other (younger) workers 
who have to take these tasks on instead; 
recognising that, given the cumulative nature of many injuries (e.g. some MSDs), reducing the 
incidence of these injuries among older workers entails reducing exposures to risk factors, such 
as excessively heavy manual work, for younger workers. 

 

The topics covered in this review include age-related changes such as the menopause, the effect of 
gender differences in employment across the work-life course, some specific hazards and risks, some 
female-dominated  work  sectors,  rehabilitation,  risk  assessment,  workplace  health  promotion  and 
gender, age and OSH in risk prevention practices and OSH strategies. 

This  is  not  a  comprehensive  review  and  some  other  relevant  aspects,  such  as  pre-existing  chronic 
disease and health disparities related to economic and social factors, are not covered, although they 
are recognised as being an important part of the equation. The general review (EU-OSHA, 2016a) does 
present  models  that  show  the  interaction  of  factors  inside  and  outside  the  workplace  and  how  this 
affects work ability and hence the sustainability of work. These models show that public health, socio-
economic  and  education  policies  can  all  have  an  impact  on  workers’  health  and  ability  to  work. 
Furthermore,  there  is  increasing  evidence  that  work  plays  a  key  role  in  socio-economic  health 
inequalities  (Burdof,  2015);  for  example,  the  unequal  burden  of  exposure  to  hazardous  substances 
across occupations is an important factor contributing to health inequalities in society (Montano, 2014). 
More  in-depth  analysis  of  the  range  of  issues  affecting  women’s  occupational  health  and  that  are 
therefore of relevance to the sustainability of women’s work can be found in EU-OSHA (2003a, 2013a, 
2014).  

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Women and the ageing workforce – Implications for OSH  

2  Sex and gender differences in age-related changes 

Key findings 

  Women  live  longer  than  men  but  are  also  more  likely  to  live  longer  with  a  chronic  health 

condition or a disability. 

  There are a number of physiological and cognitive changes associated with ageing that are 
influenced by sex (i.e. biological) and gender (i.e. socially constructed) differences and that 
can have an impact on the work ability of older women. 

  The most noticeable sex-specific age-related change is the menopause, although there has 

been very little research on the influence of the menopause in working women. 

  Osteoarthritis  and  osteoporosis  are  diagnosed  more  frequently  in  women  and  are  age-
related.  Osteoporosis  increases  the  risk  of  fractures  at  the  workplace.  While  arthritis  is 
unpredictable in nature, various measures can be taken in the workplace to help those with 
this condition manage their pain and fatigue. 

  Differences  between  men  and  women  in  the  prevalence  of  chronic  conditions,  such  as 
chronic obstructive pulmonary disease, have been observed. These differences can also be 
explained by exposure to workplace hazards. 
It is important to avoid stereotypes of older workers and older women in particular. Declines 
in physical ability and health with age often do not affect work performance. Where they do, 
simple measures can often be taken in the workplace to prevent early exit from work. Such 
measures may be beneficial for both young and older workers. 

 

2.1 

Introduction 

The physiological and psychological changes associated with ageing are likely to be influenced by both 
sex  and  gender  owing  to  the  biological  differences  between  men  and  women,  and  by  the  different 
exposures to workplace hazards experienced across occupations and sectors. 

Marmot (2013) summarised data from across the EU in relation to gender differences in life expectancy 
and ‘healthy life years’ (HLY) expectancy at birth. The data presented in Figure 1 highlight that women 
generally have longer life expectancies than men across all EU Member States. However, when looking 
at life free of limiting chronic conditions, the difference between men and women is much smaller (not 
even one year). The ratio of ‘life expectancy’ to ‘HLY expectancy’ is therefore smaller for women than 
for  men,  illustrating  the  need  to  identify  the  causes  of  women’s  ill  health  in  order  to  increase  their 
potential to live free of disability or chronic conditions. 

In addition, the increasing gap between average life expectancy and average HLY expectancy between 
EU Member States and between socio-economic groups is particularly problematic. Occupational class 
and educational level play important roles in determining health outcomes (Marmot, 2013; Burdof, 2015), 
and  social  disparities  in  health  are  increasing  in  several  European  countries.  This  means  that 
workplaces have to adapt to increasing heterogeneity in health problems. The problem of obesity is one 
way to illustrate this: the overall prevalence of obesity is the same in men in women, but is higher and 
increasing in women with low educational levels. 

16 

 
 
Women and the ageing workforce – Implications for OSH  

Figure 1: Gender differences in life expectancy and HLY expectancy at birth in EU Member States in 2010 
(Marmot, 2013) 

2.2  Specific physiological changes in working women 

While there are a number of physiological and cognitive changes that have the potential to affect work 
and OSH for all ageing individuals (as described in the general review of OSH issues and the ageing 
workforce (EU-OSHA, 2016a)) the following section identifies physical and cognitive changes that have 
the potential to affect ageing female workers specifically. Most of these changes, with the exception of 
the menopause, also occur to ageing men but, for either biological or social reasons, they  have the 
potential  to  have  a  greater  impact  on  female  workers.  It  is  important  to  recall  that  ageing  is  a  very 
individual  process  and  that  the  differences  between  people  of  the  same  age,  at  any  age,  are  often 
greater than those between different age groups. Likewise, the differences between individual women 
can be greater than the differences between men and women. 

The  following  section  looks  at  differences  between  men  and  women  in  the  prevalence  of  chronic 
obstructive  pulmonary  disease  (COPD),  stroke,  asthma,  and  osteoarthritis  and  osteoporosis.  The 
influence of the menopause on older working women is discussed in greater detail in section 4. 

Differences between men and women in the prevalence of chronic conditions have been observed, for 
instance in relation to COPD, where there has been a large increase in the number of women being 
diagnosed (Aryal et al. 2014). Prevalence rates of clinically determined COPD increased in women from 

17 

 
 
Women and the ageing workforce – Implications for OSH  

50.8 to 59.2 per 1,000 between 1998 and 2009, whereas rates for men decreased from 108.1 to 74.3 
per 1,000 during the same period. It is hypothesised that this is the result of changes in the work roles 
that women are now taking on (previously male roles) and other risk factors, including women being 
more susceptible to tobacco smoking and developing symptoms earlier with shorter exposure duration, 
and asthmatic women being more susceptible to COPD than asthmatic men. In addition, the under-
diagnosis  of COPD in  women means that the actual figures may be higher and that not all  affected 
women have access to treatment. 

Sex-related  differences  in  health  outcomes  were  identified  by  Toivanen  (2012)  in  her  review  of  the 
social  determinants  of  stroke.  The  review  examined  eight  papers  in  relation  to  stress  within  the 
demands–control model and with stroke as an outcome. A positive association was found between high 
demands, low control and high strain in a job and the incidence of stroke for both men and women. 
However, in a further analysis of four papers that considered sex differences, stress (and specifically 
low levels of control of the job) was found to be a stronger predictor of stroke in women. This review 
was  limited  by  its  non-systematic  nature  and  its  lack  of  meta-analysis.  However,  it  does  show  that 
psychosocial risks may have differing effects on men and women. 

Differences  between  men  and  women  have  also  been  found  in  relation  to  adult-onset  asthma,  with 
women appearing to be more susceptible. Melgert et al. (2007) suggest that there are biological sex 
differences  in  relation  to  adult-onset  asthma,  which  may  be  due  to  genetic  differences,  pulmonary 
differences and immunological influences. The influence of exposure to substances in the workplace 
cannot be ruled out owing to the nature of the work in which women dominate (see Table 3 in section 
3 for examples of chemical exposures prevalent in work dominated by women), and also when women 
are more exposed than men doing the same work because of ill-fitting personal protective equipment 
(PPE) or being closer to the source due to height differences (see Kennedy and Koehoorn, 2003). 

Osteoarthritis and osteoporosis are also diagnosed more frequently in women. Woolf and Pfleger (2003) 
reported  that  9.6 %  of  men  and  18 %  of  women  over  60  years  were  affected  by  osteoarthritis.  Sex 
differences in the prevalence of osteoporosis have also been identified,  with a  prevalence of 5 % of 
women at 50 years and 50 % of women at 85 years, compared with prevalences in men of 2.4 % and 
20 %, respectively. In addition, the increased occurrence of osteoporosis can also lead to an increased 
risk of fractures in older women and potentially in older female workers. The pain, stiffness and tiredness 
that arthritis can cause can all vary in a single day or over a period of months. The uniqueness of each 
person’s experience and the unpredictable nature of the condition can make it seem difficult to manage 
at work. Nevertheless, employers can support employees to find ways of working to manage their pain 
and tiredness; for example, accommodations can be made by allowing flexibility in working hours or in 
how they carry out work tasks, making changes to office chairs, equipment or technology to make tasks 
easier, or swapping certain tasks with other colleagues3. More research is needed into working with 
painful and tiring conditions such as arthritis. 

Doyal  and  Payne  (2006)  pointed  out  that  factors  other  than  age,  such  as  income,  physical  and 
psychological status, domestic circumstances, working conditions, class and ethnicity can dramatically 
vary the effect that a woman’s health can have on her employment performance. 

There  has  been  very  little  research  on  the  influence  of  the  menopause  in  working  women.  The 
menopause is part of the natural process of ageing for women, and is defined as the point at which 
menstruation has ceased for 12 consecutive months. Symptoms and their severity and the experience 
of the menopause vary greatly between women. It may therefore affect women in different ways at the 
workplace. The menopause and work are discussed in more detail in section 4. 

As mentioned above and  discussed  in the general research review (EU-OSHA, 2014a), ageing is  a 
very individual process and it is therefore important to avoid stereotypes concerning older workers, and 
older women in particular, and their work ability. For example, physical strength and endurance are very 
specific to individuals, such that some older workers may be stronger than their younger colleagues. 
Likewise, the differences in physical ability between individual women can often be greater than those 
between men and women. 

3  Based  on  advice  from  Arthritis  Research  UK  (http://www.arthritisresearchuk.org/arthritis-information/arthritis-and-daily-

life/work-and-arthritis.aspx, retrieved 10th May 2016). 

18 

                                                      
Women and the ageing workforce – Implications for OSH  

Declines in physical ability and health with age in women and men often do not affect work performance. 
Many chronic diseases are controllable. Older workers also use their experience to adapt their ways of 
working. Simple measures can often be taken in the workplace to prevent early exit from work, such as 
equipment changes, changes in the way tasks are performed, adjustment to working hours or transfer 
to alternative work if necessary (Yeomans, 2011). Simple ergonomic measures to reduce workloads, 
for example lifting aids, have a positive impact on both young and older workers, the only difference 
being that, whereas these measures facilitate work for younger workers, they often make work possible 
again for older workers. 

19 

 
Women and the ageing workforce – Implications for OSH  

3  Gender  segregation  in  the  labour  market,  OSH  and 

sustainable work 

Key findings 

  Horizontal and vertical segregations in the labour market expose women and men to different 

hazards. This will have an impact on their health across the work-life course. 

  Gender differences persist across the life course both in and outside work. 
  Horizontal  segregation  results  in  exposure  to  different  occupational  hazards  for  men  and 
women  across  the  life  course:  women  are  over-represented  in  health  and  social  work, 
education  and  other  service  activities,  whereas  men  work  predominantly  in  construction, 
transport and agriculture. 

  Vertical segregation  leads to a concentration of  women in  jobs lower down the  hierarchy. 
This can lead to prolonged exposure to certain workplace hazards, such as repetitive work 
and awkward postures, because of a lack of career mobility. 

  Part-time work is dominated by women and can limit their access to support services, such 

as OSH and human resources management. 

  Older women’s role in unpaid care work, in  addition to paid work, increases their working 
day, with the potential for stress and fatigue, especially where there is a poor fit between job 
and care responsibilities. 

  Strategies for sustainable work should address sectors in which women predominate. The 
physical and emotional demands of some women’s work should not be underestimated. 

3.1 

Introduction 

How men and women participate in European labour markets and the work that they do vary greatly. 
The differences at work occur across many dimensions, including occupation and sector, contract type, 
pay  and  working  time.  These  differences  are  a  persistent  feature  of  European  labour  markets 
(Eurofound, 2015a) and persists across working life. 

Horizontal or occupational segregation refers to the fact that men and women tend to work in different 
economic  sectors  (EU-OSHA,  2013a).  An  example  of  horizontal  segregation  can  be  found  in 
construction,  where  men  make  up  the  majority  of  the  industry’s  workforce,  whereas  the  sector  of 
childcare is very female-dominated. Vertical, or hierarchical, segregation in the workforce describes the 
issue of segregation within the same sector in relation to position, status and/or hierarchy, with women 
typically concentrated lower down the hierarchy, regardless of sector. Differences in the participation of 
men and women in work also varies in terms of type of employment contract and working time (e.g. 
part-time work, temporary work, etc.). There remains an important gap between the genders regarding 
hours of unpaid work in the home, including caring for children and other dependants. These differences 
affect men’s and women’s experiences of work across their working lives. They will have an impact on 
the sustainability of their work and the measures required to achieve sustainable work for both men and 
women. 

3.2  Horizontal segregation 

Eurofound  (2013)  reported  that  60 %  of  women  and  64 %  of  men  work  in  occupations  where  the 
majority of employees are the same gender. More women work in healthcare (77 % of the workforce), 
education  (67 %)  and  the  care  sector,  whereas  men  work  predominantly  in  construction  (91 %), 
transport (80 %) and agriculture (65 %) (EU-OSHA, 2013a; Eurofound, 2013). 

A  further  breakdown  of  employment  data  identifies  sectoral  differences  in  employment  patterns  for 
women over 50 years (Eurofound, 2012). These include greater numbers of older women employed in 
education,  healthcare  and  social  work,  as  well  as  in  non-profit  services,  associations  or  personal 
services (Table 1). 

European Agency for Safety and Health at Work — EU-OSHA 

20 

 
 
 
Women and the ageing workforce – Implications for OSH 

Table  1:  Employment  (%)  by  age  group  and  by  gender  for  workers  aged  50+,  according  to  sector 
(Eurofound, 2012) 

This is confirmed by Vendramin and Valenduc (2014), who examined patterns of employment in the 
age group 55 to 64  years. Across the EU in 2013, those aged 55 to 64 years made up 26 % of the 
employed population, with no significant difference between the proportion of men and women in this 
age  group.  The  government  service,  education,  health  and  social  work  sectors  employed  a  higher 
proportion of older workers than average, with more women of 55 to 64 years employed in these sectors 
than men in the same age group. These are working environments with specific hazards, which are 
discussed later in this report. 

3.3  Vertical segregation 

Vertical or hierarchical gender segregation in employment leads to a concentration of women in jobs 
lower down the hierarchy due to a lack of promotion opportunities and career mobility. Although it is 
reported that there are more female workers in certain sectors, such as healthcare and food production, 
men nevertheless are more likely to work in supervisory, management and technical roles within these 
sectors (EU-OSHA, 2013a). Additional findings report that, in 2010, 69 % of employees had a male as 
their immediate supervisor and more than 70 % of corporate managers and senior government officials 
were men (EU-OSHA, 2013a). 

Table  2  shows  differences  in  the  occupational  categories  of men  and  women  over  the  age  of  50.  It 
highlights that fewer women aged 50 and over hold management positions than men of the same age 
group, and that there are more women work in clerical support, service and sales positions, and in low-
skilled  jobs  such  as  elementary  occupations  (Eurofound,  2012).  Vendramin  and  Valenduc  (2014) 
reported  similar  findings,  with  more  than  half  of  women  over  the  age  of  55  years  employed  in 
administrative  occupations,  as  domestic  cleaners  and  helpers,  in  education  and  as  associate 
professionals (not health). 

European Agency for Safety and Health at Work — EU-OSHA 

21 

 
 
 
Women and the ageing workforce – Implications for OSH 

Table  2:  Employment  (%)  by  age  group  and  by  gender  for  workers  aged  50+,  according  to  occupation 
(Eurofound, 2012) 

There is evidence of higher levels of exposure to repetitive work in female workers (Doyal and Payne 
2006;  EU-OSHA,  2013a),  some  of  which  can  be  explained  by  vertical  segregation  and  women 
remaining in more highly exposed jobs. Thus, while the risks for men in the workplace may be more 
visible  from  a  risk  prevention  perspective  (e.g.  carrying  heavy  loads),  women  may  be  exposed  to  a 
greater  risk  of musculoskeletal  injury  through  postural  stress  or  repetitive  tasks  (EU-OSHA,  2013a). 
Vertical segregation can be a source of double discrimination for older women, as it can lead to a lack 
of career mobility or promotion opportunities, resulting in prolonged exposure to repetitive work or work 
involving postural constraints. 

EU-OSHA (2013a) also suggested the concept of task segregation, where women and men have the 
same job title but carry out different tasks, leading to different types and levels of exposure. A common 
misconception is that women’s work is less physically demanding than men’s work. Examples of this 
include hospital cleaners, where female workers carry out seemingly ‘lighter’ tasks and men seemingly 
‘heavier’  tasks.  However,  by  analysing  the  tasks,  studies  have  found  that  the  physical  workload  for 
women is actually higher, is more repetitive and has more postural constraints (EU-OSHA, 2013a). 

Another consequence of vertical segregation is differences in income levels between men and women. 
When income indicators are examined in female-dominated sectors, such as cleaning, sales and care 
work, it is found that women are at a higher risk of being in the lowest third of income than men in the 
same  sector.  Eurofound  (2013)  suggested  that  this  indicates  an  undervaluing  of  women’s  work 
compared with that of men. 

3.4  Hazards  and  risks  in  female-dominated  occupations  and 

sustainable work 

Because  men  and  women  have  different  job  roles  in  different  sectors  and  industries,  and  these 
differences persist across the work-life course, they are exposed to different working conditions and as 
such different OSH hazards across the work-life course. Consequently, they are likely to suffer from 
different work-related health problems. It should be noted that very little research exists on the specific 
impacts of age-related changes in women on occupational exposures and related health issues. 

Table 3 shows examples of hazards and risks found in female-dominated occupations. 

European Agency for Safety and Health at Work — EU-OSHA 

22 

 
 
 
 
 
Women and the ageing workforce – Implications for OSH 

Table 3: Examples of hazards and risks found in female-dominated occupations (EU-OSHA, 2013a) 

Exposures 

Sector 

Biological 

Physical 

Healthcare 

Infectious diseases 
(blood-borne, 
respiratory, etc.) 
Needlestick injuries 

Manual/patient 
handling 
Awkward postures 
Ionising radiation 

Nursery workers 

Infectious diseases, 
particularly 
respiratory 
Gastrointestinal 
infections 

Cleaning 

Food production 

Infectious diseases 
(e.g. animal-borne 
and mould spores) 
Organic dust 

Catering and 
restaurant work 

Infectious diseases 
(e.g. animal-borne 
and mould spores) 

Textiles and 
clothing  

Organic dusts 

Laundries 

Infected linen 
(hospitals) 

Call centres 

Education 

Infectious diseases 
from contact with 
children 

Manual/child 
handling 
Awkward postures 
Noise 

Manual handling 
Awkward postures 
Slips and falls 
Wet hands (causing 
dermatitis) 
Repetitive 
movement 
Sharp objects 
Cold temperature 
Noise 
Noise 
Manual handling 
Repetitive 
movement 
Sharp objects 
Hot surfaces 
Slips and falls 
Heat 

Noise 
Repetitive 
movement 
Awkward postures 

Manual handling 
Awkward postures 
Heat 

Overuse of voice 
due to talking loudly 
or poor acoustic 
environment 
Awkward postures 
Excessive sitting 

Prolonged standing 
Overuse of voice 
due to talking loudly 
or poor acoustic 
environment 

Chemical 
Cleaning, 
sterilising and 
disinfecting 
agents 
Drugs 
Anaesthetic 
gases 

Psychosocial 

Emotionally 
demanding work 
Unsocial hours 
Violence from third 
parties 
(patients/colleagues) 

Emotionally 
demanding work 

Cleaning and 
disinfecting 
agents 

Unsocial hours 
Violence/harassment  

Pesticide 
residues 
Sterilising agents 
Sensitising 
additives 

Monotony 
Low level of control 
in assembly line 
work 

Passive smoking 
Cleaning agents 
Cooking fumes 

Dyes and other 
chemicals, 
including 
formaldehyde 
Stain removal 
solvents 
Dusts 

Dry-cleaning 
solvents 

Poor indoor air 
quality 

Poor indoor air 
quality 

Violence and 
harassment from 
third parties 
(clients/colleagues) 
Unsocial hours 
Low level of control 

Monotony 
Low level of control 
in assembly line 
work 

Violence (verbal 
abuse) from third 
parties (clients) 
Monotony 
Low level of control 
over pace and 
content of work 
Emotionally 
demanding work 
Violence and abuse 
from third parties 
(students/parents) 

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Women and the ageing workforce – Implications for OSH 

The types of hazards and risks that predominate in this table include highly repetitive and paced work, 
awkward postures, manual handling, violence or harassment, and stress and emotionally demanding 
work.  These,  together  with  shift  work  (prevalent,  for  example,  in  healthcare  work),  are  all  issues 
affecting retention  and the  quality  of  working  life  in many  areas in  which  women  work. In  particular, 
prolonged,  cumulative  exposure  to  such  working  conditions  is  likely  to  have  implications  for  the 
sustainability of work. It is therefore important not to underestimate the physical and emotional demands 
of some women’s work in relation to sustainable work. For example, Yeomans (2011) and Doyal and 
Payne (2006) point out that the type of work that women tend to be employed in, including cleaning, 
factory  work,  retail  work  and  hairdressing,  is  often  seen  as  light  manual  work,  although  it  is  usually 
physically  demanding,  as  tasks  can  involve  moving  heavy  loads,  sustained  static  muscular  effort, 
working in awkward  postures and short-cycle repetitive movements. The same point  is made by  EP 
(2011). As noted above, a  lack of career mobility or promotion opportunities can result  in  prolonged 
exposure to work hazards whose health effects can be cumulative in nature. A lack of control over work 
— which is also prevalent in Table 3 and is related to employment in lower positions in the job hierarchy 
— is a factor linked to stress. 

The  physical  demands  of  the  types  of  manual  work  carried  out  by  women,  referred  to  by  Yeomans 
(2011) and Doyal and Payne (2006) above and given in Table 3, need to be recognised, and suitable 
accommodations may need to be provided for older workers. Any such accommodations or redesign of 
the  workplace  need  to  be  suitable  for  female  workers,  rather  than  designed  to  accommodate  only 
average male employees, to avoid increasing risks of MSDs in women (Yeomans, 2011). However, as 
pointed out in the general review (EU-OSHA, 2014a), the first priority is to introduce measures to reduce 
risks to all workers along the work-life course. 

Therefore, as with other areas of OSH, strategies for sustainable work should address those sectors 
and jobs in which women predominate, such as healthcare, education, cleaning and retail work, as well 
as male-dominated sectors, such as construction. This is also important in the context of desk-based 
work, where women lower down the job hierarchy may have less control over how they work, the variety 
in their work, the pace of work, the breaks they take, etc. 

Results from the European Working Conditions Survey (EWCS) also point to the need to address the 
sustainability of women’s work. Eurofound (2012) asked workers in Europe about their ability to continue 
to  work  up  to  the  age  of  60,  as  an  indicator  of  job  sustainability.  Figure  2  shows  that,  for  most 
occupational groups, the proportion of women who do not think they will be able to do the same job at 
the age of 60 is higher than the proportion of men. 

Figure 2: Percentage of workers aged 50-54 years who do not think they will be able to do the same job at 
the age of 60 (Eurofound, 2012) 

For both genders, mid-skilled manual workers and low-skilled workers are least likely to think that they 
could continue working. The gender difference in the replies is most pronounced for these two groups 

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Women and the ageing workforce – Implications for OSH 

and for professionals and managers. For low-skilled female workers, Eurofound identified a number of 
work-related  issues  that  can  have  a  negative  impact  on  job  sustainability,  including  exposure  to 
awkward and painful positions and poor career prospects. For high-skilled female workers, the question 
of  the  lack  of  reconciliation  between  work  and  non-working  time  seems  particularly  important 
(Eurofound, 2012). 

However, work sustainability also needs to be examined from a life-course perspective. Older workers 
need to  be able to make the best use of their changing abilities  without risk of injury or  illness. The 
occupational hazards and related risks that we are exposed to when we are young will influence our 
health as we get older, and may determine whether we reach retirement age as healthy workers or exit 
early with a work-related disability. Therefore, good work environments and practices are needed to 
ensure that younger workers reach later life without injury or illness, and strategies for sustainable work 
must  begin  with  improving  the  working  conditions  of  young  men  and  women  from  the  start  of  their 
working lives. It is therefore also relevant to look at gender differences in relation to the OSH of young 
workers, as these will influence gender differences in occupational health in later life. 

A report by EU-OSHA on the OSH of young workers (EU-OSHA, 2007) found that young workers work 
mainly in services sectors, in low-skilled occupations and on a temporary basis. Young female workers 
in  particular  are  more  prone  to  working  in  temporary  contracts  in  low-skilled  service  jobs.  Important 
findings from the report were that these young workers appear to be given the heaviest, noisiest, etc., 
types of work, are at a higher risk of accident and injury, and are less likely to receive OSH information 
and  training.  It  also  found  indications  that  rates  of  MSDs  are  increasing  among  young  women. 
Combined with evidence that they may experience barriers to accessing occupational health services 
and  rehabilitation  services,  these  are  worrying  findings  for  sustainable  working  life.  These  findings, 
including  the  gender  differences,  need  to  be  recognised  and  taken  account  of  in  OSH  strategy  and 
actions. Both young women and young men and the sectors in which they work should be covered in 
workplace  interventions  and  activities  by  OSH  authorities  and  other  stakeholders.  In  addition,  both 
‘female’  jobs  and  ‘male’  jobs  should  be  covered  in  vocational  education  (EU-OSHA,  2013a)  and,  in 
addition, risk education should be provided in schools (EU-OSHA, 2013b). 

Of course, horizontal segregation affects both men and women when it comes to OSH. Granville and 
Evandrou (2008, 2010) showed, for instance, that the coal and asbestos industries, which are largely 
male-dominated, have a major impact on men’s health in the United Kingdom. However, the risks to 
men’s  health  in  the  traditional  sectors  in  which  they  predominate  have  tended  to  receive  more 
recognition and attention (EU-OSHA, 2003a). 

As previously mentioned, the rise in official pension ages across the Member States can mean a longer 
working life, with continuous exposure to the same hazards where there is a lack of career mobility and 
continuing to work at an older age. Older working women are exposed to similar occupational risks to 
younger  women,  but  can  be  more  vulnerable  to  the  development  of  certain  health  problems  if  their 
health or physical capacity has declined because of the extended duration of their exposure to these 
risks. However, there is limited literature on older working women in relation to physical occupational 
hazards. 

3.5  Differences related to employment arrangements 

The type of employment in which individuals work and working arrangements have an impact on their 
exposure  to  OSH  hazards  and  risks  and  their  access  to  OSH  services  across  their  working  lives. 
Women are more likely to work part-time, as homeworkers, usually in the informal economy (as distinct 
from  teleworking)  or  by  providing  domestic  services  in  other  people’s  homes.  Homeworking  in  the 
informal economy and domestic services, in particular, are associated with poorer working conditions 
(EU-OSHA, 2003a, 2013a), which is an issue for safety and health throughout their work-life course. 
There are also specific OSH issues for part-time working, which is much more prevalent among female 
workers. 

Employment data from Eurofound (2012) show that 42 % of women over the age of 50 are employed 
part-time,  compared  with  only  12 %  of  men.  Part-time  employment  is  most  common  among  older 
women (over 55 years), for whom it is seen as a means of remaining in the labour market while dealing 
with personal health issues or caregiving for others. Part-time work is also more common among women 
of all ages than among men, as many employers (for business reasons) only offer part-time employment, 

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Women and the ageing workforce – Implications for OSH 

for example in home care-related work, restaurants or shops, which are all sectors in which the majority 
of workers are women. Life stage can also have an impact on the type of employment sought by men 
and women. Workers with young children may want to work shorter or more regular hours, and gender 
segregation may be reinforced by choosing employment in family-friendly sectors (Eurofound, 2013). 

Eurofound (2012) showed that occupations where individuals work fewer than 20 hours of paid work 
per week are predominantly female, including cleaners, retail staff and teachers. For part-time workers, 
evidence suggests that their access to advice and training is limited, both generally and specifically in 
relation to OSH. In addition, part-time workers are often not consulted in risk assessments, meaning 
that potential workplace hazards for this group are missed. Some workers may have several part-time 
jobs (EU-OSHA, 2013a), may be exposed to hazards in each and may not have the employment rights 
of full-time workers. 

Certain  groups  of  workers,  including  part-time  workers,  homeworkers  and  domestic  workers,  do  not 
have the same access to support services, such as  OSH and human resources (HR) management. 
This issue will be covered again later in the report. 

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Women and the ageing workforce – Implications for OSH 

4  Specific  OSH  and  health  issues,  female  workers  and 

implications for sustainable work 

Introduction 

4.1 
Owing to demographic change, many EU Member States are raising their official retirement ages (and 
in some countries it is as high as 67 years) and/or are providing economic incentives to prolong working 
life. However, efforts to extend working life in Member States are not necessarily accompanied by equal 
efforts  to  address  how  extending  working  life  will  have  an  impact  on  occupational  exposure  and, 
consequently, on workers’ health. In some cases, earlier retirement can be a way of preserving health 
and reducing the risk of disability. One of the main issues that arises from extending working life is that 
the duration of exposure to hazards in the workplace will increase, and workers will be exposed to risks 
until an older age. 

Because men and women have different job roles in different sectors and industries, they are exposed 
to different working conditions and, as such, to different OSH hazards. Consequently, they are likely to 
suffer from different work-related health problems. Types of working conditions, such as flexible working, 
may have different implications for men and women. One aspect of ageing that is unique to older women 
is the menopause. 

The  following  section  covers  a  range  of  OSH,  health  and  work  issues  from  a  gender  perspective, 
describing  the  issues  and  workplace  measures  in  relation  to  sustainable  work.  It  includes  gender 
differences in relation to a number of physical and psychosocial OSH hazards and the associated risks 
and health problems. In most cases, an age effect has also been included (either because the research 
includes data on older age groups or because the impact of longer exposure time has been researched). 

The general review (EU-OSHA, 2014a) also provides further information regarding various hazards and 
risks, including shift work, MSDs and stress. 

It  should  be  noted  that  very  little  research  exists  on  the  specific  impacts  of  age-related  changes  in 
women on occupational exposures and related health issues.  

4.2  MSDs 

Key findings 

•  MSDs in the upper body are more frequently reported by women than by men, probably because 

of task segregation, and the prevalence of symptoms related to MSDs increase with age. 

•  More attention needs to be given to risk prevention in jobs predominantly carried out by women, 
including in relation to prolonged standing and prolonged sitting work, which is prevalent in some 
women’s jobs, for example supermarket checkouts or office administration work. 

•  Measures such as workplace layout and equipment need to be suitable for female workers. 

4.2.1  MSDs, female workers and OSH issues for sustainable work 

The  most  commonly  reported  health  problems  across  the  EU  are  MSDs.  The  most  recent  survey 
identified that, across the EU, 22.8 % of workers reported muscular pain and 24.7 % reported back pain 
(EU-OSHA, 2013a). European data on recognised diseases identify that the incidence rate of MSDs is 
lower in women than in men, apart from carpal tunnel syndrome and tenosynovitis of the hand or wrist 
(EU-OSHA,  2013a).  When  looking  at  the  broader  category  of  ‘work-related  health  problems’  (i.e. 
problems not necessarily officially recognised as occupational diseases), the 2007 Labour Force Survey 
ad  hoc  module  on  work-related  accidents,  health  problems  and  hazardous  exposures  showed  that, 
while  men  (of  all  age  groups)  were  more  likely  than  women  to  report  back  problems  as  their  most 
serious work-related health problem in the previous 12 months, women were more likely than men to 
report neck, shoulder, arm or hand problems (Eurostat, 2015c). 

Some studies have confirmed these findings. De Zwart et al. (2000) looked at the reporting of certain 
MSD-related symptoms within a sample of workers of working age. These data showed that there were 

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Women and the ageing workforce – Implications for OSH 

significantly more complaints of neck, shoulder, arm or wrist pains in women than in men. However, 
this research did not identify any difference in occupational exposure that could explain this outcome. 
Doyal and Payne (2006) found that women reported more musculoskeletal symptoms than men and it 
appeared that the incidence (and sometimes severity) of these symptoms increased with age. 

Horizontal segregation can explain some of these findings. As mentioned before, healthcare and social 
care  are  sectors  in  which  women make  up  the  majority  of  the  workforce.  Certain  tasks  within  these 
sectors,  and  in  particular  the  handling  of  patients,  can  involve  significant  physical  loads.  Based  on 
findings  from  the  National  Institute  for  Occupational  Safety  and  Health  (NIOSH),  EU-OSHA  (2003a) 
found that, in the USA, the reporting rate of over-exertion injuries for healthcare workers was double 
the national cross-sector average, and for homecare workers was three times the national average. 

Task segregation can play a role in the occurrence of certain types of MSDs in women. Messing (1993, 
cited  in  Doyal and Payne,  2006) found that female train cleaners  were employed to clean toilets on 
trains, which resulted in the adoption of poor musculoskeletal postures when carrying out this work, as 
they spent 25 % of their time in crouched postures. Heilskov-Hansen et al. (2014) examined gender 
differences in task distributions and task exposures in painters. A postural and load analysis was carried 
out examining men and women painters over the period of one working day per participant. Differences 
were found in the proportions of different tasks (standing, brush painting, roller painting and spraying) 
between the sexes. In addition, Meyland et al. (2014), in examining muscular load in house painters, 
found that women worked at approximately 50 % higher relative muscular loads than men. This may 
explain why there is a higher prevalence of musculoskeletal complaints in women when carrying out 
similar work tasks (Nordander et al., 2013). 

While no specific research was identified on the combination of age and gender and the occurrence of 
MSDs,  vertical  segregation  can  result  in  women  remaining  in  occupations  with  more  repetitive  and 
monotonous tasks, with less control over the pace of their work and involving more postural constraints 
(EP, 2011). Over time, this extended exposure may lead to an increased occurrence of MSDs. 

4.2.2  MSDs and OSH measures for sustainable work for women 

Women report more musculoskeletal symptoms than men in the age range of 50-59 years, as a result 
of  both  horizontal  segregation  (e.g.  working  in  sectors  involving  a  lot  of  manual  handling,  such  as 
healthcare) and vertical segregation (e.g. working in occupations involving highly repetitive tasks). 

The increase in the reporting of MSDs in older women reflects a number of different issues, including 
assumptions  about  women’s  work  being  less  physically  demanding  than  it  perhaps  is  and  vertical 
segregation, leading to women carrying out highly repetitive tasks and lacking opportunities to move 
between different work tasks. 

When considering MSDs, the risk assessment process should: 

 

involve a diverse mix of people (in terms of age, gender, full-time/part-time) in developing and 
carrying out risk assessments; 

  ensure that all work tasks are risk assessed for both genders; 
  ensure that all work tasks are risk assessed for all working arrangements (e.g. full-time/part-

time); 

  ensure that work tasks are risk assessed to reduce the risk of over-exertion injuries; and 
 

test risk reduction measures on a diverse mix of employees. 

To help prevent work-related MSDs among women, workplace layouts, equipment and tools, etc., need 
to be suitable for the female working population (Yeomans, 2011). There are examples of ergonomic 
interventions to prevent MSDs among female workers in EU-OSHA (2014). 

The following example describes measures taken in a printing company  in France to reduce MSDs, 
specifically targeting older female workers. 

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Women and the ageing workforce – Implications for OSH 

Good company practice: printing company, France (EU-OSHA, 2014) 

A French printing company identified high rates of sickness absence and of complaints of musculoskeletal aches 
and pains in one of their finishing workshops. On analysing the data, it was found that those affected were mostly 
older female employees, but it was unclear whether this was due to sex differences and age-related changes or 
to other factors such as duration of employment. An objective examination revealed that finishing assistants 
were particularly affected, which was a mostly feminine position (as men tended to work as machine operators). 
The women tended to be employed long term in this job, while men might start in this job, but be promoted from 
it quickly. 

The role of the finishing assistant was analysed and it was found to involve carrying loads of up to 35 kg every 
45 seconds (around 11 tonnes per day) and working in awkward postures and with arms raised when loading 
the machine. Employees also had to stoop over the production line, adding stress to the back, shoulders, arms 
and  knees.  The  company  took  a  number  of  intervention  measures,  including  reducing  the  loads,  reducing 
working  height  and  providing  rotating  platforms  for  the  pallets.  As  well  as  workplace  design  changes,  the 
intervention examined how staff were represented within the company’s decision-making forums and improved 
the representation of women on different committees. Recommendations were also made regarding improving 
career mobility among these workers. Staff development specifically targeting women was improved, including 
recognition of their skills and a renaming of the job to ‘assembly operator’. 

The evaluation of this intervention is ongoing, but the main success factors included the involvement of both 
senior management and workers in the project, and a greater understanding of the fact that the risks that female 
workers are exposed to may be different from the risks faced by male workers.  

Given the prevalence of work-related MSDs among female workers and the major impact that this may 
have on the sustainability of their work, more attention needs to be given to its prevention in jobs with 
high rates of MSDs that are predominantly carried out by women. In particular, more attention in terms 
of MSD prevention needs to be given to work involving prolonged sitting or prolonged static standing, 
which are prevalent in some women’s jobs, such as at supermarket checkouts, office administration 
work, hairdressing and retail shop work (EU-OSHA, 2013a). 

4.2.3  Sedentary work 

Because  of  both  horizontal  and  vertical  segregation,  women  tend  to  work  in  more  sedentary 
occupations than men (e.g. administrative office work) and more frequently work with computers than 
men.  According  to  the  fourth  EWCS  (Eurofound,  2008),  more  female  workers  (48.5 %)  than  male 
workers (43.1 %) worked with computers. In all age groups, women reported greater use of computers 
at work than men. The difference between the genders is much larger in low-skilled occupations than 
in high-skilled occupations, reflecting the difference in the types of jobs done by low-skilled males (e.g. 
plant workers, craft workers, etc.), that is, more physical jobs, and some low-skilled women (e.g. clerical 
support), that is, more sedentary work, often combined with lack of control over the way of working, the 
pace of work or when breaks can be taken, etc. 

As mentioned, prolonged sitting in static postures, even if the workstation and equipment are ergonomic, 
is also a risk factor for MSDs. The general review (EU-OSHA, 2014a) referred to guidance on making 
office work more physically dynamic, including through more moving about in the office. 

Sedentary  work  has  been  associated  with  rises  in  metabolic  syndrome,  which  increases  the  risk  of 
diabetes  and  cardiovascular  disease.  The  nature  of  sedentary  work  also  means  that  people  have 
reduced  levels  of  physical  activity,  further  contributing  to  the  risk  of  developing  health  problems. 
Inactivity is associated with health risks such as coronary heart diseases, type II diabetes and certain 
types of cancers (EP, 2008). 

Although no studies have been identified on the impact of sedentary work on older working women, it 
can be assumed that longer cumulative exposure increases the risks of developing health problems in 
older women. 

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Women and the ageing workforce – Implications for OSH 

4.3  Psychosocial risks and health problems 

Key findings 

•  Work-related stress may have a major impact on the sustainability of women’s work along the life 
course, and more attention needs to be given to its prevention along the life course, including a 
focus on jobs predominantly carried out by women. 

•  Women, and in particular older women, are more prone to harassment and psychological violence 

than men. 

•  Control  and  prevention  measures  to  reduce  psychosocial  risks  within  the  workplace  are  well 

developed and should be adapted, with both age and gender considered. 

4.3.1  Psychosocial risks, female workers and OSH issues for sustainable 

work 

Work-related stress is commonly reported among the EU workforce. For example, stress, depression 
and anxiety were the second most commonly reported work-related illnesses, after MSDs, according to 
results from the United Kingdom Labour Force Survey (2008/2009), and more working days were lost 
owing  to  stress,  depression  and  anxiety  than  to  MSDs  (Yeomans,  2011).  Findings  presented  in  the 
general review (EU-OSHA, 2016a) included the following: work-related stress, anxiety and depression 
increase with age and then decrease after the age of 55 years, which may be due to a ‘healthy worker 
effect’, that is, when those that have ‘burnout’ as a result of long exposure to psychological risks may 
have  left  the  workforce  or changed  job;  and  being  in  good-quality  work  is  generally  associated  with 
increased well-being compared with being out of work. Taken together, this suggests that preventing 
work-related stress across the life course and promoting quality work are important for the sustainability 
of work. 

Because of the sectors in which they are over-represented, such as healthcare, education and the retail 
trade, women are more likely to interact with third parties in their daily jobs and are thus often exposed 
to a certain type of violence at work, whether from colleagues or superiors or from customers, patients 
and relatives, students and parents, etc. (Doyal and Payne, 2006, cited in Payne and Doyal, 2010). The 
fifth EWCS (Eurofound, 2013) showed that women of all age groups report more frequently than men 
that they have to deal with angry clients almost all of the time. This is supported by figures from the 
United Kingdom for 2005-2006, which suggest that the incidence of workplace violence for those aged 
between 55-59 years was higher for women than for men (Labour Force Survey tables of HSE, 2008, 
cited  in  Payne  and  Doyal,  2010).  EU-OSHA  (2003a)  specifies  that  men  tend  to  experience  more 
physical violence and assault,  while  women tend  to  experience more intimidation and psychological 
violence. According to the fifth EWCS, negative health outcomes are reported by workers experiencing 
discrimination, verbal abuse, threats and humiliating behaviour, physical violence, bullying and sexual 
harassment. Older women may face both age and sex discrimination. 

In relation to the workplace, research on harassment has shown that older women are more likely to 
report experience of harassment than older men (Parent et al., 2007, cited in Payne and Doyal, 2010; 
Villosio et al., 2008). Women are also more likely to suffer from bullying at work (10 % of women versus 
7 % of men). Again, this may reflect the sectors that women are employed in, as there appears to be 
an increased risk in female-dominated public sectors (EU-OSHA, 2003a). 

The research by Campos-Serna et al. (2013a) identified that women reported higher strain, iso-strain 
(i.e. workers with a score above the median for job demands) and effort–reward imbalance than men. 
In addition to general frustrations about role conflict and fairness in the workplace, it is interesting to 
note that women experience greater frustrations in male-dominated workplaces while men experience 
greater  frustrations  in  female-dominated  workplaces,  compared  with  gender-neutral  workplaces 
(Purvanova and Muros, 2010). Even when the work demands are (or, based on job title, appear to be) 
the same, responses to psychosocial risks may be different between men and women. Arvidsson et al. 
(2006) studied air traffic controllers subjected to the same work demands and identified that women 
reported  lower  decision  latitude,  particularly  regarding  influence  and  freedom  at  work,  but  reported 
greater social support than men. 

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Women and the ageing workforce – Implications for OSH 

In terms of impacts, the systematic review by Theorell et al. (2015) found an association in both genders 
between depressive symptoms and low decision latitude, job strain and bullying. Manty et al. (2015) 
researched workers aged 40 to 60 years, comparing those with repeatedly high levels of job control 
with those with repeatedly low levels of job control. The analysis identified that declines in health were 
associated with low levels of job control. As seen in Table 3 in section 3.4, a low level of job control is 
frequently  a  characteristic  of  work  in  female-dominated  occupations.  Purvanova  and  Muros  (2010) 
investigated  two  aspects  of  burnout:  emotional  exhaustion  and  depersonalisation.  The  research 
concluded by suggesting that burnout was experienced more by women than by men. When the two 
aspects of burnout are separated, women were more likely to report emotional exhaustion and men are 
more likely to report depersonalisation (Matlin, 2004, cited in Purvanova and Muros, 2010). 

When age is taken into account, EU-OSHA (2013a) highlighted that younger women are more at risk 
of threats or actual violence, bullying or harassment. The fifth EWCS also shows that the proportion of 
female workers reporting that they have to deal with angry clients decreases with age. This is further 
supported  by  the  European  study  on  OSH  risks  to  vulnerable  groups  of  workers  (EP,  2011),  which 
shows  that  young  women  are  particularly  vulnerable  to  unwanted  sexual  attention,  especially  in  the 
hotel and restaurant sector. In 2005, 6 % of female workers under 30 years — and 2 % of all workers 
— reported being exposed to unwanted sexual attention. 

Women of different age groups are likely to be exposed to different psychosocial risks, depending on 
the sectors they work in and their position at the workplace. They are also likely to have different coping 
mechanisms  and,  similarly  to  older  men,  older  and  more  experienced  women  may  have  developed 
better  coping  mechanisms  than  their  younger  counterparts.  Owing  to  increased  experience,  older 
individuals may identify ways of dealing with intimidation and violence in the workplace, including taking 
individual prevention measures before they occur. 

4.3.2  Psychosocial  risks  and  OSH  measures  for  sustainable  work  for 

women 

As described in section 4.3.1, women are more likely to be employed in sectors where there is a higher 
exposure to psychosocial risks, for example in public-facing roles. At the same time, because of their 
involvement in informal care work, older women have greater daily workloads and are more exposed 
to emotionally demanding tasks than men, and are at risk of cumulative exposure to psychosocial risks 
both  within  and  outside  the  workplace.  A  better  fit  between  work  and  life  outside  work,  for  example 
through flexible working, and a more even distribution of domestic chores would benefit women. 

When burnout is  examined,  women report more emotional exhaustion  than men. Generally,  women 
report poorer psychosocial working conditions with lower levels of control, higher emotional demands 
and, in some sectors, higher rewards in their jobs, but also more monotony and more psychological 
harassment. There is, as yet, no specific research available that evaluates the impact of psychosocial 
risks  on  older  female  workers.  However,  increased  stress  and  burnout  due  to  increased  duration  of 
exposure to psychosocial risk is a potential problem that needs to be investigated. 

Control and prevention measures to reduce psychosocial risks within the workplace are well developed 
and  should  be  adapted,  with  both  age  and  gender  considered,  and  applied  to  risk  assessment 
processes. The following box presents key elements in relation to tackling harassment and bullying at 
the workplace: 

Key elements for workplace policies to tackle harassment and bullying  

•  A clear definition of harassment and bullying. 
•  Detailed provisions for preventive measures. 
•  Detailed provisions for dealing with incidents. 
•  A complaints procedure and an individual responsible for it. 
•  Protection and support for victims of bullying or harassment. 
•  Awareness training for all staff on the impact of such behaviours. 
•  Specific training for those responsible for dealing with incidents. 

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4.4  Life-cycle  approach  to  OSH,  cumulative  exposures  and 

recognition of risks to female workers 

Key findings 

• 

Improving  the  recognition  of  the  risks  in  women’s  work  remains  of  key  importance  for  the 
sustainability of women’s work. 

•  Occupational  cancers  are  more  frequently  recognised  in  male-dominated  sectors  and  there  is 
limited  research  related  to  both  age  and  gender  aspects.  Links  between  night  work  and  breast 
cancer have been found. Many cancers are long-latency diseases and are more likely to affect older 
workers. 

• 

It is important to recognise where and how women are exposed so that preventive measures can 
be taken that are also appropriate for female workers. For example, differences in exposure can be 
due to ill-fitting PPE, tool design or work organisation. 

While  MSDs  and  stress  can  be  associated  with  cumulative  exposures,  this  section  looks  at  some 
hazards and health problems that are cumulative in nature and are more associated with men’s work. 
It also looks at the recognition of work-related cancers in women and their implications for sustainable 
work, as well as respiratory diseases and asthma. It also briefly covers noise and vibration. 

4.4.1  Cancer 

According  to  EU-OSHA  (2003a,  2013a)  work-related  risks  to  women  have  tended  to  receive  less 
recognition  in  terms  of  data  collection,  research  and  linkage  to  medical  diagnosis,  as  compensable 
occupational diseases and in relation to risk prevention. According to a recent report on the situation of 
older  working  women  in  United  Kingdom,  health  and  well-being  issues  specific  to  older  women  are 
frequently  overlooked  by  employers  (Scottish  Commission  on  Older  Women,  2015).  However,  the 
situation has improved to some extent in some areas, owing to a wider recognition of the need to take 
a gender-sensitive approach to OSH (EU-OSHA, 2013a). Nevertheless, improving the recognition of 
the risks in women’s work remains of key importance for the sustainability of women’s work, especially 
in  relation  to  prolonged  exposure  to  hazards  whose  effects  are  cumulative  in  nature  or  have  a  long 
latency  period.  While  this  is  a  common  issue  concerning  all  types  of  risks,  the  issue  in  terms  of 
occupational-related cancers will be explored further here. 

The recognition of occupational exposures and cancer in women is perceived to be low (EU-OSHA, 
2003a, 2013a). Historically, much of the data on occupational cancers has been collected on men rather 
than  on  women.  This  reflects  trends  in  occupational  diseases  in  general,  as  mentioned  above,  as 
national data show that occupational diseases affecting female workers are significantly less frequently 
reported and recognised than those affecting male workers (Tieves, 2011, cited in EU-OSHA, 2013a). 
This  is  probably  because  of  a  focus  of  the  data  collection  on  male-dominated  industries,  where 
exposures to carcinogens and dangerous substances are reportedly higher than in other sectors of the 
economy.  For  instance,  data  published  by  EU-OSHA  (2003a)  identify  that  20-30 %  of  working men, 
compared  with  5-20 %  of  working  women,  may  have  been  exposed  to  lung  carcinogens  including 
asbestos, diesel exhaust, nickel, silica, beryllium, cadmium and chromium. 

However, EU-OSHA (2013a) highlighted that, through the recent recognition of night work being linked 
to breast cancer, more data are being collected on women and workplace exposures. This is discussed 
further in section 4.7. The recognition of a link between night work and breast cancer has promoted a 
broader  understanding  of  organisational  factors  that  have  the  potential  to  cause  cancer,  and  may 
increase the research on the impact of other ‘softer’ workplace risks on the occurrence of cancer, rather 
than the traditional physical or chemical risks previously studied. French data suggest that similar rates 
of  cancers  due  to  workplace  exposures  have  been  found  in  men  and  women  for  three  specific 
carcinogens.  Furthermore,  rates  of  mesothelioma  are  increasing  in  women  (EU-OSHA,  2013a).  In 
addition, a potential link has been found between occupational chemical exposure and cancer in middle-

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aged  healthcare  workers,  hairdressers,  cosmetic  industry  workers  and  home  service  workers,  all  of 
which are predominantly female professions (EU-OSHA, 2003a, 2013a). 

In investigating occupational cancer, including breast cancer, a number of issues have been highlighted 
in relation to women at work, including death certificates not including occupational information, non-
inclusion of women in occupational exposure assessment as more women join the workforce, and the 
exclusion of women from samples because they work part-time. 

Gender  differences  need  to  be  given  more  consideration  in  the  collection  of  exposure  data  and  the 
development of risk reduction measures, in particular: 

  gender considerations need to be included in routine data collection; 
 

further  research  is  needed  on  female-dominated  occupations  with  high  levels  of  harmful 
exposures; 

  gender considerations need to be included in the analysis of existing data where this has not 

been done before; 
jobs need to be analysed by task, rather than by job title. 

 

Although  there  is  limited  research  related  to  both  age  and  gender  aspects,  many  cancers  are  long-
latency diseases and are more likely to affect older workers. 

4.4.2  Noise and vibration 

Cumulative  exposure  to  noise  and  vibration  can  have  an  impact  on  health  and  therefore  on  the 
sustainability of work and health into retirement. Overall, women are less exposed to occupational noise 
(Campos-Serna et al., 2013a; EU-OSHA, 2013a) and vibration (EU-OSHA, 2013a) than men. 

However, in some sectors, including food production and textiles, women may be exposed to high levels 
of noise (EU-OSHA, 2013a). Fredriksson et al. (2015) measured noise levels in a female-dominated 
obstetric care facility and evaluated the impact of the noise levels using a questionnaire. The measured 
noise levels exceeded 80 dB(A) in 46 % of the shifts monitored and 55 % of staff self-reported noise-
related symptoms. The data analysis identified significant associations between noise exposure and 
the occurrence of tinnitus, and between noise exposure and auditory fatigue. In addition, because of 
horizontal workplace segregation, in general women are exposed more than men to moderate levels of 
noise, for example work in school classrooms (Sjodin et al., 2012). Noise levels below those that can 
cause  hearing  damage  can  nevertheless  have  physiological  or  psychological  impacts,  such  as 
increasing  blood  pressure  and  levels  of  stress.  Further  research  is  needed  to  examine  the  health 
impacts of this exposure in the context of extending working lives. 

Regarding vibration, investigation shows that 30 % of women working in manufacturing environments 
are exposed to vibration, meaning that, in these working environments, vibration is equally an issue for 
women as it is for men. It is also suggested that, for a given level of exposure, women may suffer from 
vibration-related symptoms at a higher rate than men (EU-OSHA, 2003a). Further research is required 
to find out if this is due to physiological differences or differences in exposure because of, for example, 
ill-fitting PPE, tool design or work organisation. 

In general, there is a lack of research on women and gender differences in relation to risks such as 
noise and vibration (EU-OSHA, 2003a are, 2013a). Rectifying such gaps in the knowledge are important 
for improving the sustainability of women’s work. 

4.4.3  Respiratory disease and asthma 

Work-related respiratory diseases and asthma have an impact on the sustainability of work and health 
into retirement, but less research has been done on exposure in women in particular. 

Information on self-reported respiratory disease across the EU-27 shows that 6 % of men and 3 % of 
women reported respiratory difficulties associated with work (EU-OSHA, 2013a). 

However, data collected in the United Kingdom (HSE, 2009, cited in EU-OSHA, 2013a) identified that, 
after the age of 65  years, specific respiratory diseases were reported more by women than by men, 

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including  mesothelioma  and  pneumoconiosis.  Both  of  these  are  long-latency  diseases,  which  can 
explain why they are more commonly reported among older age groups. However, even in the younger 
age groups, sex differences have been identified. Women aged 35-54 years are more likely to report 
allergic alveolitis than men of the same age, and women aged 25-34 years are more likely to report 
bronchitis and emphysema than men (HSE, 2009, cited in EU-OSHA, 2013a). 

In addition, evidence has shown that reporting rates of occupational asthma have increased for women 
across the EU. Toren and Blanc (2009) analysed data on asthma caused by occupational exposures. 
Only five papers provided estimates for both men and women, but they estimated an average reporting 
rate of 11.5 % for women, compared with 9.1 % for men. Occupational asthma in women predominates 
in industries such as bakeries, cleaning, healthcare and beauty (EU-OSHA, 2013a). An example of a 
known  cause  of  occupational  asthma  appearing  in  a  new  context  is  in  eyelash  extensions  using 
cyanoacrylate glue (Lindstrom et al., 2013). Finally, evidence shows gender differences in the fitting of 
PPE and, in particular, respiratory protective equipment, with the latter usually designed to fit males, 
with  a  poor  fit  for  women  resulting  in  increased  exposure  for  them  (Kennedy  and  Koehoorn,  2003). 
Differences  in  stature  between  men  and  women  can  result  in  women  being  closer  than  men  to  the 
source of a hazardous substance (Kennedy and Koehoorn, 2003). 

Although it has been shown that there is an increase in respiratory symptom reporting with age (EU-
OSHA,  2013a),  the  impact  of  relevant  occupational  exposures  on  older  working  women,  including 
considerations of longer exposure time and cumulative exposures, are not well researched. There is 
evidence that, similarly to carcinogens, data collection on exposure to fumes, etc., and the occurrence 
of respiratory diseases has focused on male-dominated sectors, and female-dominated sectors, such 
as the cleaning and hairdressing industries, have been less investigated. Health effects from exposure 
to cooking fumes in the restaurant sector is another under-researched area. 

4.5  Multiple exposures, female workers and sustainable work 

Key findings 

•  Older working women can be subject to multiple occupational exposures, which can have a 

cumulative or synergistic effect. They can also be subject to the combination of occupational and 
non-occupational exposures (e.g. physical work and emotionally demanding caring 
responsibilities). 

•  Actions should be designed that target multiple exposures, owing to older women’s roles in 

unpaid caring work. 

Although  individual  research  studies  predominantly  consider  exposure  to  one  particular  hazard,  it  is 
clear that, in the workplace, individuals may be exposed to more than one hazard at the same time. 
This can include, for example, exposure to both physical and psychosocial hazards, but also exposure 
to several chemicals in the workplace. Combined exposures can have either an additive or a synergistic 
effect: additive means that the combined effects on health are the sum of the individual effects, whereas 
synergistic means that the combined exposures have an impact greater than the sum of the exposures 
(EU-OSHA, 2013a). Antagonistic effects, where the effects of one hazard are reduced by exposure to 
another, can also occur but are uncommon. Table 3 in section 3.4 lists the potential multiple exposures 
in certain sectors that are female-dominated (EU-OSHA, 2013a). 

Looking at multiple exposures is particularly interesting in the context of an ageing female workforce, 
as  cumulative  effects,  in  particular  synergistic  ones,  may  appear  only  after  a  certain  duration  of 
exposure, thus having a greater impact on older women. It is apparent that, depending on the sector in 
which they are employed, men will also be subject to multiple exposures in their work. In addition to 
multiple  occupational  exposures,  exposures  to  non-occupational  hazards  can  also  result  in  an 
increased  susceptibility  to  workplace  hazards.  For  example,  work  at  home  (including  the  manual 
handling of children or older adults, exposure to cleaning chemicals and the provision of care), which is 
predominantly performed by women in most societies, can have an additive or even synergistic effect 
in combination with exposures experienced in the workplace. 

More research is needed into the effects of multiple exposures to work hazards across the life course. 

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4.6  Accidents, female workers and sustainable work 

Key findings 
  There is mixed evidence on whether or not the incidence of non-fatal accidents is higher among 

older women than other groups of women. 

  Slips  and  trips  are  a  common  cause  of  workplace  injuries  among  all  workers.  Workplace 

measures to reduce the risks of slips and trips would benefit all workers. 

When examining European data on standardised incidence rates of accidents at work resulting in over 
three days of absence, the general review (EU-OSHA, 2016a) noted that rates are substantially higher 
for  men  than  for  women  in  all  age  groups,  with  occupation  being  the  dominant  factor  influencing 
accident rates. However, the data also show that, among women, rates are higher in the 55-64 age 
group than the average for all ages together. 

Doyal and Payne (2006) partly confirmed this finding by reporting that women are less likely to suffer 
from a major incident than men, but that the most common age to suffer a serious injury is between 45 
and 54 years (Doyal and Payne, 2006). This same report identified that the incidence and severity of 
slip, trip and fall injuries among women increases with age in comparison with men. 

Nevertheless,  the  evidence  is  mixed.  For  example,  two  reports  that  analysed  the  United  Kingdom 
Labour  Force  Survey  data  (HSC,  2000  cited  by  Yeomans  (2011);  Davies  and  Jones,  2005  cited  by 
Yeomans (2011)) showed no substantial variation between age groups. 

Slips and trips are a common cause of workplace injuries among all workers. Workplace measures to 
reduce  the  risks  of  slips  and  trips  would  benefit  all  workers.  Risk  prevention  measures  can  include 
improved  lighting,  non-slip  footwear  suitable  for  women,  well-maintained  flooring  and  keeping 
workplaces orderly and floors free from obstacles. 

4.7  Night or shift work and sustainable work 

Key findings 

•  There is an emerging body of research showing links between night work and breast cancer, but 
more research is needed on these links and the effect of duration of exposure in older women. 

The link between night work and breast cancer has only recently been recognised as an occupational 
risk (EU-OSHA, 2013a). The International Agency for Research on Cancer (IARC) has classified shift 
work, when it causes disruption of the body’s circadian rhythm (body clock)) as a probable carcinogen 
(IARC, 2010). Since 2008 the Danish National Board for Industrial Injuries has offered compensation 
to women who developed breast cancer following a long history of shift working.  Continued exposure 
to  night  work  by  extending  working  life  might  therefore  be  considered  a  risk  factor  for  older  female 
workers and more research is needed on the links between breast cancer and night work and the effect 
of duration of exposure in older women. 

Based on existing evidence, the following aspects should be considered when measures are developed 
to protect the health and well-being of women working nights and shifts (Crawford et al., 2009; Blok and 
De Looze, 2011), including: 

limiting night work for older workers that report difficulties (Yeomans, 2011); 

 
  giving these workers priority transfer to day shifts; 
  giving them a choice of preferred shifts; 
 
 
  arranging more frequent health checks; 
  giving training and counselling on sleep management, diet, exercise and stress. 

shortening their working hours; 
reducing their workload; 

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Women and the ageing workforce – Implications for OSH 

Providing  older  workers  with  increased  control  over  work  is  recommended  to  help  reduce  stress 
(Griffiths et al., 2009), and may be particularly beneficial to female workers needing to accommodate 
care commitments outside work, for example. 

However, risk prevention measures for older working women need to be adopted based on a life-course 
perspective,  and  considerations  should  be  given  to  the  potential  negative  effects  of  some  of  these 
measures on younger staff, for example replacing older workers in night work by younger workers or 
transferring some of the workload from older colleagues to younger ones. Particularly because of the 
possible cumulative health effects of working shifts, measures are needed to improve shift working for 
all workers. 

The general review (EU-OSHA, 2016a) includes some additional information on preventing risks from 
shift work. 

4.8  Work and the menopause 

Key findings 

The menopause remains a taboo in society and, therefore, in the workplace. 

  Simple  workplace  measures  can  support  women  going  through  the  menopause,  for 
example access to drinking water can be provided, layered clothing can be used for uniforms 
and flexible working can be arranged to facilitate doctor’s appointments. 

  More research and practical, non-stigmatising advice for the workplace are needed. 

The menopause remains a taboo in society and, therefore, in the workplace, and research and practical 
advice related to the workplace on the subject remain sparse. 

Griffiths et al. (2010) carried out an exploratory study to investigate the experiences of women working 
through  the  menopause  and  to  identify  factors  that  could  improve  this  experience.  A  number  of 
symptoms have been attributed to the menopause including hot flushes (or flashes), palpitations, night 
sweats, sleep disturbance, fatigue, poor concentration, irritability, mood disturbances, skin irritation and 
dryness of the skin. It is unclear if sleep disturbance caused by the menopause leads to fatigue, poor 
concentration and irritability, or whether these are distinct (unrelated) symptoms of the menopause. 

It is important to note that not everyone suffers from these symptoms to the same extent, and many 
women  may  encounter  few  problems.  However,  some  women  will  experience  symptoms  that 
significantly affect their well-being, and these may also affect their performance at work. Griffiths et al. 
(2010) surveyed 912 women within the age range of 45-55 years who were assessed as being in peri-
menopause (43 %), natural menopause (30 %) or surgical menopause (8 %) or who used hormones 
(18 %). The survey found that approximately half of the respondents found it somewhat or fairly difficult 
to cope with work, with only 5 % reporting that it was extremely difficult to cope with work. The rest of 
the sample did not find it difficult at all. 

In  examining  menopausal  symptoms  in  relation  to  work,  poor  concentration,  tiredness,  lowered 
confidence,  feeling  depressed  and  poor  memory  were  found  to  have  a  significant  impact  on  work 
capacity.  The  study  also  noted  that  hot  flushes  were  a  major  source  of  distress.  A  report  by  the 
European Risk Observatory (ERO) in 2013 highlighted the fact that, for many women going through the 
menopause, the psychosocial context is as important as physical or biological parameters; those with 
higher  levels  of  control  over  their  work  are more  likely  to  develop  coping  strategies  than  those  who 
report low levels of work control’. 

The  report  by  the  Scottish  Commission  on  Older  Women  (2015)  from  United  Kingdom,  expressed 
concerns  that  if  misunderstandings  and  misinformation  around  the  menopause  cause  difficulties  for 
women, and discourage them from seeking support from their employer, this may leave them with no 
support to accommodate or overcome any problems and they may therefore struggle to maintain their 
usual level of performance. 

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The study by Griffiths et al. (2010) also identified the work factors that made symptoms more difficult to 
cope with. These included 

  hot and poorly ventilated environments; 
 
  high visibility work such as formal presentations. 

formal meetings; and 

The study went on to identify a number of different coping strategies used at work, including: 

  adjustments to the work environment, such as opening windows or using fans; 
  adjusting work routines, such as changing working hours, taking days off and flexible working 

patterns; 

  active coping strategies, such as discussing issues openly with managers; 
 
compensatory strategies, including through the use of technology; and 
  avoidance tactics, such as withdrawal from challenging or difficult situations. 

Other considerations for the workplace were also identified by Griffiths et al. (2010). These include: 

  management awareness — because many women do not disclose symptoms, an increased 

 
 

awareness would enable managers to deal more sensitively with any problems arising; 
flexible working — many women found this helpful in dealing with issues around disturbed sleep; 
the temperature of the work environment — having some control over the working temperature 
was found to be helpful by those sampled; 

  development of formal and informal sources of support — support from the employer, such as 
through HR, an occupational health professional or a diversity advisor, as well as more informal 
sources,  such  as  peer  support  from  other  women  also  going  through  the  menopause,  were 
viewed positively. 

It  is  important  that  employers  create  and  maintain  a  positive  workplace  culture  that  supports 
menopausal women (STUC et al., 2014). In the UNITED KINGDOM, the Trades Union Congress (TUC) 
has also developed guidance to help manage workers going through the menopause, based on their 
own research and the cited study (TUC, 2011). Simple, non-stigmatising measures that could be taken 
in the workplace were identified, including providing access to drinking water, using layered clothing for 
uniforms and arranging flexible working to facilitate doctor’s appointments. 

Guidance for union representatives on dealing with issues around the menopause (TUC, 2011) 

•  Employers should ensure that all line managers have received awareness training on the effect of the 
menopause on the individual and their work, and on the adjustments necessary to support women 
who are experiencing the menopause. 

•  Employers can ensure that, as part of a wider occupational health awareness campaign, issues such 
as the menopause are highlighted, so that all staff know that the employer has a positive attitude 
towards the issue, thereby avoiding individual embarrassment. Guidance on dealing with the 
menopause should be freely available in the workplace. 

•  All women should be given information on the support available to them for any issues that arise as a 
result of the menopause. Traditionally, the menopause is viewed as a social taboo, leaving many 
women feeling uncomfortable about discussing it with their line manager, especially if their line 
manager is a man, and other options should be made available. This may be through HR, for 
example, or a welfare officer. Many employers have employer assistance programmes that can act 
as a go-between. 

•  Sickness absence procedures should make it clear that they are flexible enough to cater for 

menopause-related sickness absence. Women should experience no detriment because they may 
need time off during this time. 

•  Working time arrangements should be sufficiently flexible to ensure that they meet the needs of 

menopausal women, who may require more breaks during the day or need to leave work at short 
notice. 

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Women and the ageing workforce – Implications for OSH 

•  Risk assessments should consider the specific needs of menopausal women and ensure that the 

working environment will not make their symptoms worse. Specific areas that need to be addressed 
include temperature and ventilation. The assessments should also address welfare issues, such as 
toilet facilities and easy access to cold water. 

More awareness raising and support for workplaces is needed, including advice on non-stigmatising 
measures,  model  policies  and  risk  assessment  checklists.  In  addition,  more  research  on  workplace 
implications is needed. 

4.9  Unpaid work and caring responsibilities 

Key findings 

•  More workers are likely to have care duties for sick relatives as the general population ages. 

•  Women are more likely to be informal carers of family members than men, although older men 

are more likely to be carers than younger men. 

•  The needs of family carers are different from those with childcare responsibilities. 

•  The approach taken by workplaces in dealing with family carers needs to be adjusted, with a shift 
away from the current model that is focused on women caring for children, to be relevant to carers 
of older family members and to both women and men. 

•  As well as employment policies that provide for the reconciliation of work and care responsibilities 
for employees, an ageing population in Europe requires additional resources for the care of older 
and disabled people and services promoting independent living as part of an integrated strategy. 

Measures for the reconciliation of work and family life are increasingly recognised as being important 
in the context of the Europe 2020 employment strategy and as a driver for gender equality. Although 
men generally work more paid hours than women (42 hours per week versus 38.8 hours for women), 
when  the  impact  of  unpaid  work  and  caring  activities  is  added  (using  a  combined  measure  of  paid 
working hours, commuting hours and unpaid working hours), women are found to work on average 64 
hours  per  week,  compared  with  men’s  53.4  hours  per  week  (Eurofound,  2013).  The  report  from 
Eurofound identified that much of this is the time spent caring for others (26.4 hours per week for women 
versus 8.8 hours per week for men).  

With an ageing working population and the increase in pension age, more workers are likely to have 
care duties for sick relatives. According to Eurofound’s European Quality of Life Survey (Eurofound, 
2014), 19 % of working men and 29 % of working women aged 50 years and over provide care at least 
several times a week for their children or grandchildren, while the figure is 20 % and 21 %, respectively, 
for those who are retired. In addition, with increasing life expectancy, people aged 50 years and over 
also often care for partners or relatives with health problems or disabilities. Of those in employment, 
31 % of men and 36 % of women care for relatives, with 10 % of men and 14 % of women doing so at 
least several times a week. 

Figures from the United Kingdom 2011 census and other sources, compiled by CarersUK, also highlight 
the extent to which ‘eldercare’ is an issue for workers, in particular older working women (CarersUK, 
2014). The majority of carers are of working age and around one in every nine employees has caring 
responsibilities. The peak age bracket for caring responsibilities is between 50 and 64 years, with one 
in five people in this age bracket being carers. However, the number of carers over the age of 65 years 
is increasing more rapidly than the general carer population. While the total number of carers in the 
United  Kingdom  has  risen  by  11 %  since  2001,  the  number  of  older  carers  rose  by  35 %.  This  has 
implications for the sustainability of work, as official retirement ages are rising, and in some countries it 
is  as  high  as  67  years.  Around  half  of  the  United  Kingdom’s  caring  population  combines  work  with 
unpaid  caring  responsibilities  and  many  find  that  they  have  to  give  up  work  because  of  these 
responsibilities. 

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The figures also illustrate how the burden falls more on older working women than older working men: 
one in four women aged 50-64 years has caring responsibilities, compared with one in six men. Women 
are more likely to be what is commonly referred to as ‘sandwich carers’ (i.e. combining eldercare and 
childcare) and are also more likely to give up work in order to care. Qualitative research in the United 
Kingdom found that men tend to care for their partners or children while women also care for parents 
and grandparents (TUC, 2014). 

While the highest proportion of care is provided by women of 50 years or older, older men are more 
likely to be carers than younger men, for example caring for a sick spouse or elderly parent. Caring for 
a sick adult and childcare have different requirements, while current strategies aimed at carers often 
focus on younger women with childcare needs. 

As highlighted by a report on flexible employment options (Hunt, 2006), caring for adults differs from 
caring for children in a number of significant ways: 

  Caring for a child is usually chosen and planned, whereas caring for an adult often results from 

unforeseen circumstances. 

  Adults are often cared for outside the carer’s household and adults’ needs are less predictable, 

with sudden demands creating unexpected pressures. 

It  appears  from  Eurofound’s  data  (Eurofound,  2014)  that  combining  work  and  caring  for  partners  or 
relatives  is  more  problematic  than  combining  work  and  caring  for  children.  This  may  be  because  of 
easier access to childcare support than to eldercare support. With working and caring every day for 
elderly or disabled people, 21 % of carers report having work–life balance problems, compared with 
16 % of people who are looking after children or grandchildren. 

According to Eurofound (2014), while different forms of state and employer support may be offered to 
assist people caring for family members, these tend to support workers who are providing childcare — 
in general, younger workers. Support for people aged 50 years and over providing care for partners or 
elderly parents is generally less available, although conflict between work and other aspects of life is 
common for men and women in this situation. 

Using  data  from  the  Labour  Force  Survey,  the  report  of  the  EU  Expert  Group  on  Gender  and 
Employment (EC, 2010) looked at flexibility in the organisation of working time, with a particular focus 
on the areas of flexible working time schedules, working from home and working atypical hours. Overall, 
the report noted that flexibility in terms of working time schedules still appeared to be relatively limited 
and differed by Member State. The only countries where the majority of employees have flexible working 
time  schedules  are  Denmark,  Finland,  Germany,  Norway  and  Sweden.  In  countries  with  the  lowest 
levels of flexibility in working time, notably the eastern and southern European Member States, flexibility 
practices are not common (Plantenga and Remery, 2010). 

Although  flexible  working  time  is  still  not  the  norm  in  the  United  Kingdom,  carers  have  been  given 
specific rights (CarersUK, 2014). 

Rights of carers in the United Kingdom (CarersUK) 

The  United  Kingdom  is  one of  the  Member  States  where  legislation  on  flexible  working  for  carers  has  been 
introduced, and where good practice recommendations can be found. From 30 June 2014, the right to request 
flexible working has been available to all carers in the United Kingdom if they have been employed for 26 weeks 
continuously. Previously it was available only to certain parents and carers. Individuals now have the right not 
to be badly treated, treated less favourably or dismissed from their job just because they have requested flexible 
work. Employers can refuse a request only if they have good business reasons for it. The request can cover 
changing  hours,  times  or  places  of  work.  Examples  of  flexible  working  include  flexi-time,  home  working  or 
teleworking, job sharing, part-time working, school term-time working, shift-swapping or self-rostering, staggered 
hours, compressed hours and annualised hours. 

The report of the EU Expert Group on Gender and Employment (EC, 2010) suggested that, as long as 
‘flexibility’ continues to be considered as mainly a ‘female’ way of organising working time, the use of 

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Women and the ageing workforce – Implications for OSH 

these schemes may offer limited choice. The report of the Scottish Commission on Older Women from 
the United Kingdom (2015), concluded that ‘Public policy has not kept up with the changing realities of 
the  complex  patterns  of  caring  demands  placed  on  older  women,  either  in  respect  of  valuing  and 
integrating  the  contribution  made  by  unpaid  carers  into  health  and  social  care  systems;  or  by 
incentivising employers to recognise and accommodate the needs of unpaid carers in the workplace’. 
In  addition,  Eurofound  (2014)  points  out  that  if  older  carers,  who  are  also  in  paid  employment,  are 
unable to provide the hours of care they want to give, then the demand for formal care will increase, 
implying greater public expenditure. Caring responsibilities may make it more difficult in the first place 
for people aged 50 years and over to remain in, or take up, employment. 

Expanding and creating forms of support to facilitate this group of carers  would  benefit  this  growing 
segment  of  the  population  and  facilitate  longer  working  lives  (Eurofound,  2014).  Carers  say  that 
continuing to work gives them financial security, a break from caring, a sense of identity, self-esteem 
and social contacts. The EU Expert Group on Gender and Employment (EC, 2010) found that flexible 
working time schedules are often considered a mechanism to support working parents in combining 
work and family life. Eurofound confirms this by proposing that measures are taken to facilitate caring 
and part-time employment. 

A civil service trade union in the United Kingdom, the Public and Commercial Services Union (PCS), 
has negotiated company policies that provide support for carers. It suggests that employers consider 
offering some of the following (PCS, 2016): 

flexible working options for all employees; 
reduced hours or career breaks for a specific period; 

 
 
  paid or unpaid leave at short notice; 
 
  private space and time to make phone calls; 
  a helpline or information/advice service; 
 

time off during working hours to deal with emergencies or to take someone to an appointment; 

counselling  services  or  a  welfare  officer  —  trained  practitioners  who  offer  impartial  and 
confidential support; 

  a carer support group or focus group; 
  expenses to cover the costs of care it the carer is away from home on business or training; 
  monetary allowances (vouchers) towards the costs of elderly care; 
 

training courses — general courses such as on stress or time management may help to cope 
with changed circumstances; 

  occupational  health services — to help monitor employees’ health  and to provide advice on 

concerns. 

Siemens in Germany provides an example of how a company policy for carers can work (Eurofound, 
2002). 

Good company practice: Siemens, Germany 

Older female workers are often carers of elderly relatives. Employed carers in Germany report high levels of 
stress  and  very  often  experience  work  interruptions  or  have  to miss  work  altogether.  In addition,  they  are 
prone to financial loss, for example as a result of unpaid time off, and they often miss business meetings and 
training opportunities and lose out on promotions. The greatest negative consequence for employers is the 
loss of qualified, committed and experienced employees. 

Siemens is one German company that has implemented a policy for carers for their employees. The measures 
involve  flexibility  in  working  time,  place  of  work  and  leave  options,  as  well  as  an  information  and  referral 
service and counselling and advice in coaction with company-based social work measures.  

Preconceptions regarding who may be affected by care duties should be avoided, in order to develop 
appropriate reconciliation policies and practices, which are essential to promoting the employment of 
both older women and men. Flexible working time schemes and part-time policies as have already been 
implemented  for  young  parents  should  also  be  considered  for  all  carers,  to  avoid  older  carers,  and 
especially older female workers, dropping out of work. In addition, there is a continued need to promote 
a more equal share of care responsibilities between women and men. 

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Women and the ageing workforce – Implications for OSH 

According to the Confederation of Family Organisations in the European Union (COFACE), 80 % of the 
time spent caring for people with disabilities and older people in Europe is provided by informal carers 
(Uherecky, 2015). As well as employment policies that provide for the reconciliation of work and care 
responsibilities  for  employees,  an  ageing  population  in  Europe  requires  additional  resources  for  the 
care of older and disabled people and services promoting independent living as part of an integrated 
strategy. 

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5  Female-dominated work and sustainable work 
As previously mentioned, both female-dominated and male-dominated work sectors need to be covered 
in actions and strategies to promote sustainable work. The following section includes the results from 
interventions  carried  out  in  two  sectors  —  healthcare  and  education  —  and  the  measures  and 
recommendations formulated based on these interventions. These sectors have been chosen because, 
in addition to being female-dominated, they employ a large proportion of working women over the age 
of 50  years and because  OSH studies or interventions have been carried out in relation to  age  and 
gender and the good practices identified. The general review (EU-OSHA, 2016a) also addressed the 
cleaning sector and provided some additional information in relation to the healthcare sector. 

5.1  Healthcare 

Key findings 

•  An example of integrated strategy development is the strategy of the Working Longer Group of the 
included  developing  and 
United  Kingdom  National  Health  Service.  Recommendations 
implementing a risk assessment framework to assist organisations in addressing the cumulative 
impacts of working longer by supporting staff with health, safety and well-being issues throughout 
their working lives. 

•  Training  programmes  in  the  healthcare  sector  to  promote  patients’  resources  are  a  ‘win–win’ 
solution, as they improve caregivers’ working environments and improve patients’ sense of dignity 
and control over their situation. 

• 

If older workers are in good health and their ‘job fit’ is right, they can work as productively as their 
younger counter parts. 

5.1.1  OSH hazards and risks in the context of an ageing workforce 

Women of all ages have a high rate of employment in the healthcare sector. However, it is also a sector 
in which the age of the workforce is increasing (EU-OSHA, 2013a) and in which there are a number of 
hazards for which long-term exposure is problematic. These include physical workload and emotionally 
demanding  work. Workers may  be exposed to a  very  wide  variety  of hazards in  healthcare and it  is 
recognised as a high-risk sector (EC, 2011). 

In particular, risks include  patient lifting, exposure to  cleaning and sterilising chemicals, exposure to 
psychosocial hazards (such as violence and aggression), shift work and night work, and exposure to 
infectious agents. Stresses and strains arising from awkward and static postures when treating patients 
can also give rise to problems. 

Reducing musculoskeletal problems is a particular challenge in the context of extending working life in 
the healthcare sector. For example, the United Kingdom Health and Safety Executive (HSE) reports 
that one in four nurses has, at some time, taken time off as a result of a back injury sustained at work 
(EC, 2011). The HSE also reports that over 5,000 manual handling injuries are reported within health 
services each year, approximately half of which happen during the handling of patients. 

Psychosocial issues are also a key issue among healthcare workers. The Nurses’ Early Exit (NEXT) 
study found that nurses in general were not satisfied with their job. According to the study, 15.6 % of 
nurses in Europe think frequently and seriously (several times a month) of leaving the profession early 
(EC, 2011). Prolonged exposure to stressful situations can lead to burnout, which shares features with 
stress, mainly relating to emotional exhaustion or excessive fatigue, but differs from stress in that it also 
includes factors related to depersonalisation, personal concern and personal fulfilment. 

Finally, there is increasing evidence linking night work and breast cancer (EC, 2011; EU-OSHA, 2014). 
Extending working life could mean increasing this risk if exposure to night work is prolonged. 

The issue of extended duration of exposure to hazards is critical for older women, as it can increase 
the risk of injury, ill health, fatigue and burnout, and can cause an inability or lack of desire to continue 
to cope with very physically and psychologically demanding work. Thus, all of these hazards and related 

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Women and the ageing workforce – Implications for OSH 

risks may either act as push factors outside the workplace or result in workers reaching retirement age 
in poor health. 

5.1.2  Measures and recommendations 

An  example  of  integrated  strategy  development  in  a  female-dominated  sector  is  the  strategy  of  the 
tripartite Working Longer Group (WLG) of the National Health Service (NHS) in the United Kingdom 4. 
The  WLG  is  a  partnership  group  of  trade  unions,  NHS  employers  and  health  department  (ministry) 
representatives. It was established to review the implications of the NHS workforce working for longer 
to an older retirement age. This group was established to address the impact of the increase of the 
retirement age from 65 years to 68 years in the NHS workforce, which is 77 % female, with nearly two-
thirds of nurses over the age of 40 years (Lee, 2015). 

The WLG’s recommendations are based on an audit of research on the impact of extending working 
life in the healthcare sector (Weyman et al., 2013). The recommendations cover four main areas: data, 
pension options and retirement decisions, working arrangements and the work environment, and good 
practices in relation to occupational health, safety and well-being. The audit of existing evidence found 
that, if older workers are in good health and their ‘job fit’ is right, they can work as productively as their 
younger counterparts. This highlighted the importance of fully implementing sector guidelines on health 
and  well-being  at  work to ensure that a  longer  working life does not adversely  affect an employee’s 
health  or  ability  to  work  effectively  and  safely.  Specific  recommendations  were  made  with  regard  to 
developing  and  implementing  a  risk  assessment  framework,  in  order  to  assist  organisations  in 
addressing the cumulative impact of working for longer. For employers, this means supporting staff with 
health, safety and well-being issues throughout their working lives to enable them to for work longer 
(EU-OSHA, 2015; Lee, 2015). 

The audit report identified good practice and evidence-based measures in relation to managing older 
workers  in  the  healthcare  environment  (see  Appendix  C  for  details).  One  such  measure  is  to  train 
healthcare workers and other staff that handle patients to promote the patient’s resources, and to enable 
him or her to participate more actively in the process of moving, thus reducing physical strain on the 
worker. Additional benefits to this approach include contributing to the goal of maintaining a sense of 
dignity and self-control for the patient (EC, 2011). However, the report concludes that there are still a 
number of evidence gaps with regard to successful measures to managing an ageing workforce in this 
sector (Weyman et al., 2013). 

There is a vast range of different jobs in the healthcare sector. Different types of work may need different 
approaches to age management and, within these, there may be specific needs according to gender. 
The  ambulance  service,  for  example,  is  one  where  questions  about  the  sustainability  of  working 
conditions  have  been  raised.  It  is  also  a  work  area  that  has  opened  up  to  women.  As  the  study  by 
Weyman et al. (2013) makes clear, OSH aspects, including age management, must be integrated into 
all managerial development processes, that is, corporate strategy, HR and organisational development 
(EC, 2011). Good OSH management aimed at extending working life in healthcare is not based on just 
one  solution,  but  is  dependent  on  a  variety  of  measures  and  factors,  including  stress  prevention, 
ergonomics, improved work organisation, work health promotion, training and development, and senior 
management  commitment.  EC  (2011)  provided  risk  prevention  measures  for  the  healthcare  sector, 
which, if implemented, would benefit all workers along the life course. 

The following below highlights an example of the improvements that can be made to reduce MSDs in 
the healthcare sector (EC, 2011). 

Good company practice: Berufsgenossenschaftliches Unfallkrankenhaus Hamburg (BUKH), Germany 

The project started in the nursing sector with approximately 600 healthcare workers. A staff survey revealed a 
high level of exposure to physical hazards but, at the same time, the desire of the nursing staff to be able to 
pursue their occupation for as long as possible. The setting up of ‘Health circles’, through which the staff could 
discuss issues related to their working conditions, created an environment in which issues could be expressed 
and concrete solutions could be generated. 

4  http://www.nhsemployers.org/wlr accessed 9 May 2016 

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High absenteeism rates were a major concern in the organisation. The project’s objective was therefore to take 
action to reduce days lost owing to illness, prevent the occurrence of occupational diseases, improve the quality 
of care and increase job satisfaction and well-being of the staff. To this end, a coordinated package of measures 
was put together including selection and purchase of handling devices and training of senior management and 
employees.  The  project  involved  staff  from  the  OSH  and  health  promotion  department  and  from  the  HR 
department, as well as worker representatives. 

Another objective of the measures adopted by ‘Health circles’ related to preparing for demographic change and 
keeping employees at work long enough to avoid a shortage of skilled staff and allow for the transmission of 
knowledge and know-how. 

5.2  Education 

Key findings 

•  A combination of measures is recommended for the retention of staff in the education 
sector, including improvements in working conditions and measures to improve career 
mobility. 

5.2.1  OSH hazards and risks in the context of an ageing workforce 

Education is  another female-dominated sector in  which individuals are exposed to multiple hazards, 
including infectious diseases, poor indoor air quality, prolonged standing, medium to high levels of noise, 
risk  of  voice  loss,  emotionally  demanding  work,  and  exposure  to  violence  and  aggression  and  to 
stressful situations. 

Some hazards relevant to sustainable work are more recognised, such as the emotional demands of 
the work and the risk of violence. The extent of other hazards and health problems are less recognised. 
One  example  is  voice  disorders  (EU-OSHA,  2005a)  although  there  is  a  growing  body  of  research 
concerning voice disorders among teachers. A study by Roy et al. (2004) found that being a teacher, 
being  a  woman  and  being  between  40  and  59  years  of  age,  were  among  the  factors  positively 
associated  with  having  experienced  a  voice  disorder  in  the  past.  Cantor  Cutiva  and  Burdorf  (2015) 
identified  that,  in  a  survey  of  621  Colombian  teachers,  69 %  reported  voice-related  symptoms. 
Statistical and survey data reviewed by the United Kingdom National Union of Teachers (NUT) showed: 
an increased prevalence of voice disorders among teachers compared to other professions; and a third 
of  head  teachers  reporting  that  voice  problems  had  caused  teachers  to  take  time  off  work  (NUT, 
undated). Prevention measures include improvements in classroom acoustics, avoiding speaking for 
long periods of time and instruction for teachers about voice care (NUT, undated; EU-OSHA, 2005b). 
The possible adverse effects of exposure to classroom noise is mentioned in the section 4.4.2. on noise. 

Education is a work area which has been undergoing considerable change, for example to respond to 
curriculum  changes,  extending  the  breadth  of  teachers’  duties  (classroom  and  non-classroom), 
changes  in  the  management  and  provision  of  education,  and  changes  in  the  role  of  teachers. 
Technology, among other things, means that the way in which education is delivered has changed and 
will continue to change. Technology also provides new mediums for harassment of staff, for example 
so-called cyber harassment (as per the 2010 European Trade Union Committee for Education (ETUCE, 
2010)  Practical  Guidelines  for  Anti-Cyber  Harassment  Measures  in  Education).  While  this  section 
focuses on teaching staff, it is important to consider non-teaching support staff as well. 

5.2.2  Measures and recommendations 

To  prevent  early  retirement  and  avoid  shortages  of  skilled  labour  in  the  future,  the  sector  needs  to 
create more sustainable working conditions, which will allow the sector to retain older workers at the 
same time as attract new recruits. According to a report of the Organisation for Economic Co-operation 
and  Development  (OECD),  the  provision  of  financial  incentives  and  of  opportunities  for  professional 

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development, and the improvement of working conditions, are needed if serious (teacher) shortages 
are to be avoided (Santiago, 2001). 

The  Victorian  TAFE  Association,  a  vocational  education  and  training  provider  in  Victoria,  Australia, 
produced a toolkit for managing their ageing workforce (Andrews et al., 2005). According to an analysis 
of  resources  in  the  organisation,  the  priorities  were  staff  development  and  retention,  while  also 
managing workloads and enhancing flexibility. The toolkit provides a framework strategy for managing 
an ageing workforce, which applies from the moment the worker enters the organisation to the moment 
they leave, and beyond. The strategy incorporates both OSH and HR elements and recommends the 
following: 

  promoting and implementing lifelong learning strategies; 
  monitoring development activity by age; 
  encouraging employees to build their résumé, assisting them in documenting skills developed 

on the job that may not be formally recognised; 

  encouraging job mobility, particularly among older workers, to increase their exposure to new 

challenges and work variety; 

  undertaking  assessments  of  physical,  environmental  and  organisational  risk  factors  in  the 

 

workplace for older workers; 
initiating  health  and  well-being  programmes  that  aim  to  counteract  health  issues  associated 
with each age group. 

5.3 

Implementing measures in work predominantly carried out by 
women 

Key findings 

  OSH measures need to be suitable for female workers, not designed to accommodate only 

the average male employee. 

  Consideration needs to be given to the suitability of risk prevention measures for women in 

work where women are in the minority. 

As mentioned in section 3, the type of work that women tend to be employed in — including cleaning, 
factory  work,  retail  work  and  hairdressing  —  is  frequently  physically  demanding  in  terms  of  moving 
heavy loads, sustained static muscular effort, working in awkward postures and short-cycle repetitive 
movements. Ill-fitting PPE, tool design or work organisation can cause or increase exposure to hazards, 
and  any  measures  to  reduce  OSH  risks for  the  female  workforce  or  to  accommodate  older  workers 
(such as equipment or a redesign of the workplace) need to be suitable for female workers rather than 
just  designed  to  accommodate  average  male  employees  (Yeomans,  2011).  To  improve  the 
sustainability of work for all workers by protecting them from exposure to hazards across the life course, 
OSH measures also need to be suitable for both men and women, including in situations where women 
are in the minority. An example is suitable PPE for female construction workers, as well as the design 
of tools and equipment and the layout of workplaces. Removing such barriers to employment can help 
encourage more women to enter such sectors. 

Examples of the implementation of OSH measures that are suitable or designed for female workers are 
given in EU-OSHA (2014). 

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6 

‘Groups’ of female workers and sustainable work 

Key findings 

  Young women and the sectors in which they work should be included in strategy and actions 

on young workers. 

  Part-time  and  other  ‘atypical’  workers  may  not  have  the  same  access  to  OSH  support 

services. 

  There  is  a  lack  of  information  on  the  experiences  of  older  female  workers  from  different 

ethnic groups. 

  Cultural and language barriers may be two factors that make it more difficult for older women 
from ethnic groups to obtain support. They may face multiple levels of discrimination based 
on age, sex and ethnicity. 

This section briefly considers OSH and sustainable work in relation to certain groups of female workers. 

Section 3 discusses the concept of the life-course approach to OSH, which starts with improving the 
OSH of young workers, such that younger workers reach later life without injury or illness. In this section, 
the importance of including the sectors in which young women predominate in OSH strategy and actions 
aimed at young workers was raised, as was the fact that this also needs to include both workplaces and 
vocational training. As cited in the general review (EU-OSHA, 2016a), Crawford et al (2009) reporting 
on musculoskeletal symptoms in nurses identified that nurses reported musculoskeletal problems as a 
result of previous employment and working in healthcare on entry to the profession. Thus prevention of 
injuries during training can be seen as a key component of reducing the risks of injury at this time. 

Section  3  also  covers  some  issues  related  to  part-time  working,  including  that  part-time  and  other 
groups of ‘atypical’ workers may not have the same access to support services, such as occupational 
health services, which may have an impact on the maintenance of long-term health and well-being. 

In  the  United  Kingdom,  according  to  the  Scottish  Commission  on  Older Workers  (2015),  the  (work) 
experiences  of  older  female  workers  from  different  ethnic  groups  are  rarely  considered  in  most 
published reports, and there is almost no freely available data on employment rates for older women 
by ethnicity. Where there are data, the sample size may be too small to allow detailed analysis. 

Based on an analysis of data by one United Kingdom review on the OSH of ethnic workers, South Asian 
males  (in  particular  Bangladeshis)  and  Black  Caribbean  men  are  much  less  likely  to  remain  in 
employment if they have a limiting long-term illness. For women, this effect is even more extreme for 
South Asians with limiting long-term illness; these women are less likely to remain in employment and 
Bangladeshi women with a disability actually appear to leave the workforce (Szczepura et al., 2004). 

Cultural  and  language  barriers  may  be  two  factors  that  make  it  more  difficult  for  older  women  from 
ethnic groups to obtain support or assert their rights in the workplace, and may also affect their ability 
to access relevant support services and obtain medical advice and care outside the workplace. Raising 
issues  such  as  the  menopause  may  be  even  more  taboo  in  certain  ethnic  groups.  They  may  face 
discrimination in the workplace on three levels: because of their age, because of their sex and because 
of their ethnicity. 

This report has mentioned that anthropometric differences between men and women are important for 
the fit between the workplace, tools and PPE, where women can be at an increased risk if the average 
man is used as the design standard. In addition, if the design standard is the average Caucasian man, 
this could mean a still greater misfit for women from some ethnic minorities (EU-OSHA, 2003a). 

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7  Risk  prevention,  health  promotion,  OSH  systems  and 

gender and sustainable work 

This section will consider the integration, or ‘mainstreaming’, of gender into OSH systems, services and 
risk prevention methods in relation to sustainable work. It will consider risk assessment, which is the 
key tool in the European OSH risk prevention framework for the workplace, workplace health promotion, 
OSH systems and labour inspection and access to occupational health and rehabilitation services. 

7.1  Age- and gender-sensitive risk assessments 

Key findings 

  Workplace  risk  assessment  needs  to  cover  the  cumulative  exposure  to  hazards  and 

incorporate the complexities of age and gender. 

  This includes taking account of broader issues, such as that a lack of career movement for 

women can result in long-term exposure to the same hazards. 
  Support for age- and gender-sensitive risk assessments is needed. 

For the promotion of sustainable work, it is important to integrate age and diversity into risk assessment, 
so that OSH strategies promote diversity through risk prevention and so that risks are tackled at their 
source. This should be underpinned by key principles based on the importance of collective measures, 
consultations with employees and valuing diversity as a resource. Therefore, it is important to address 
age equality, gender equality and OSH in one policy and practice framework. 

Taking a gender-sensitive approach to OSH means giving consideration to gender differences in the 
risk assessment process and the implementation of measures to reduce risks and promote sustainable 
work. Equally, gender issues need to be taken into account in broader age management activities in 
workplaces. 

A number of aspects should be considered regarding gender and risk assessment: 

 

It should be ensured that the diversity of the workforce, including a balanced representation of 
gender, age and type of employment arrangements, is represented in workplace committees, 
groups and other data collection routes for risk assessment and risk reduction measures. 
  Considering that job titles are not always the best indicator of what people actually do at work, 
work  tasks  should  be  examined,  taking  into  account  both  gender  and  age,  to  get  a  better 
understanding  of  the  actual  tasks  carried  out,  and  the  hazards  that  workers  are  exposed  to 
when carrying out those tasks. 

  Workers  with  non-standard  working  arrangements,  such  as  part-time  or  temporary  workers, 

should be covered by risk assessment procedures. 

In addition to gender, consideration should also be given to age, in order to cover the full diversity of 
the workforce. Improved understanding is needed of the different roles played by different groups of 
workers within an organisation, as well as the physiological changes associated with age and gender. 
This will allow better  evaluation of the risks that different groups  of workers face and the necessary 
mitigating measures. In addition, given that sustainable work strategies need to focus on the cumulative 
physical and emotional impacts of work, the assessment of cumulative exposures to hazards should 
take into account differences related to both gender and age; for example, older men and older women 
or older and younger women should be considered within one occupation/sector. Taking an age- and 
gender-sensitive approach need not be complicated, with the first step being to ensure that the different 
groups  of  workers  are  considered  and  consulted  during  risk  assessment.  However,  support  for  risk 
assessments that incorporate all of the complexities of age and gender is also needed. 

Therefore,  a  number  of  additional  aspects  should  be  considered  regarding  age,  gender,  risk 
assessment and measures for sustainable work, although this is not a definitive list: 

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 

considering older men and older women and young male and young female workers during risk 
assessment; 
considering the physical and emotional load in older women’s work; 

 
  paying attention to whether or not there is a lack of control over how tasks are done, decision-

 
 
 

 

making, the pace of working, etc.; 
considering measures for both male and female family carers; 
recognising the menopause as a work issue and providing non-stigmatising support; 
investigating the length of exposure over time and the reasons for prolonged exposure (e.g. 
lack of career mobility), particularly where there is a high incidence of certain work-related ill 
health complaints or injuries among a group; 
considering if equipment or workstations are suitable for women as well as for men, including 
when adjustments are made to support continued working in the case of a women with health 
or ability changes; 

  ensuring that young workers, including female workers, older workers and older female workers, 

are consulted. 

Information and checklists for diversity-sensitive risk assessments are given in EU-OSHA (2009) and 
for gender-sensitive risk assessments are given in EU-OSHA (2003a, 2003b, 2014) and WHO (2011), 
with examples of good practice interventions given in EU-OSHA (2014). 

The close link between  gender equality, cumulative  exposure to hazards  and sustainable  work, and 
how to take account of this during risk assessment, is demonstrated by the intervention in a French 
printing  company  referred  to  in  section  4.2.2,  where  women  working  in  ‘finishing’  suffered  from 
exceptionally high rates of MSDs. Ergonomic improvements were recommended, but more had to be 
done to prevent exposure to repetitive tasks for long periods. An analysis of the length of time spent in 
different jobs by gender revealed that men were more quickly promoted from roles involving ‘finishing’ 
work  than  women,  so  one  of  the  recommendations  included  promoting  women’s  career  path 
development  and  skill  recognition,  in  order  to  prevent  women  from  becoming  trapped  long  term  in 
repetitive jobs. 

The following box provides an example of a company initiative that was put in place to help address the 
risks faced by a specific group of workers, namely older female workers.  

Good  company  practice:  improving  the  work  capacity  of  older  female  workers,  the  Food 
Service Centrum, Finland (Eurofound, 2005, 2009) 

The Food Service Centrum in Finland  provides catering services to the education and  healthcare 
sectors and local government. The work in the company is mostly physical, with few opportunities for 
non-physical work. The company, conscious of the ageing of its workforce, decided to implement a 
well-being programme to support the work ability and well-being of its kitchen workers, half of whom 
were  over  45  years  of  age  and  many  of  whom  were  female,  and  to  improve  the  company’s 
productivity. 

To do that, it set up the Senoriita group, which aimed to give female employees over 45 years the 
opportunity  to  discuss  any  hazards,  risks  and  health  issues  they  experienced.  Participants  in  the 
Senoriita group reported being highly satisfied following the initiative, particularly with regard to the 
information  they  received  about  physiological  and  psychosocial  aspects  of  women’s  ageing  and 
insights  regarding  how  to  manage  these  changes.  A  key  component  of  their  satisfaction  was 
discussing these issues with women of the same age. At the company level, the measurement of 
psychosocial and well-being indicators was improved, as was the company’s work ability index. 

This  particular  measure  was  set  up  to  complement  other  initiatives  within  the  company,  which 
included allowing older workers with limited work capacity to work part-time while receiving a partial 
pension, providing training to workers on new electronic equipment, and individual interventions to 
improve work ability. 

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Taking gender and age into account during the risk assessment procedure is only part of the solution. 
It is equally important that services provided to a company, such as occupational health services, also 
take a gender- and age-sensitive approach. 

7.2  Workplace health promotion and diversity 

Start box 

Key findings 

  Approaches to workplace health promotion should be tailored to ensure that they are both 

age and gender appropriate. 

  Workplace  health  promotion  should  be  complementary  to  an  effective  risk  prevention 

system. 

There are many social and economic factors that interact to strongly influence health and well-being. 
For example, women are more likely than men to report that their general health is poor or that they 
have  a  long-standing  illness. This  is  partly  attributable  to  women’s  lower  economic  status.  (Marmot, 
2013). While the causes of this may be outside the workplace, there is a link between economic status, 
type of work and working conditions, and workplace health promotion (WHP) activities, which go beyond 
just  healthy  lifestyle  education,  have  a  role  to  play.  WHP  is  not  part  of  the  European  OSH  legal 
framework. It should  be complementary and supportive of an effective risk prevention system in the 
workplace, and should play a role in improving the health and well-being of workers. However, there 
can be differences in terms of who participates in WHP programmes at both an individual level and an 
organisational level, as highlighted in the general review (EU-OSHA, 2016a). 

A study  undertaken for EU-OSHA  on WHP looked at  its diversity, in terms of who participates,  who 
does  not  and  why  (EU-OSHA,  2012).  The  review  found  that  different  employee  groups,  including 
different  gender  groups,  have  different  patterns  of  participation  in  relation  to  different  types  of WHP 
activity. In addition, these differences in participation are not uniform across the various WHP activities. 
Gender- and age-sensitive interventions should take these findings into account to ensure equal access 
to, and participation in, WHP of men and women and different age groups. The literature indicates that 
the likelihood of participating in WHP: 

  decreases with age; and 
 

is lower in males. 

Motivation for employees to participate in WHP is: 

lower if they have a low educational attainment level; 
lower in association with adverse health behaviour; and 

 
 
  associated  with  work-related  issues,  such  as  support  from  managers  and  co-workers,  an 

inability to participate during working hours and low control over the work situation. 

The groups most likely to be recruited for WHP activities are not necessarily those that are most likely 
to exhibit sustained participation in them. In general, the review of the literature observed that: 

  Male employees, employees with a high educational attainment level, employees in managerial 

positions and married employees are more likely to be recruited for WHP. 
In contrast, female employees, employees with a low educational attainment level, employees 
in  non-managerial  positions  and  unmarried  employees  are  more  likely  to  show  sustained 
participation in WHP activities. 
In addition, sustained participation was observed to increase with age and among women. 

 

 

Studies covered in the review also suggest that: 

  Male  employees  were  less  likely  to  participate  in  WHP  activities  focusing  on  nutrition  and 
different kinds of treatment (such as massage, physiotherapy and  psychological  assistance) 

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Women and the ageing workforce – Implications for OSH 

than  female  employees,  whereas  there  were  no  differences  in  terms  of  gender  for  activities 
focusing on physical exercise, smoking cessation and the reduction of stress. 

  Women were significantly more likely to engage in physical activities when they were offered a 
fitness  centre,  on-site  exercise  classes  or  paid  time  to  exercise  at  work,  while  men  were 
significantly more likely to participate in competitive activities in sports leagues. This study also 
observed that the likelihood of participating in physical activities attenuated with age, and those 
employees over 60 years were significantly less likely to engage in them. 

  Older  employees  were  more  likely  to  take  part  in  smoking  cessation  and  stress  reduction 
programmes than younger individuals, whereas no significant age differences were observed 
when it came to participation in programmes that focused on nutrition, physical exercise and 
treatment. 

  Regarding  participation  in  health  screening,  younger  workers  tend  to  participate  because  of 
incentives, while older employees see an added value in the health screening itself. The onset 
of chronic disease in older workers, and the fact that their health might not be as good as they 
want it to be, might have an influence on this behaviour. 

Research therefore suggests that  individualised  approaches  to WHP  will  lead  to  higher  employee 
enrolment.  For  example,  the  STUC  et  al.  (2014)  suggested  that  employers  should  include  the 
menopause in workplace health campaigns. Different strategies and messaging for WHP are required 
for  men  and  women  (World  Economic  Forum,  (2008)  cited  by  Men’s  Health  Forum  (2008))  and 
understanding the variation in participation and recruitment trends across sub-groups of workers may 
be  useful  to  help  further  tailor  WHP  programmes,  as well as  to  better  target  communication  and 
marketing strategies at different groups to encourage active participation and commitment. 

As part of a life-course approach, the workplace can be an opportunity for early interventions on health 
promotion  targeting  young  workers.  However,  as  suggested  above,  it  is  important  to  remember  that 
young men and women will have different needs and motivations from older men and women in terms 
of participation in these interventions (EU-OSHA, 2007, 2012). 

A low educational attainment level or lower pay have also been identified as barriers to involvement 
in  WHP  For  women  evidence  suggests  that  obesity  is  more  prevalent  among  women  with  a  low 
educational  attainment  level  than  other  groups  (Roskam  et  al.,  2010,  cited  in  Marmot,  2013).  The 
qualitative research of Nobrega et al. (2016) on workplace interventions to reduce obesity in workers 
with a low educational attainment level or with lower pay identified that unusual or inflexible working 
arrangements, such as working long hours or non-traditional shifts, limited participants’ ability to follow 
guidance on diet and exercise. Difficulties in accessing better food choices and in planning breaks in 
the work schedule were identified as barriers. On the other hand, participants identified both physical 
and psychological demands as being related to being overweight. The authors conclude that working 
conditions should be the starting point for workplace programmes on obesity. The study provides one 
example of how work may influence health inequalities which are commonly perceived to be lifestyle 
issues.  

Thus, WHP initiatives need to take into account work organisation and working arrangements, involve 
workers in the development of programmes and collectively identify facilitators and barriers to allow 
implementation to be more effective. The following example describes a WHP intervention focused on 
one specific target group: men in the postal sector. 

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Good  company  practices:  ‘male-friendly’  staff  wellness  programme  reduces  absence  at  Royal  Mail, 
United Kingdom (EU-OSHA, 2014) 

The  Royal  Mail  wished  to  reduce  sickness  absence  by  developing  a  tailored  and  more  engaging  health 
promotion programme for their male employees. Male manual workers were targeted with booklets produced 
by the Men’s Health Forum5, written in the format of a well-known series of car maintenance manuals. This style 
of presentation was both recognisable and engaging, and felt to be more attractive to men. Wives and partners 
were also engaged to encourage their partners to take part in the health promotion activity. After evaluating the 
intervention, the company saw a reduction in its sickness absence rates, as well as lower staff turnover and 
greater employee satisfaction.  

7.3  OSH systems, labour inspection and strategies for sustainable 

work 

Key findings 

  A  gender-specific  approach  is  needed  for  sustainable  work  strategies,  and  policy  plans 

should be assessed for any possible gender impacts. 

  OSH  systems  need  to  be  able  to  provide  practical  support  for  the  workplace  on  the 

intersection between age and gender. 

  Labour  inspectorates  need  to  adopt  diversity  strategies  to  routinely  incorporate  age  and 
gender issues into their work, avoid discrimination in their practices and be able to support 
workplaces effectively. Examples of this exist. 

  Older female workers should be viewed as a valuable asset, and the double discrimination 

they may face should be addressed through awareness raising. 

The importance for the promotion of sustainable work of an effective OSH system to support workplaces 
and  that  covers  small  businesses  and  all  workers  was  discussed  in  the  general  review  (EU-OSHA, 
2016a).  This  includes  legal  and  enforcement  measures;  services  for  enterprises  and  organisations, 
such as occupational health services; incentives; awareness raising and campaigns; knowledge and 
solutions;  networking  for  the  exchange  of  good  practice;  and  cooperation  between  employers  and 
workers. 

EU-OSHA  (2003a)  highlighted  the  importance  of  systematically  mainstreaming  gender  into  OSH 
systems, strategies and actions. As sex- and gender-related differences persist throughout the working 
life, a gender-specific approach is needed for sustainable work strategies, and policy plans should be 
assessed for any possible gender impacts. OSH systems need to be able to promote a risk prevention 
culture in general, but they also need to be able to provide practical support for the workplace on the 
intersection between age and gender, especially for small businesses. 

Labour  inspectorates  need  to  be  able  to  support  the  process  of  incorporating  age  and  gender 
considerations into sustainable workplace strategies without discriminating. By mainstreaming diversity 
into its strategy and practice, labour inspection can be equipped with the appropriate tools and expertise 
to  systematically  apply  its  activities  to  a  diverse  workforce.  One  example  of  how  to  achieve  this  is 
provided by the diversity mainstreaming strategy implemented by the Austrian Labour Inspectorate. 

Firstly, a Total Quality Management project carried out within the Austrian labour inspection highlighted 
the need for systems to avoid gender stereotyping in this process. A gender mainstreaming framework 
and  strategy  were  put  in  place  resulting  in  information,  a  survey,  tools  (indicators,  guidelines  and 
checklists) and cooperation in pilot sites. Implementation was through a gender mainstreaming group 
and an intranet portal. Gender-related issues, such as the need for work–life balance measures, were 
mainstreamed  into  the  organisation  and  into  the  working  conditions  of  inspectors  —  which  helps  to 
make inspectors more aware of gender issues — and were also mainstreamed into the daily OSH work 
of labour inspection. Implementation actions included training and inspection checklists for inspectors 

5 Men’s Health Forum: https://www.menshealthforum.org.uk/ accessed on 9 May 2016. 

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to use in companies. The project was then extended to cover all areas of diversity, so, as well as age 
and  gender  mainstreaming  approaches,  other  diversity  areas  were  subsequently  integrated  into 
Austrian’s  OSH  strategy.  The  labour  inspection  systematically  includes  diversity  in  its  advice  to 
workplaces,  and  in  its  campaigns  and  guides,  such  as  actions  to  combat  MSDs,  specific  advice  for 
cleaners  and  age  projection  tools  for  small  businesses.  It  carries  out  gender  and  diversity  impact 
assessments,  for  example  when  developing  strategies  and  plans  (EU-OSHA,  2014).  The  diversity 
mainstreaming strategy means that age and gender have been included in the Austrian national OSH 
strategy  2013-2020,  which  defines  the  approach  to  the  prevention  of  work-related  and  occupational 
diseases  as  a  holistic  one,  including  a  life-course  perspective.  Within  this  approach,  gender  and 
diversity aspects are highlighted and the importance of dealing with psychosocial and MSD prevention 
are named as targets (EU-OSHA, 2014). 

Another example is the single equality scheme of the United Kingdom HSE, which resulted in research 
and advice for employers on different areas of diversity (EU-OSHA, 2014). 

The example in the following box shows how an external health programme can support an intervention 
in  a  small,  female-dominated  workplace.  Factors  enabling  this  intervention  included  access  to  a 
municipal health promotion programme, which included training for the kindergarten director and partial 
funding of assistance from an external occupational therapist. 

Good workplace practices: Kindergarten, Denmark (EU-OSHA, 2016c) 

An  example  of  an  intervention  to  promote  sustainable  work  in  a  workplace  in  which  women 
predominate  is  seen  in  a  small  kindergarten  with  19  employees  in  Denmark,  which  introduced  a 
range of sustainable work adjustments to retain staff affected by repetitive movements and lifting. 
These adjustments specifically addressed the fact that workers had to bend frequently and that the 
available furniture was only suitable for children and was not height-adjustable. A partially funded 
external occupational therapist provided help in determining risk prevention measures and provided 
individual advice on working methods. Hydraulic, height-adjustable changing tables and chairs were 
acquired and the load was spread by having fathers helping to move furniture. Exercise programmes 
and physiotherapy were made available to staff at low cost. These measures to prevent MSDs were 
facilitated through trade union and worker involvement and access to a municipal health promotion 
programme, which included training for the kindergarten director. 

On the basis of this review, an OSH strategy for sustainable work with a gender focus would need to 
include a focus on the cumulative impact of the exposures women face throughout their working lives 
(a life-course approach) in particular sectors and jobs, including in relation to repetitive and monotonous 
work, prolonged standing and sitting, stress and emotionally demanding work, and paced and shift work. 
A strategy for a lifelong approach to sustainable work should encompass risk education and prevention 
for  girls  and  boys  in  schools,  and  ensure  that  OSH  education  addresses  the  risks  associated  with 
female-dominated jobs and that OSH is included in vocational training in typical women’s jobs. 

Mechanisms for collaboration between employers and workers are also an element of the OSH system. 
Although not developed under OSH social dialogue, an example of integrated strategy development 
through collaboration between the social partners in a sector dominated by a female workforce is the 
strategy of the tripartite WLG of the NHS in the United Kingdom (Lee, 2015), which was described in 
section 5.1.2. 

The general review (EU-OSHA, 2016a) highlighted that, because of the complex interaction between 
influences within and outside the workplace, an integrated policy approach, which considers all of these 
influences, is essential for supporting workers throughout their working lives, and to ensure that support 
is offered if early exit from the workforce is unavoidable. In particular, cooperation is needed between 
OSH,  employment,  education,  public  health  and  social  security  activities.  Again,  a  gender-focused 
approach to cross-policy actions on sustainable work will be needed to ensure that these strategies and 
actions  are  equally  supportive  of  and  appropriate  for  both  men  and  women.  For  example,  gender 
differences  related  to  pre-existing  chronic  diseases,  social  and  economic  disparities  in  health  and 
access  to  OSH  infrastructure  are  aspects  relevant  to  a  broader,  cross-policy  gender  focus.  Marmot 
(2013)  concludes  that  the  public  health  sector  needs  to  tackle  health  inequalities  in  its  own  core 
activities,  but  that  there  must  also  be  wider  engagement  with  other  sectors.  Schulte  et  al.  (2012) 
provided a framework for the interaction between personal and occupational risk factors in the safety 
and health of the workforce in relation to public health research and intervention. 

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The  general  review  (EU-OSHA,  2016a)  found  a  need  to  promote  the  value  of  older  workers  to 
employers and highlighted a role for OSH systems in doing this through awareness raising. In particular, 
older female employees are a valuable asset to organisations, and it is important to counter stereotyped 
views of their abilities and  the double  discrimination that they may face in  the  workplace, that  is, as 
older workers and as women. 

7.4  Access to support services 

Key findings 

  Gender inequalities in OSH systems and in access to services can have an impact on the 

sustainability of women’s work. 

  A lack of recognition of the work-relatedness of some health problems among women, as 
well as childcare and other care obligations, can be barriers to access to support services. 
  Women of all ages need equal access to  appropriate/adapted rehabilitation programmes 
and vocational retraining adapted/relevant to the sectors and jobs they are usually employed 
in. Barriers to equal access to rehabilitation and vocational services need to be tackled by 
focusing specifically on gender. 

EU-OSHA (2003a, 2013a) has identified some gender inequalities in OSH systems and in access to 
services and these can have an impact on the sustainability of women’s work. 

Certain groups of workers, including part-time workers (see section 3.5), who are predominantly female, 
do not have the same access to support services such as OSH and HR management. 

The general review (EU-OSHA, 2016a) highlighted the importance for sustainable work of access to 
occupational health services, including occupational health surveillance over the life course. However, 
small businesses and their employees, as well as ‘atypical’ workers such as self-employed or ‘casual’ 
workers, are often not covered by such services Women working in these circumstances may be at a 
particular  disadvantage  in  relation  to  accessing  services  owing  to  the  lower  status  of  their  jobs,  for 
example if employed on a casual basis in a small business in the catering sector. 

The lack of access to support mechanisms may have an impact on the maintenance of long-term health 
and  well-being,  especially  in  the  context  of  extending  working  life.  One  Swedish  example  highlights 
differences in accessing support, where only 59 % of women (mostly blue collar workers) have access 
to support mechanisms compared with 64 % of men. The gender gap is especially pronounced for the 
youngest age group. The gender gap, however, has declined since the previous survey in 2011, where 
it was much more marked in the two youngest age categories (Arbetsmiljöverket, 2014). 

Accessing  other  services,  such  as  medical  care,  is  something  that  becomes  more  frequent  as  the 
population ages. While there is widespread recognition that, during pregnancy, women require more 
frequent health checks, without any penalties in the workplace for their absence, such consideration is 
not generally given to older workers. The United Kingdom TUC notes that this is a particular issue for 
older women experiencing menopausal symptoms. A separate issue raised by EU-OSHA (2003a) is 
that medical practitioners may be less likely to consider work-related factors when treating woman’s ill 
health than men’s, in which case causal factors and, therefore, prevention measures may be missed. 

EU-OSHA  (2013a)  identified  that  there  were  44.6  million  people  within  the  EU  with  either  a  long-
standing health problem or a disability. Working with a chronic health problem or a disability will become 
increasingly  common  as  the  workforce  ages.  Thus,  the  issue  of  the  rehabilitation  of  workers  with 
limitations in their work ability following a health problem and their reintegration in the workplace is of 
critical importance in the context of population ageing. 

Older women who suffer from a disability are at risk of a triple discrimination, that is, in relation to their 
gender, age and disability. EU-OSHA (2013a) identified that women with a disability generally receive 
lower  compensation  for  their  loss  of  work  ability  and  experience  greater  difficulty  in  the  process  of 
reintegrating into the labour market with limited work ability. It has been shown that the services offered 
for vocational rehabilitation are biased towards industrial sectors,  which are mostly male-dominated, 
rather than service or public sector work, which are mostly female-dominated. This occurs if access is 

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dependent on having a recognised occupational health problem, as occupational diseases in sectors 
dominated by men are more likely to be formally recognised. In addition, counsellors’ advice has been 
found  to  differ  according  to  gender,  with  women  receiving  less  advice  in  terms  of  re-employment 
prospects. Furthermore, rehabilitation schemes are not always able to take into account women’s needs, 
such as their family carer responsibilities, during the rehabilitation period. 

A specific gender focus needs to be given to rehabilitation after work-related illnesses and the design 
of  programmes.  As  an  example  of  good  practice  for  rehabilitation,  the  French  work  injury  insurance 
organisation Anact has promoted a guide for rehabilitation of female workers following breast cancer, 
which  was  developed  by  an  association  of  occupational  physicians  (Association  CINERGIE,  2008). 
Breast cancer is one of the most frequent female cancers and affects mainly older women. 

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8  Conclusions 
Addressing  exposures  to  safety  and  health  risks  and  better  risk  prevention  for  all  employees  in  the 
workplace  remains  a  priority  for  improving  health  and  well-being  in  the  EU.  Although  this  review 
examines gender issues in relation to the older workforce, it is important to stress a working ‘life-course’ 
approach, starting as early in working life as possible, as the duration of exposure is an important factor 
in  relation  to  chronic  conditions  and  disability.  Long-term  exposure  can  have  negative  impacts,  for 
instance when it comes to exposure to chemicals or to awkward postures, but it can also have positive 
impacts, for instance if younger workers are involved in WHP from the start of their careers, improving 
their lifestyle choices and thus their long-term health. By introducing these opportunities at an earlier 
age, there is likely to be better health across the life course and workers are likely to be healthier at 
retirement. 

This review highlighted a number of sex-specific physiological and cognitive changes relating to ageing 
individuals in the workforce and the related health outcomes. Although many of these changes occur 
for both men and women, there are some notable exceptions, such as the menopause, which occurs 
specifically in older women (50 years and older), a susceptibility of women to chronic conditions such 
as COPD and a higher prevalence in women of osteoarthritis and osteoporosis. 

Horizontal  and  vertical  segregation  in  terms  of  women’s  participation  in  the  workforce  are  important 
factors to consider in a gender-sensitive approach. It appears that horizontal and vertical segregation 
function as mediators of occupational exposure to hazards and risks along the life course. This review 
has highlighted some of the differences in terms of exposure to occupational hazards and related risks 
and  health  problems  that  result  from  horizontal  and/or  vertical  segregation.  Within  horizontal 
segregation, the issue of task segregation (i.e. the fact that, even with a similar job title, men and women 
tend to do different work tasks) is a major issue for older working women, in particular those in low-
skilled jobs. Another important issue when it comes to the OSH of older working women is their role as 
family  carers  and  the  availability  of  measures  that  enable  them  to  combine  work  and  care 
responsibilities. This is an issue that demonstrates how gender stereotypes can also be prejudicial to 
men: older men are more likely than their younger counterparts to have care responsibilities, while most 
flexible care arrangements are geared towards the childcare responsibilities of younger women. 

Given these gender differences, in the future, it will be important to create sustainable working patterns 
for  older  workers,  with  a  specific  focus  on  older  female  workers,  through  measures  that  address 
workloads,  work  tasks,  flexible  working  hours,  the  work–life  balance,  support  in  the  workplace  for 
specific  gender-related  health  issues,  and  workforce  development.  Strong  policy  frameworks, 
investment and resources  are crucial for supporting  actions,  at strategic and practical  levels, on the 
complex intersection between age and gender. This requires consistent, coordinated actions to address 
age, gender and OSH actions related to risk management, the adaptation of work and the balance of 
work  and  care  responsibilities  across  the  life  course.  Older  female  workers  are  a  valuable  asset  to 
organisations  and,  as  part  of  this  gender  focus,  it  is  important  to  counter  stereotyped  views  of  their 
abilities and avoid the double discrimination that older women may face in the workplace. 

8.1  Gaps in knowledge and support 

In general, however, data were rarely available to look at the combined impacts of gender and age. 
Major  gaps  have  been  identified  in  the  literature  in  relation  to  the  adaptation  of  physical  and 
organisational work factors to older female workers. Although very few studies have looked specifically 
at  the  issues  of  age  and  gender  combined,  a  few  examples  do  exist  of  actions  and  programmes 
specifically targeting older women in the workforce, but much more research is needed examining both 
the exposure of older women to occupational hazards and related risks and the effectiveness of targeted 
actions in relation to other actions or interventions. 

One of the difficulties faced in this review of gender-specific issues in relation to the OSH of an ageing 
workforce  is  the  absence  of  research  on  the  interlinkages  between  age  and  gender,  and  of  sound 
evidence  on  what  to  base  policy  initiatives.  Although  data  are  available  on  basic  demographic 
parameters,  such  as  age,  sex  and  gender,  in  relation  to  workforce  participation,  there  are  very  few 
datasets available that examine them in combination, that is, the impact of the participation of women 
50 years and over in different economic sectors, with different working arrangements, on their OSH and 

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Women and the ageing workforce – Implications for OSH 

well-being. This should be looked at from a life-course perspective that is, looking at what needs to be 
done from the start of women’s working life to avoid the development of health problems with age. As 
has  been  mentioned,  there  is  a  significant  lack  of  information  on  older  female  workers  from  ethnic 
minorities.  

In  general,  gathering  more  evidence  on  the  links  between  work,  age  and  gender  will  require  risk 
assessments  and  intervention  evaluations  that  disaggregate  data  to  assess  differences  in  exposure 
and risk by age and gender. In addition, the design of research and investigations on interventions in 
relation to gender is crucial. These issues have been covered in previous EU-OSHA reports, which also 
highlight that it is important to recognise where and how women are exposed and the true extent of 
exposure (EU-OSHA, 2003a, 2013a). The WHO raised similar concerns about lack of information on 
gender differences in incidence of health problems in general because of data not always presented 
disaggregated by sex, and where it is, no gender analysis if the data taking place (WHO, 2003).  

Kennedy  and  Koehoorn  (2003)  considered  whether  or  not  taking  sex  and/or  gender  into  account  is 
important in exposure research. The paper presents the following findings: 

 

 

for men and women with the same job title there exists apparent gender differences in exposure 
because of differences in job tasks or schedules; 
true sex differences occur in actual levels of personal exposure, for example through ill-fitting 
PPE, being closer to the source of exposure and differences in responses to exposure; 

  a gender bias exists in exposure measures because of biased study methods or designs; for 
example, there is a  lack of consideration of gender differences in the  validity or  accuracy  of 
assessment tools or in considering the impact of the healthy worker effect. 

The paper by Kennedy and Koehoorn concludes that failure to consider sex/gender differences at all 
steps  along  the  pathway  of  epidemiological  studies,  from  potential  hazards  to  the  measurement  or 
estimation  of  personal  exposure may  result  in  biased  results.  This  can  be  mitigated  to  an  extent  by 
ensuring that work tasks, rather than job titles, are assessed; by considering the possibility of gender-
stratified analyses rather than gender adjustments; and by ensuring that the healthy worker effect is 
examined for both genders in terms of magnitude and direction. 

Thus,  only  a  few  studies  have  looked  at  whether  or  not  sex  has  an  impact  on  exposure  to  certain 
occupational hazards and related risks. This can arise in relation to body size and shape, for example 
where women, because they are generally shorter, may be closer to an exposure source. Kennedy and 
Koehoorn (2003) give the example of liquor store workers, with women more exposed to measurable 
dust than men. It is unclear whether this  was due to their proximity to the sources or to methods of 
working, but a measurable effect was found. In contrast, differences in body shape and size mean that 
women generally have a smaller surface area of skin potentially exposed to possible chemical hazards. 
However,  Polychronakis  et  al.  (2008,  cited  in  EU-OSHA,  2013a)  identified  that  organ  blood-flow  is 
relatively higher in females than in males, which would suggest that the rate at which chemicals can 
circulate  once  absorbed  is  faster  in  women.  There  may  also  be  gender  differences  in  true  personal 
exposure owing to the way that the work is carried out, although these differences can be difficult to 
explain. It is suggested by the authors that gender differences in true personal exposure are lost during 
analyses, when adjustments for gender are made. 

No studies have looked at these direct impacts in relation to older working women, but it is likely that a 
longer  duration  of  exposure  to  these  occupational  hazards  constitutes  an  increased  risk  for  these 
workers.  More  research  is  needed  on  the  age–gender  intersection,  OSH  and  sustainable  work.  In 
parallel, OSH-related interventions and measures that target age- and gender-specific health problems 
should be considered, such as MSDs, breast cancer and the menopause. In general, gathering more 
evidence on the  links between  work, age  and gender  will require risk assessments and  intervention 
evaluations that disaggregate data to assess differences in exposure and risk by age and gender. 

Based  on  the  analysis  of  the  literature,  a  number  of  general  gaps  in  research  and  data  have  been 
identified: 

  Further  work  is  needed  to  improve  the  collection  of  data  on  hazards  to  which  women  are 
exposed, rather than making assumptions about work tasks and job roles, or correcting for sex 
and gender, in research studies. 

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Women and the ageing workforce – Implications for OSH 

  Because of horizontal segregation in certain sectors, such as cleaning and healthcare, women 
can be exposed to multiple hazards; further research is needed to examine this in relation to 
age and extending the working life. 

  Further research is needed to understand why women report poorer mental health outcomes 

than men exposed to the same psychosocial risks. 

  Further  research  is  needed  to  strengthen  our  understanding  of  the  impact  of  women’s  dual 
roles of paid and domestic work on their health, especially in the context of extending working 
lives. 

  Studies need to include older female workers from different ethnic groups. 

More specific research gaps have also been identified: 

  Our understanding of the possible impact of the menopause on a woman’s working life is still 
limited  and  this  is  an  area  for  which  further  research  is  needed,  in  order  to  identify  support 
strategies for the workplace. 

  Further research is needed on the links between night work and breast cancer in women to 
increase our understanding of the potential causal mechanisms and to improve risk prevention 
strategies. 

  Further research is needed on working in painful and tiring conditions. 

In addition to the need for more research on  the intersection between age and  gender in relation to 
OSH  and  sustainable  work,  more  practical  support  for  the  workplace  is  needed.  OSH-related 
interventions and measures that target age- and gender-specific health problems should be considered, 
such as MSDs, breast cancer and the menopause. 

8.2  Overall conclusions and possible policy implications 
The key findings of the review are summarised below: 

  The  cumulative  physical  and  emotional 

  Sex- and gender-related differences in working conditions persist throughout the working life: 
sex- and gender-related differences between men and women influence the health issues they 
may  face,  what  jobs  they  do,  their  conditions  of  work  and  the  occupational  risks  they  face 
throughout their working lives. Therefore, a gender-specific approach is needed for sustainable 
work strategies, and policy plans should be assessed for any possible gender-specific impacts. 
impacts  of  women’s  work  should  not  be 
underestimated:  sustainable  work  strategies  need  to  focus  on  the  cumulative  impact  of  the 
exposures  women  face  throughout  their  working  lives  (a  life-course  approach)  in  particular 
sectors and jobs, including in relation to repetitive and monotonous work, prolonged standing 
and sitting, stress and emotionally demanding work, and paced and shift work. 
In  the  workplace,  support  for  risk  assessments  of  the  cumulative  exposure  to  hazards  that 
incorporate  the  complexities  of  age  and  gender  is  needed:  the  assessment  of  cumulative 
exposures should take into account differences related to both gender and age; for example, 
older  men  and  older  women  or  older  and  younger  women  should  be  considered  within  one 
occupation/sector. 

 

  Segregation  into  low-level  jobs  without  career  promotion  can  lead  to  long-term  exposure  to 
hazards:  attention  needs  to  be  paid  to  women’s  career  development,  to  avoid  them  being 
trapped in low-level jobs resulting in long-term exposure to the same hazards. 

  The barriers to equal access to rehabilitation and vocational training need to be tackled: women 
of  all  ages  need  equal  access  to  appropriate/adapted  rehabilitation  programmes,  and 
vocational  retraining  should  be  adapted/relevant  to  the  sectors  and  jobs  they  are  usually 
employed in. A lack of recognition of the work-relatedness of some health problems, as well as 
childcare and other care obligations, can be barriers to access to these services. 

  Simple  non-stigmatising  workplace  measures  can  support  women  going  through  the 
menopause: understanding and support for female workers during the menopause are needed; 

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Women and the ageing workforce – Implications for OSH 

such  support  could  be  as  simple  as  providing  access  to  drinking  water.  More  research  and 
practical, non-stigmatising, advice for the workplace in this taboo area is needed. 

  WHP strategies need different approaches for male and female audiences. 
  Flexible work measures need to be relevant to carers of older relatives and to both men and 
women: the workplace approach to family carers needs to be adjusted away from the current 
model  that  focuses  on  women  who  care  for  children,  so  that  it  is  relevant  to  both  male  and 
female carers of older relatives. 

  Labour inspectorates need diversity strategies, and examples of such strategies exist: labour 
inspectorates need to adopt diversity strategies in order to routinely incorporate age and gender 
issues into their work, avoid discrimination in their practices and be able to support workplaces 
effectively. 

  More  research  on  the  age–gender  intersection  is  needed:  more  research  is  needed  on  the 
intersection between gender and age in relation to OSH and sustainable work, combined with 
more practical support for the workplace. 

  Older female workers should be viewed as a valuable asset and the double discrimination that 
older  female  workers  may  face  should  be  addressed  through  awareness  raising:  simple 
measures can often be taken in the workplace to allow women with declining health or abilities 
to continue working. Measures to reduce work demands will often benefit all workers. 

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Women and the ageing workforce – Implications for OSH 

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Appendix A: Summary of findings on the ageing workforce 
and the implications for occupational safety  
The report ‘The ageing workforce: implications for occupational safety and health – a research review’ 
(EU-OSHA, 2016a) examined a number of issues related to the ageing workforce, OSH and sustainable 
work. It was carried out through desk-based research that reviewed existing information relevant to the 
topic. A summary of the report follows.  

Background — why be concerned about ageing and sustainable work? 

The  proportion  of  older  people  in  the  general  population  is  increasing  across  the  EU.  Even  more 
importantly, this ageing of the general population is mirrored by the ageing of the working population, 
reflecting, in parallel with demographic trends, a number of socio-economic developments. For instance, 
there has  been  a  push at the  European  level to  increase the  employment rate of those aged 55-64 
years. Furthermore, many Member States have increased the official pension age to more than 65 for 
both  men  and  women,  and  many  Member  States  are  planning  to  increase  the  retirement  age  even 
further.  These  changes  are  motivated  by  concerns  regarding  meeting  state  pension  costs.  An  older 
working population, an increase in the number of years worked and continuing to work at an older age 
have implications for OSH and sustainable work. 

However, economic measures, such as increasing the official pension age, will be successful only if 
workers  are  able  to  work  and  retain  their  physical  and  mental  health  into  retirement.  This  requires, 
among others, measures to improve occupational health. 

In particular, increasing the pension age has two possible implications for occupational risk prevention 
and the sustainability of work. Firstly, many occupational diseases and the effects of demanding work 
develop over time from cumulative  exposure; therefore, extending the  number of  years worked may 
extend the exposure to hazards and increase the risks of developing occupational diseases or having 
one’s physical ability affected by demanding  work. Secondly, the  work ability  of those aged  over 65 
years  and  their  continued  ability  to  work  in  physically  or  mentally  arduous  working  conditions  in 
particular must be considered. For both of these implications of working for longer, the importance of 
reducing the exposure to hazards and making work easy for all workers is clear. In 2010, of those aged 
50-54 years, 33.7 % did not think that they would be able to do the same job at 60 years of age. However, 
this overall average masks important differences between sub-groups of the working population: both 
men and women in low-skilled jobs, which are likely to be more physical in nature, have considerably 
greater concerns than men and women in professional and managerial jobs 6. 

The ageing of the working population, combined with increases in official pension ages to more than 65 
years, means that more employees are likely to develop chronic health problems while still at work, as 
the prevalence of chronic health problems increases with age. Some of these chronic health problems 
will  have  a  work-related  component.  However,  regardless  of  whether  work  contributes  to  a  chronic 
health problem or not, policies to promote working for longer and to reduce the incidence of early exit 
from the workforce need to focus on helping those with chronic diseases function actively at work 7 

In order for workers to stay in work as they age, attention must be paid to creating good-quality working 
conditions,  with  an  appropriate  work–life  balance,  employment  security  and  lifelong  learning 
opportunities throughout the working life8. This is what is meant by ‘sustainable work’. 

6 Eurofound – European Foundation for the Improvement of Living and Working Conditions (2012), Sustainable work and the 
ageing  workforce.  A  report  based  on  the  fifth  European  working  conditions  survey,  Luxembourg:  Eurofound.  Retrieved  22 
January  2016  from:  http://www.eurofound.europa.eu/publications/report/2012/working-conditions-social-policies/sustainable-
work-and-the-ageing-workforce 

7 Eurofound – European Foundation for the Improvement of Living and Working Conditions (2014), Employment opportunities for 
people  with  chronic  diseases:  Executive  summary,  Dublin,  Ireland:  Eurofound.    Retrieved  27  April  2016  from: 
http://www.eurofound.europa.eu/sites/default/files/ef_publication/field_ef_document/ef1459en1.pdf 

8 Eurofound  –  European Foundation  for  the Improvement  of  Living and Working  Conditions  (2012a), Employment trends  and 
from: 

policies 
http://www.eurofound.europa.eu/publications/report/2012/labour-market-social-policies/employment-trends-and-policies-for-
older-workers-in-the-recession 

recession,  Dublin.:  No  EF/12/35/EN.  Retrieved  22  January  2016 

for  older  workers 

the 

in 

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Focus of the review 

Creating  sustainable  working  conditions  requires  a  wider  understanding  and  appreciation  of  the 
influence of any age-related changes in work capabilities or susceptibilities and the cumulative impact 
of  exposure  to  risks  throughout  the  working  life.  This  review  has  collated  evidence  on  the  current 
situation  in  relation  to  the  challenges  of  an  ageing  workforce  for  OSH.  The  review  examined  the 
following three questions: 

 

 

 

‘What changes occur in ageing individuals within the workforce, and what are the likely impacts 
of work along the life course on health and ability?’ 
‘What are the implications of these changes and the impacts of work along the life course in 
relation to OSH and sustainable work?’ 
‘What OSH measures can be considered to mitigate any potentially adverse safety and health 
effects and to promote sustainable work along the life course?’ 

The review recognises that chronological age is not the most appropriate index of a person’s abilities 
or needs and, instead, considers ‘work ability’, which looks at an individual’s resources in relation to the 
demands of their work. 

The review considers OSH factors that influence work ability and sustainable work within and outside 
the workplace. The report also considers measures to promote sustainable work across the life course. 
A  ‘life-course  approach’  to  OSH  focuses  on  improving  prevention  of  risks  for  all  workers,  thereby 
reducing  the  damage  to  workers’  health  throughout  life  and  limiting  early  exit  from  the  workforce, 
improving  the  sustainability  of  work  with  high  physical  demands,  and,  in  addition,  making  specific 
accommodations for individual workers if needed. This is key to promoting a longer working life and 
healthy retirement. 

Therefore,  when  addressing  these  questions,  the  report  also  considers  the  implications  of  the 
cumulative exposure to hazards over the life course, the possible implications of increased cumulative 
exposure due to longer  working lives, and OSH challenges  with regard to sustainability over the life 
course. 

There are many different determinants of health and work ability, which are influenced by a variety of 
interacting factors within and outside the workplace. For example, working conditions are influenced by 
the culture within a workplace, national OSH policy and services, national health policy and services, 
and the interaction between these factors. These interactions are represented by the Work Ability House 
(FIOH), shown in following figure. This report also considers OSH, work ability and sustainable work in 
this broader context of influences. 

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Model of work ability9 

Changes  associated  with  ageing,  the  impact  of  work,  and  the  implications  for  occupational 
safety and health and sustainable work 

A number of key findings  were made  in response to the question ‘What changes occur in  ageing 
individuals within the workforce, and what are the likely impacts of work along the life course 
on health and ability?’: 

  There  are  a  number  of  changes  to  physiological  systems  with  age,  including  reductions  in 
aerobic power, muscle strength, stature, dexterity and mobility. The age at which these changes 
start to take place and the extent of such changes vary widely across individuals. 

  Older  workers  can  often  compensate  for  losses  to  work-related  functional  capacity  with 

strategies and skills gained through experience. 

  Physical  strength  and  endurance  is  also  very  specific  to  individuals,  such  that  some  older 

workers may be stronger than their younger colleagues. 

  While some cognitive abilities decline with age, such as memory and reaction time, according 
to laboratory-based studies, there is evidence that work performance is unlikely to be affected, 
as  older  individuals  can  generally  compensate  for  any  decline  with  experience,  better 
judgement and job-specific knowledge. Strengthening of other mental characteristics, such as 
ability to reason and motivation to learn, can also help older workers to compensate for any 
changes and maintain work performance. 

  The key elements of cognitive performance important for workplace safety and health, such as 
intelligence, knowledge and use of language, do not generally show any marked decrease until 
after the age of 70 years. 

  Statistical data show that older workers are more likely than younger workers to  suffer from 
chronic health problems, such as cardiovascular disorders and musculoskeletal diseases. This 
does not necessarily affect their work performance and many chronic diseases are controllable. 

9  FIOH  –  Finnish  Institute  of  Occupational  Health,  Multidimensional  work  ability  model,  FIOH.  Helsinki.  Available  at: 

http://www.ttl.fi/en/health/wai/multidimensional_work_ability_model/pages/default.aspx 

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  Chronological age is not the most important determinant of health, and ageing is not inevitably 
accompanied by illness and disease. Health is influenced by numerous other external factors, 
including lifestyle, exercise and nutrition. 

 

  The extent of exposure to hazards throughout the working life is one external factor that can 
influence  the  health  of  older  workers.  For  example,  health  can  be  affected  by  long-term 
exposure to chemical substances or physical work. There can be a long latency period before 
the effects of exposure are seen, as is the case with exposure to asbestos. 
In contrast to some stereotypical views of the abilities of older workers, they are an asset to 
organisations. Older workers are often more reliable than younger workers and often show a 
greater  level  of  commitment.  Furthermore,  turnover  and  (short-term)  absenteeism  rates  are 
often  lower  among  older  workers  than  younger  workers,  and  they  have  a  wider  diversity  of 
expertise, knowledge and skills. 

The  key  findings  that  were  made  in  relation  to  the  question  ‘What  are  the  implications  of  these 
changes and the impacts of work along the life course in relation to OSH and sustainable work?’ 
are summarised below: 

  Cumulative exposure over the course of working life to a wide variety of physical and chemical 
agents has implications for occupational health and, therefore, the sustainability of work. 
  Physiological  changes  can  lead  to  the  deterioration  of  physical  capabilities.  This  does  not 
necessarily affect work performance, but can result in a reduced tolerance of certain aspects 
of physical work. There is evidence that long-term exposure to demanding work increases the 
impact of deterioration. 

  While most jobs do not require workers to work at full physical capacity, some older workers 
with physically demanding jobs may be working at (or close to) the limit of their capacity and 
may, therefore, be more at risk of musculoskeletal injuries or chronic fatigue than their younger 
counterparts. However, experience may protect against this to some extent. In other words, the 
propensity for injury is related more to the difference between the demands of the work and the 
worker’s ability to work than to age. 
In general, the prevalence of musculoskeletal disorders (MSDs) increases with age, probably 
as part of the normal ageing process; however, declining health does not necessarily mean a 
decline in job-related performance. Other factors, such as work demands, may have a greater 
influence on the risk of developing work-related ill health than age. The increased prevalence 
of  MSDs  with  age  is  most  pronounced  in  workers  involved  in  physically  demanding  jobs, 
irrespective of age. 

 

  A worker’s physical capacity or ability to work should be used to determine if they are capable 
of performing a specific job and the associated risk of MSDs, rather than their age. Employers 
may need to provide additional support, including adjustments to the work. 

  Some  age-related  changes  could  result  in  increased  risk  under  certain  circumstances,  for 

example exposure to extreme temperatures or driving at night. 

  Rates of accidents at work associated with more than three days of absence are lower among 
older  workers  than  among  younger  workers.  However,  older  workers  are  more  at  risk  of  a 
severe or fatal accident. Although less likely to have an accident, older workers take longer to 
recover from any injury sustained. Occupation, not age, is the dominant factor that contributes 
to risk of injury. 

  Generally,  the  evidence  suggests  that  work-related  stress,  anxiety  and  depression  increase 
with  age  and then decrease after the age of 55  years. The causes of work-related stress in 
older workers are different from those in younger workers. For instance, older workers are more 
likely to experience stress because of the responsibility they have for other people’s work and 
the workload, rather than the physical work environment. 

  There is evidence that continuing to work in good-quality working conditions is associated with 
better physical health and psychological well-being than being out of work. Good social support 
at  work  can  contribute  to  a  reduced  likelihood  of  early  retirement  —  workers  need  to  be 
managed in an age-appropriate manner. 

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  There is evidence that some older workers, but not all, have difficulties with shift work and may 
need additional support or the option of non-shift work. Age is associated with changes in sleep 
patterns and a reduced tolerance of routine changes such as those usually associated with shift 
work. There is some evidence for a link between prolonged exposure to night work and breast 
cancer. 

  The experience of older workers may enable them to increase their efficiency in the workplace 

(by learning to adopt different ways of working). 

  Many age-related changes, such as hearing or vision changes, that could affect safety at work 
can  generally  be  corrected  with  simple  aids  or  work  adjustments.  This  also  applies  to 
circumstances in which chronic disease affects performance at work. 

  Measures that make work less demanding for older workers would often benefit all workers. 
For example, measures to prevent the development of MSDs as a result of manual handling, 
repetitive work, and static and awkward postures would benefit workers of all ages. 

Chronological age is not the most important determinant of health and performance 

The  determinants  of  health  status  and  performance,  and  the  age-relatedness  of  both,  are  complex. 
There are a number of changes that occur across the life course in relation to physiology, psychology 
and human processing. However, it is apparent that ageing is a very individual process. Chronological 
age is not the most important determinant of health, and ageing is not inevitably associated with illness 
and disease. Furthermore, age is not the  best indicator of performance or ability. Older  workers are 
vastly different from each other because of the interaction of both external and internal factors with the 
ageing  process.  Important  external  factors  include  lifestyle,  exercise  and  nutrition.  No  stereotype  of 
older workers is likely to be true for all, even for the majority of older workers, particularly the belief that 
chronological age is the most important determinant of health or that older workers take more time off 
work10. 

One study11 concluded that chronological age is unlikely to be the best predictor of work preferences 
or ability, and that focusing on older workers may lead to good practice relevant to employees of all 
ages  being  overlooked.  The  authors  stated  that  older  workers  essentially  exhibit  the  same  set  of 
vulnerabilities as workers of other ages, even if considered a relatively high-risk or vulnerable group. 

As mentioned above, one external factor that can influence the health and physical capacity of older 
workers is the extent of exposure to hazards throughout their working life. For example, health can be 
affected  by  long-term  exposure  to  chemical  substances  or  physical  work,  and  there  can  be  a  long 
latency period before the effects of such exposure are seen, for example in the case of exposure to 
asbestos. Dworschak et al. (2006) 12 stated that ‘If workers are required to perform work under adverse 
conditions  on  a  permanent  basis,  they  will  almost  inevitably  encounter  health  and  performance 
problems as they grow older.’ Work should maintain physical and mental health, not contribute to its 
deterioration. However, according to the European Working Conditions Survey (EWCS), workers aged 
35-44 and 45-55 years are more likely to report that their health is at risk from work than those aged 
over 55 years, which has implications for the future health of these workers. Those aged 55 years or 
over in craft and elementary occupations are more likely to report that they do not think that they will be 
able to  work until they  are 60  years old than those in  managerial or professional jobs. Therefore, to 

10 Benjamin, K. & Wilson, S. (2005), Facts and misconceptions about age, health status and employability, Health and Safety 

Laboratory, HSL/2005/20, Buxton, UK. Available at: http://www.hse.gov.uk/research/hsl_pdf/2005/hsl0520.pdf 

11 Weyman, A., Meadows, P. & Buckingham, A. (2013), Extending working life. Audit of research relating to impacts on NHS 

employees, London, UK: NHS Employers. Retrieved 22 January 2016 from: 
http://www.nhsemployers.org/~/media/Employers/Documents/Pay%20and%20reward/WLR%20-%20Extending%20Working
%20Life%20-%20An%20audit%20of%20research%20relating%20to%20impacts%20on%20NHS%20Employees%20May%2
02013.pdf 

12 Dworschak et al. (2006, cited in Weyman et al., 2013). See footnote 10. 

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Women and the ageing workforce – Implications for OSH 

ensure that work is sustainable, it is important that it helps to maintain physical and mental health and 
does not contribute to its deterioration13 14. 

Demands of work: work ability — an individual’s resources in relation to work demands 

As  mentioned  above,  age-related  changes  happen  to  individuals  at  different  ages  and  to  differing 
degrees, and may also be compensated for at work, so may not affect work performance. It should also 
be recognised that age-related changes are not the only factors that affect the ability to work. Whether 
any such change affects work performance or not also depends on the nature of the work itself, or, in 
other words, the demands of the work. The concept of ‘work ability’ looks at an individual’s resources 
in relation to the demands of a particular job. 

It is difficult to predict the effects that age-related changes may have on the work ability of those aged 
over 65 years, who will now more often continue to work because of increases in official pension ages. 
The effects of continuing to work longer may be both positive, in terms of keeping people active, and 
negative, in terms of exposure to occupational hazards. 

Health problems may not or need not necessarily affect work performance 

An individual’s health may change with age, but age is not necessarily the best determinant of health 
status. In addition, having an illness does not necessarily mean that an employee’s work will be affected. 
In  certain  cases,  adjustments  to  work  can  enable  an  employee  with  a  health  problem  to  continue 
working. Evidence also suggests that, in general, good work has a positive effect on both physical and 
mental health and  well-being,  while  not  working has  been associated with  poor  physical and mental 
health. The biggest barrier to working with a health problem may be employers’ attitudes, rather than 
the health condition itself. 

Work  should  be  made  easier  and  healthier  for  all,  with  specific  measures  for  individuals  if 
needed 

According to the concept of ‘sustainable work’, workplaces should promote the health of workers of all 
ages and support those who have health conditions. This suggests that the first priority should be to 
improve risk prevention measures and make work easier for the benefit of all workers across the work-
life course, especially in the case of mentally or physical demanding work, but also with regard to work 
that is associated  with the risk of developing  MSDs, such as working in  awkward postures. It  would 
appear that the workers who are most likely to have problems later in life if their ability to work declines, 
because their work is particularly demanding, are also most likely to have their health compromised by 
their work. 

Although physical capabilities may decline with age, this need not necessarily affect work performance. 
Many changes, such as age-related vision changes, can be corrected by either personal equipment or 
simple workplace adaptions. In many cases, adjustments can be made to specific tasks. However, if 
such  adjustments  are  not  possible,  the  transfer  of  workers  to  less  demanding  work  should  be 
considered in order to retain experienced workers. Evidence suggests that the consideration of work 
ability — an individual’s resources in relation to the demands of the work — is the most appropriate way 
of determining whether or not any changes in a worker’s health or capabilities puts them at an increased 
risk from their work. 

Older workers should be viewed as an asset 

Finally, older workers have been identified as a valuable asset to organisations, because they are often 
more  reliable  than  younger  workers  and  often  show  a  greater  level  of  commitment.  Furthermore, 
turnover and (short-term) absenteeism rates are often lower among older workers than younger workers, 
and they have a wider diversity of expertise, knowledge and skills 15. It is important to be objective about 

13 Eurofound – European Foundation for the Improvement of Living and Working Conditions (2012b), Sustainable work and the 
ageing workforce. A report based on the fifth European working conditions survey, Luxembourg: Eurofound. Retrieved 22 
January 2016 from: http://www.eurofound.europa.eu/publications/report/2012/working-conditions-social-policies/sustainable-
work-and-the-ageing-workforce 

14 Eurofound – European Foundation for the Improvement of Living and Working Conditions (2015), ‘First findings: Sixth 

European Working Conditions Survey’, Retrieved 3 May 2016 from: 
https://www.eurofound.europa.eu/sites/default/files/ef_publication/field_ef_document/ef1568en.pdf 

15 Harrison and Higgins (2006) cited in Okunribido, O. & Wynn, T. (2010), Ageing and work-related musculoskeletal disorders: 

A review of the recent literature, UK, HSE: Research Report 779. Available at: http://www.hse.gov.uk/research/rrpdf/rr799.pdf  

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the performance of older workers and counteract the stereotypical views of the abilities and attitudes of 
older workers that some employers may have. 

Occupational  safety  and  health  measures  and  systems  that  support  sustainable  work  and 
mitigate any potentially adverse effects on safety and health 

The  findings  related  to  the  question  ‘What  OSH  measures  can  be  considered  to  mitigate  any 
potentially  adverse  safety  and  health  effects  and  to  promote  sustainable  work  along  the  life 
course?’ are discussed in the following sections. 

Models of sustainable work 

In terms of OSH, the concepts of ‘sustainable work’ and the ‘life-course approach’ can be used to inform 
an  integrated  approach  to  improving  working  conditions  for  all,  along  with  considering  the  individual 
changes that can occur with ageing and the implications of these changes for workplace safety and 
health.  Various  models  have  been  put  forward  to  help  us  understand  the  multifaceted  nature  of 
sustainable  work.  These  models  reflect  the  various  influences  from  both  within  and  outside  the 
workplace and, therefore, highlight the importance of an integrated policy approach that includes an 
OSH component. 

The four models briefly summarised in the review were selected because of their relationship to OSH, 
but also because they differ in their perspectives on other factors. These models are: 

the work ability concept16; 

 
  a model to monitor sustainable employability17; 
 
 

the conceptual framework on age and employment18; 
the schema for understanding the domains encompassed by sustainable work 19. 

These four models of sustainable work present the various complex and interacting elements that can 
influence the sustainability of work and the work ability of individuals, and therefore the continuation of 
or early exit from work of those individuals. By improving understanding in this way, these models can 
help  to  inform  improvements  in  policy  and  interventions  aimed  at  retaining  older  workers  in  the 
workforce. The work ability concept (FIOH, 2010) has already been described above. 

Occupational safety and health measures and systems to support sustainable work 
The  models  described  above  depict  influencing  factors  from  within  and  outside  the  workplace.  The 
report examined two important influences: the safety and health of working conditions, and the OSH 
systems,  legislation  and  policy  needed  to  ensure  that  safe  and  healthy  working  conditions  are 
maintained, including the interaction between OSH and other policy areas such as health, social policy, 
employment and education in the context of sustainable work. 
There is evidence that OSH performance needs to improve if the EU is to prolong the working life of its 
workforce, especially in some demanding jobs. According to the European Working Conditions Survey, 
significant  proportions  of  the  workforce  report  exposure  to  challenging  working  conditions  such  as 
painful and tiring positions, working at high speed or adverse social behaviour 20). Long-term exposure 
to such working conditions could lead to early exit from employment. 

16 FIOH – Finnish Institute of Occupational Health, Multidimensional work ability model, FIOH. Helsinki. Available at: 

http://www.ttl.fi/en/health/wai/multidimensional_work_ability_model/pages/default.aspx  

17 TNO (2012), Model developed to monitor sustainable employability. Retrieved 25 January 2016 from: 

http://publications.tno.nl/publication/100446/zzgzb5/kraan-2012-model.pdf 

18 Hasselhorn, H.M.,  Peter, R., Rauch, A., Schroder, H., Swart, E., Bender, S., du Prel, J-B, Ebener, M., March, S., 

Trappmann, M., Steinwede, J. & Muller, B.H. (2014), 'Cohort profiles: The lidA cohort study – a German cohort study on work, 
age, health and work participation', International Journal of Epdiemiology, Vol. 43, No 6, pp. 1736-1749 

19 Eurofound – European Foundation for the Improvement of Living and Working Conditions (2015b), Sustainable work over the 

life course: Concept paper, Publications Office of the European Union, Luxembourg. Retrieved 23 January 2016 from: 
https://www.eurofound.europa.eu/fr/publications/report/2015/working-conditions/sustainable-work-over-the-life-course-
concept-paper 

20 Eurofound – European Foundation for the Improvement of Living and Working Conditions (2015), ‘First findings: Sixth 

European Working Conditions Survey’, Retrieved 3 May 2016 from: 
https://www.eurofound.europa.eu/sites/default/files/ef_publication/field_ef_document/ef1568en.pdf 

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Improved risk prevention for all workers 

Key finding: In relation to OSH, sustainable work consists of two main elements, both of which are 
covered by the European  legal framework on OSH: (1) ensuring  work does not  damage physical or 
mental  health  across  the  life  course,  by  controlling  risks  to  all  workers  (generic  measures);  and  (2) 
taking additional steps if and when necessary to protect any particularly vulnerable groups or individuals. 

Therefore, the first OSH priority, in terms of sustainable work, is to ensure that working conditions do 
not  negatively  affect  workers’  health  or  their  work  ability,  or,  put  another  way,  to  ensure  that  work 
positively contributes to the maintenance of workers’ physical and mental health across the work-life 
course. To achieve this, continued efforts are needed to improve risk prevention and make work easier 
and safer for the benefit of all workers. Various measures that would make work easier for all workers 
have been identified in this report. 

Specific measures for older workers if and when necessary 

In  addition  to  good  OSH  management  aimed  at  reducing  risks  to  all  workers,  additional  specific 
measures are also needed for older workers if and when necessary, depending on the type of work and 
the individual, so that their work can be organised in a way that allows them to continue to work in a 
safe and healthy manner. This needs to be done on an objective basis, in order to avoid discrimination 
and  actions  being  based  on  stereotypes  of  older  workers. This  implies  that  a  diversity-sensitive  risk 
assessment approach is needed. It is proposed that the assessment of work ability of individual workers 
could also be used as part of an OSH management approach based on risk assessment. Work ability 
assessment may be especially applicable to demanding working conditions. The report has identified 
various, often simple, accommodations that can be made to allow those with changed abilities or health 
conditions to continue working. 

Key finding: ‘Work ability’ refers to an individual’s resources (for example, physical capacity, attitudes, 
experience) in relation to work demands (for example, work content, work environment, work culture). 
The  work  ability  concept  has  been  incorporated  into  a  self-assessment  tool,  the Work  Ability  Index, 
which can assist with the early identification of risks to individual workers in order to counteract them. 

Occupational safety and health risk prevention measures and workplace accommodations 

Various  measures  have  been  identified  in  this  report  that  would  make  work  easier  for  all  workers, 
including  changing  the  way  tasks  are  carried  out  to  avoid  or  reduce  physically  demanding  work, 
exposure to repetitive work or dangerous substances, etc.; using equipment to make work easier; and 
improving career progression to avoid prolonged exposure to risks (in relation to, for example, highly 
repetitive work, which is often carried out in some female-dominated types of work). 

In particular, measures to prevent the development of MSDs, caused by manual handling, repetitive 
work, or static and awkward postures, would benefit all workers and contribute to the sustainability of 
work. Taking frequent breaks and the use of properly adjusted ergonomic workstations is suggested for 
computer-based work. 

The report has also identified various, often simple, accommodations that can be made, including the 
use of personal devices or equipment, or changes to working hours, tasks or roles, to enable individuals 
with reduced work ability or changes in health to remain in work. 

Key  finding:  OSH  measures  to  make  work  easier  for  all  and  workplace  accommodations  to  allow 
workers with declines in health or performance to remain in work are often very simple. 

General mitigating measures 

In summary, the report has identified the following key measures that can mitigate adverse effects 
on safety and health: 

  A comprehensive approach to age management in the workplace, to promote sustainable work 
and  counter  the  effects  of  ageing,  includes  OSH,  health  promotion  and  human  resources 
measures. 

  Risk  assessment  can  support  sustainable  working  by  being  used  to  identify  risk  prevention 
measures  to  improve  working  conditions  for  the  whole  workforce  or  identify  measures  for 

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Women and the ageing workforce – Implications for OSH 

specific groups or individuals. Work ability evaluation can be used as part of risk assessment. 
OSH  aspects  of  age  management  can  be  accommodated  within  the  normal  workplace  risk 
assessment and management process. 

  Health surveillance monitoring over time and access to occupational health services are issues 

that need to be addressed, particularly for temporary workers and small businesses. 

  Ergonomics has an important role to play in reducing the demands of work for all workers and 

making specific adjustments for groups of workers or individuals. 

  Workplace health promotion interventions should be age appropriate, gender appropriate and 

inclusive of all age groups. 

  Older workers can often benefit from appropriate flexible working arrangements, allowing them 
to accommodate other activities such as responsibilities as carers or to facilitate working with 
health  problems.  Social  policy  also  influences  whether  or  not  workers  can  combine  caring 
responsibilities and work. 

  Other  measures  include  maintaining  up-to-date  skills  and  knowledge,  with  training  methods 
adapted to different age groups; and viewing older workers as an asset and developing their 
roles, for example through training and mentoring of younger, less experienced workers. 
  The prevention of injury and ill health in younger workers is an essential part of a sustainable 
work approach. The promotion of ‘healthy schools’ and risk education in schools is also part of 
a lifelong approach. 

  Rehabilitation  should  be  focused  on  staying  in  work,  and  early  interventions  are  crucial. 
Rehabilitation programmes should be interdisciplinary. Simple workplace accommodations can 
often allow workers with chronic diseases to remain in work. More needs to be done to support 
individuals living with chronic MSDs, who are either in work, or planning to return to work in 
future. 

  Specific gender-related issues, in relation to sustainable work, need to be taken into account, 
as in any other OSH area. Such issues include reducing the high demands of certain jobs in 
which  women  predominate,  for  example  health  care  and  cleaning;  workplace  measures  to 
support women going through the menopause; the double workload of family carers; and equal 
access to rehabilitation services. 

  A sector- or job-specific approach allows interventions to address the specific work challenges 
identified and takes account of the specific context. Many of the measures identified to reduce 
workloads in specific sectors would benefit all workers in the sector. 

The figure below was produced by the Federal Institute for Occupational Safety and Health (BAuA) in 
Germany to depict various measures in the workplace that contribute to work ability and sustainable 
work. 

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Women and the ageing workforce – Implications for OSH 

How to improve work ability and promote sustainable work in the workplace21 

Support of OSH systems to promote sustainable work 

Key finding: As suggested by the models, an effective OSH system is needed to support the 
approach to sustainable work of combining improved protection for all workers with measures for 
individuals at greater risk as and when necessary. 

Elements of an effective OSH system and the tools it requires include: legal measures; enforcement; 
services available to enterprises and organisations, such as occupational health services; incentives; 
awareness raising and campaigns; knowledge and solutions; networking for exchange of good practice; 
and cooperation between employers and workers, for example through tripartite advisory committees22. 
All of these areas are relevant to achieving sustainable work. 
As mentioned above, the European OSH legal framework is based on risk assessment and combines 
the collective measures of protecting all workers as the priority with work adapted to individual workers 
and measures to protect vulnerable groups. This framework is supportive of achieving sustainable work 
if effectively implemented. The promotion of well-being in addition to risk prevention requirements is 
likely to increase the impact of legislation with regard to supporting sustainable work. The modern labour 
inspectorate combines enforcement activities with the provision of support, advice and information to 
workplaces. To carry out these roles, a labour inspectorate needs to be equipped with the appropriate 
tools and expertise to apply its activities to a diverse workforce. 

The importance of access to occupational health services, including health surveillance throughout the 
working  life,  has  been  highlighted  as  an  issue  in  this  report.  This  is  a  problem  particularly  for  small 
businesses and temporary workers, such as construction workers or cleaners, many of whom may be 
migrants and perform the most demanding work. The provision of basic occupational health services 
linked to primary health care has been suggested as one way to greatly increase the coverage of small 
businesses  and  workers  not  covered  by  employers’  occupational  health  systems  or  work  insurance 
systems. Small businesses in particular need access to OSH support in general, for example for risk 
assessment, and especially with regard to assessments of individual workers and for determining risk 
prevention measures and suitable workplace adjustments for individuals. A sector-based approach may 
be most effective for small businesses and could be more easily targeted to their specific needs. 

Work-focused rehabilitation services are also highlighted in this report as being of key importance for 
workers and also small businesses. This implies the need for an integrated approach between health 
and social policy and employment and OSH policy, as covered by the models. 

21 Sedlatschek, C, INQA project, BAuA, (undated). 
22 Takala J, Urrutia M, Hämäläinen P, Saarela KL. ( 2009), ‘The global and European work environment – numbers, trends, and 

strategies’, Scandinavian Journal of Work, Environment and Health Suppl, 7, pp 15–23 

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Women and the ageing workforce – Implications for OSH 

Awareness raising campaigns should be implemented to disseminate the benefits of older workers to a 
workplace and raise awareness of those elements of the workplace that are not suited to their needs 23. 
However, this is likely to have a greater impact if combined with support and incentives for small and 
medium-sized  enterprises  (SMEs)  to  improve  OSH,  and  to  take  measures  to  accommodate  older 
workers or carry out workplace health promotion activities. 

Continued research into OSH in general, and in relation to the ageing workforce in particular, is needed 
to improve knowledge and solutions. Existing OSH knowledge and best practice needs to be shared, 
including best practice on how to support small businesses in the context of an ageing workforce. 
OSH authorities and organisations need to take a strategic approach to achieving sustainable work. 
The most effective way to do this is likely to be by incorporating or mainstreaming age and other areas 
of  diversity  throughout  their  strategy  and  practices.  The  diversity  strategy  of  the  Austrian  Labour 
Inspectorate is a good example of how this can be done. 

OSH  systems  can  also  promote  a  life-course  approach  that  starts  before  working  age,  through 
cooperation with education policy, to embed risk education in school curriculums and promote health in 
schools, including through raising awareness of the ergonomics of furniture and other elements that 
could contribute to the development of MSDs. 

Integrated policy approach 

Key finding: As depicted in the conceptual models relating to sustainable work, improving the retention 
of  older  workers  is  not  just  a  function  of  maintaining  their  health  and  capacity  and  providing  quality 
working  conditions,  but  it  is  also  essential  to  take  other  inter-related  factors  into  account,  including 
motivation, learning opportunities and broader socio-political and institutional factors, such as income 
distribution, and pension and tax regimes. 

There are many social and economic factors which interact to influence strongly health and wellbeing24 
and also skills and motivation to work. As mentioned above with regard to rehabilitation, the models for 
sustainable work depict how various policy areas outside the workplace interact in the context of the 
sustainability of work, emphasising the importance of an integrated policy and services approach that 
includes OSH. 

Given the evidence of persisting risks, especially in some sectors, considerable improvements to OSH 
are needed in many instances to prolong working lives. In cases in which work demands exceed an 
individual’s work ability, because of the working conditions or declines in workers’ health, even after 
accommodations have been made, there will need to be provisions for them to either change to another 
field of work entirely or exit from the workforce. Therefore, complementary policies and services are 
needed to support workers who, unavoidably, have to exit employment early. This, again, underlines 
the importance of an integrated policy approach. 

Gaps in the knowledge 

Finally, the review identified a number of evidence gaps. An improved understanding is needed of how 
to make work sustainable for all ages and promote work ability and the needs of workers throughout 
the life course. More evidence is needed on the effectiveness of potential interventions on workers of 
any age. Furthermore, more knowledge is needed in relation to extending the working life beyond 65 
years of age, for example in relation to work capacity and a potential increase in the length of exposure 
to work hazards. 

Overall conclusions and possible policy implications 

Economic  measures,  such  as  increasing  the  official  pension  age,  will  be  successful  only  if  workers 
remain able to work and retain their physical and mental health into retirement. Work should allow the 
maintenance of physical and mental health, not contribute to its deterioration. 

23 Okunribido, O. & Wynn, T. (2010), Ageing and work-related musculoskeletal disorders: A review of the recent literature, UK, 

HSE: Research Report 779. Available at: http://www.hse.gov.uk/research/rrpdf/rr799.pdf  

24 Marmot, M. (2013), Health inequalities in the EU. Final report of a consortium, Consortium lead: Sir Michael Marmot, European 

Union. Available at: http://ec.europa.eu/health/social_determinants/docs/healthinequalitiesineu_2013_en.pdf 

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The overall aim of OSH in relation to sustainable work is to limit early exit from the workforce and ensure 
that working allows healthy workers to maintain their physical and mental health throughout their work-
life course, and remain healthy into retirement. 

While many changes in health and ability can be linked to age, ageing is not necessarily associated 
with ill health or declining performance. There is a huge variation in health and ability among workers 
of the same age. In addition, older workers can often compensate for losses to work-related functional 
capacity  with  strategies  and  skills  gained  through  experience.  The  focus  of  OSH  in  relation  to  age 
management should be on work ability in relation to work demands, not chronological age. 

Cumulative exposure to demanding work across the work-life course can have a significant impact on 
health and functional ability, so is a particular concern with regard to sustainable work. 

There  is  evidence  that  continuing  to  work  under  good-quality  working  conditions  is  associated  with 
better physical health and psychological well-being than being out of work. 

Improved  OSH  management  to  reduce  risks  and  make  work  easier  for  all  workers  could  have  a 
significant impact on the sustainability of work. A life-cycle approach to OSH and sustainable work is 
needed for the health of workers to be maintained. 

Specific measures for older workers should be taken if and when necessary — depending on the type 
of work and the individual — and should avoid discrimination and not be based on stereotypes of older 
workers. 

Measures  to  make  work  less  demanding  would  often  benefit  all  workers,  for  example  measures  to 
prevent MSDs caused by manual handling, repetitive work, and static and awkward postures. 

The tool of risk assessment can support sustainable working by identifying risk prevention measures to 
improve  working  conditions  for  the  whole  workforce  or  identifying  measures  for  specific  groups  or 
individuals. OSH aspects of age management can be accommodated within the normal workplace risk 
assessment and management process. Individual work ability assessments can be used as part of risk 
assessment. 

Often  simple  workplace  accommodations  can  allow  workers  with  health  or  performance  declines  to 
remain in work. In the workplace, human resources and OSH departments should cooperate on age 
management and related measures. 

Older workers often benefit from flexible working arrangements, allowing them to accommodate other 
activities such as responsibilities as carers. 

Effective, robust OSH systems are needed that are equipped to support SMEs and atypical workers 
and  that  have  diversity  issues  mainstreamed  into  their  strategy  and  actions.  Access  to  basic 
occupational health services is an issue for small businesses, and health surveillance across the work-
life course is needed for those workers not currently covered. OSH systems should promote well-being 
at work, as well as improved risk prevention measures, to achieve sustainable work. 

If effectively implemented, the European OSH legal framework, based on risk assessment, combining 
collective measures to protect all workers as the priority with work adapted to the individual worker and 
measures to protect vulnerable groups, is supportive of achieving sustainable work. 

A sector-based approach may be most effective for small businesses and can be more easily targeted 
to their specific needs. 

Many  factors  influence  the  sustainability  of  work,  from  both  within  and  outside  the  workplace.  The 
integration of policies and  services is needed, including between OSH, employment, education, and 
public health and social security, both to promote sustainable work, in order to minimise early exit from 
employment, and to make provisions for those who, unavoidably, need to change occupations or exit 
the labour market. 

A comprehensive approach to age management would incorporate the fields of OSH, health promotion 
and human resources. 

As  with  all  areas  of  OSH  policy,  gender-related  issues  should  be  taken  into  account  in  relation  to 
sustainable work. 

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Women and the ageing workforce – Implications for OSH 

Further research is needed, including in relation to demanding work and working sustainably after the 
age of 65 years. Sharing experiences of strategy development and the implementation of interventions 
should be promoted. 

Older  workers  are  valuable  assets  to  organisations.  Increased  efforts  are  needed  to  counter 
stereotypical views and discrimination, and support organisations in prolonging the working lives of their 
employees. 

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Women and the ageing workforce – Implications for OSH 

Appendix B: Search protocol and selection methodology 
In addition to the previous studies by EU-OSHA on gender and OSH and by Eurofound on gender and 
work sustainability, this review was informed by a literature research.  

The methodology used for the literature search can be summarised as follows 

A number of different approaches were taken to identify relevant research and resources for this review, 
in  line  with  the  search  protocol.  Firstly,  an  assessment  of  the  academic  literature  was  carried  out. 
Secondly, searches were performed on relevant EU and research institutes’ websites. Finally, a search 
identified other grey literature using Scirus and OpenGrey. 

A  particular  focus  was  given  to  identifying  systematic  reviews,  meta-analyses,  literature  reviews, 
guidance and grey literature. 

An initial screening was carried out independently by two researchers. Full publications were obtained 
of the selected documents for those documents that were deemed to fit these inclusion and exclusion 
criteria. Two researchers independently analysed the full texts and a joint decision was made on those 
to include in the review. 

the 

from 

Information 
to  projects  and 
recommendations arising from various non-governmental organisations and other organisations active 
in  the  field  at  both  European  and  national  levels,  particularly  with  regard  to  possible  strategies  or 
measures to promote sustainable work. 

literature  search  was  supplemented  with  references 

Search protocol 

A search protocol was developed consisting of the following elements: 

  What gender-differentiated data are there in relation to changes in patterns of retirement across 

the EU? 

  What are the main hazards for older female workers, by sector? 
  What is the impact of health promotion for older female workers? 
  What  is  the  impact  of  early  intervention  for  OSH  and  health  promotion  for  younger  female 

workers? 

The following describes the search protocol that was used.   

Topics to be addressed by the reviews 

The search material will provide the information basis for the topics required in the technical 
specifications document, so that the following is included:  

  An  overview  of  demographic  change,  changing  retirement  patterns  and  the  societal  and 

business costs of ignoring OSH. 

  An overview of OSH issues and older workers, including the realities and myths about age and 

 

work, older workers’ capability to change and the impact of individual differences 
Information on ensuring a holistic approach to OSH for everyone (including the promotion of 
sustainable work across the life-course) , taking into account diversity, access to occupational 
health and support for enterprises, in particular small and medium-sized enterprises and micro 
enterprises. 

  An overview of OSH and younger workers and the importance of the maintenance of OSH at a 

younger age to ensure lifelong employability. 
Information on WHP and older workers — what works and what does not. 
Information on hazards for older workers in relation to sectors and other risk factors. 

 
 
  An overview of the interaction between OSH policy and older workers, considering other policy 

areas including employment, health, research and education 

  A summary of key OSH statistics in relation to age including injury, health, work disability and, 

if available, return to work. 

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Women and the ageing workforce – Implications for OSH 

Building research questions 

1. 

What gender dimensions have an impact on OSH for older workers? 

Search strategy for the review 

Population 

  Adult 
  Employed 
  Employee 
  Worker 
  Ageing worker 
  Older worker 
  At work 
  Economically active 
  Younger worker 
  Greying workforce 
  Active ageing models 
  Life course 
  Gender 

Intervention 

A broad definition of the term ‘intervention’ was used, ranging from large-scale intervention studies to 
smaller  scale  workplace  design  changes,  management  training  courses  or  safety  and  health 
considerations, with the following search terms used: 

  Measurement of impact of occupational safety initiative 
  Measurement of impact of occupational health initiative 
  Measurement of impact of health promotion initiative 
  Ergonomics 
  Health promotion 
  Occupational safety 
  Occupational health and safety 
  Occupational health 
  Occupational medicine 
  Occupational hygiene 
  Worker protection 
  Risk control 
  Risk reduction 
  Training for employees 
  Training for managers 
  Age management 
  Rehabilitation 
  Return to work 
  Work disability 
  Education 

Outcomes 

  Reduction/increase in ill health 
  Reduction/increase in sickness absence reporting 
  Reduction/increase in accidents 
  Reduction/increase in capability 
  Extended working life 
 
 

Improvement/decline in retention of workers 
Improvement/decline in morale 

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Women and the ageing workforce – Implications for OSH 

Improvement/decline in work ability 
Improvement/decline in management style 
Improvement/decline in mental well-being 
Improvement/decline in employability 

 
 
 
 
  Reduction in premature departure from work 

Publication types 

  Systematic reviews 
  Reviews 
  Guidance 
  Guidelines 
  Reports 
  Articles 

Inclusion criteria 

  Employed 
  Employed but not working 
  Voluntary work 
  Published post-2000 

Exclusion criteria 

  Economically inactive 
  Published pre-2000 

Search databases 

For academic research, the following databases were used to identify published reviews: 

  Embase 
  Medline 
  PsycINFO 
  SciSearch 
  Sociological Abstracts 
  Social Sciences Citation Index 
  Social Policy & Practice 
  Social SciSearch 

Grey literature searches were also carried out using databases such as Scirus and OpenGrey. Further 
websites that were searched include: 

  EU-OSHA 
  ENWHP (European Network for Workplace Health Promotion) 
  DG SANCO 
  DG EMPL (European Commission’s Directorate General for Employment, Social Affairs and 

Inclusion) 

  DG SANCO (European Commission’s Directorate General for Health and Consumer Protection) 
  ETUC/ETUI (European Trade Union Confederation/European Trade Union Institute) 
  BusinessEurope 
  UEAPME (European Association of Craft, Small and Medium-sized Enterprises) 

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Women and the ageing workforce – Implications for OSH 

ILO (International Labour Organization) 

  CEEP (European Centre of Employers and Enterprises providing Public Services) 
 
  WHO (World Health Organization) 
  NIOSH 
  Mental Health Europe 
  European Social Network 
  EuroHealthNet 
  TAEN (The Age and Employment Network) 

Each study was assessed on external validity and its applicability to the target population and to the 
settings defined in the scope. The following phrases were used to evaluate the evidence in relation to 
each research question: 

 
 

likely to be applicable across a broad range of populations and settings 
likely  to  be  applicable  across  a  broad  range  of  populations  and  settings,  assuming  it  is 
appropriately adapted 

  applicable  only  to  populations  or  settings  included  in  the  studies  —  the  success  of  broader 

application is uncertain 

  applicable only to settings or populations included in the studies. 

Identification of Member States’ OSH websites and searches for relevant material 

This included a request sent to EU-OSHA’s focal points for relevant reports and tools available within 
each nation state. Experts involved in the project for each country were also asked to supply relevant 
reports, documents and tools for this component of the work. 

Screening of titles, abstracts and full texts  

Details of all relevant publications identified in the search, including title and abstract (where available), 
were  stored  in  a  RefWorks  database.  Initial  screening  of  the  titles  and  abstracts  was  carried  out 
independently  by  two  researchers  using  the  Preferred  Reporting  Items  for  Systematic  Reviews  and 
Meta-Analyses (PRISMA) guidelines. The inclusion criteria were: 

research on the employed, whether working or not; 
research on those in voluntary work; 

 
 
  documents published in English, after 2000. 

Exclusion criteria reflected the reverse of the inclusion criteria: 

research on the economically inactive; 

 
  documents not published in English; 
  documents published before 2000. 

For those documents that fit the inclusion criteria, the full publications were obtained. Emphasis was 
placed on systematic reviews, meta-analyses, literature reviews, guidance and grey literature, with data 
extraction  carried  out  on  the  included  publications.  Data  were  extracted  for  each  of  the  included 
publications to summarise and evaluate the  evidence presented.  The following  screening  procedure 
was used: 

Initial screening of title and abstracts (without looking at full text) 

 
  By two independent reviewers 
  Score all abstracts 

o  Score 1 = potentially eligible study 
o  Score 0 = irrelevant for research question(s) 
o  Score 2 = interesting paper for introduction or discussion but not answering research 

question (s) 

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Women and the ageing workforce – Implications for OSH 

  Reason for excluding paper should not be documented 
  No consensus needed between reviewers 
  Screening of full-text articles 
  Order all papers that received a score of 1 
  Development of scoring sheet with inclusion and exclusion criteria and add scoring YES/NO 
  All full texts have to be scored by two independent researchers 
  Consensus needed between reviewers 

Limitations of the research reviewed 

When  evaluating  research  in  the  field  of  ageing  and  gender,  research  study  design  is  an  important 
consideration,  and  there  is  little  longitudinal  research  to  draw  upon  (i.e.  research  where  the  same 
sample  or group of people has been followed up over a  period of time). Comparing this  with cross-
sectional research, where different groups of people are evaluated at one point in time, or even where 
repeated cross-sectional groups have been evaluated at different times, can cause bias in results when 
identifying  differences  or  similarities  between  groups.  This  is  essential  when  examining  age-related 
change, as comparison groups may have important differences (e.g. fit individuals over the age of 60 
years versus unfit 30-year-olds). 

Other types of research in this area have a number of additional inconsistencies. Different reporting 
and  recording  systems  are  used  internationally,  making  the  collation  and  comparison  of  data  from 
different  countries  difficult.  In  addition,  the  categories  used  to  break  down  age  groups  often  differ 
between  studies,  which  has  an  impact  on  accurate  comparisons.  In  some  studies,  ‘ageing  workers’ 
may  wrongly be regarded  as a homogeneous group  (e.g. all those  55  years and older). Finally, the 
widespread previous assumption of retirement at a certain age (usually 65 years) results in a lack of 
data available on workers over 65  years old, which should be noted as a limitation for the evidence 
base.  

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Appendix  C:  Features  of  good  practice:  summary  of 
findings (Weyman et al., 2013) 
Components  of  good  practice  Six  domains:  recruitment  &  retention;  occupational  health;  education, 
training, development & promotion; flexible working, systems of work and ergonomics design; changing 
the  attitudes  of  people  towards  older  workers  and  evidence  based  measures  of  organisational 
performance to support this…A focus on older workers risks masking elements of good practice relevant 
to employees of all ages. While older workers might be considered a higher risk or more vulnerable 
group they essentially exhibit the same set of vulnerabilities as workers of other ages. 

Identified features of employer good practice and selected key points made in relation to these features 
by the authors: 

  work ability perspective – extend beyond individuals, to a more holistic perspective on 
systems of work and the configuration of work, orientated around sustaining older 
employment. 

  defining older workers – chronological age unlikely to offer the best predictor of work 

preferences or ability and risks masking elements of good practice relevant to employees of 
all ages. Older workers might be considered a higher risk but essentially exhibit the same set 
of vulnerabilities as workers of other ages. 

  organisational learning – an organisational epidemiological perspective focused on profiling 
which groups are at risk, from what, and in what way(s) offers the potential for a strategic 
approach to intervention. 

  occupational health – a proactive approach to prevention of harm and promotion of well-being 

focused on (1) systems of work and (2) individuals. 

  ergonomics – changes to work design and bespoke solutions for individuals. 
  part-time and flexible work - employers need to do more than simply offering flexible options, 

 

 

 

adopting a proactive, managed approach.  
training and personal development – a managed process needed. Managers, particularly line 
managers need training in the principles of good practice for managing an older workforce. 
line management role – a challenging and key role in the management of older worker issues. 
Support needed. 
countering age discrimination – focus on enhancing capacity to work and actions to challenge 
(employees’ beliefs of) age discrimination by managers and employers. 

  organisational culture and climate - impact on the experiences and behaviour of older 

employees in relation to work and retirement. 

Occupational health and well-being 

Source 

Monitor demographic patterns of sickness absence and 
presenteeism to identify vulnerable groups by job role and 
gather epidemiological data on known risk factors 

Ilmarinen (1999), Capita 
(2012), Weyman (2012) 

Sustainable lifestyle health promotion 

EHEA (1993), NPAW (2000), 
Black (2008), Ilmarinen 
(2012),Smeaton et al. (2012) 

Management standards for stress at work 

Cox et al. (2009), HSE (2013)  

Apply management standard principles to non-stress issues 
(e.g. MSDs) 

Biron et al. (2012), Weyman et 
al. (2012), Karanika-Murray 
and Weyman (2013) 

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Women and the ageing workforce – Implications for OSH 

Occupational health and well-being 

Source 

Managed approach to accessing treatment and rehabilitation in 
work — extending this to individual case managers 

Black (2008), Borman (2009), 
Black and Frost (2011) 

Regular individual health monitoring (e.g. for 40+ age group) 

Limit exposure to heavy physical and high-stress work 

Black (2008), Borman (2009), 
Black and Frost (2013) 

Griffiths (2000), Watson et al. 
(2003) 

Regular individual work ability assessment — using risk 
assessment and management principles (avoiding limiting the 
work ability assessment to only health elements) 

Ilmarinen (1999, 2012), Capita 
(2012) 

Ergonomics 

Physical work environment — consider lighting levels, noise 
levels and thermal environment 

Job design — promote employee control and autonomy over 
their work; reduce physical loads; set appropriate work rate 
standards, production targets and workloads 

EHEA (1993), Walker and 
Taylor (1999), NPAW (2002), 
Australian Public Safety 
Commission (2003), 
Siegenthaler et al. (2008) 

Equipment design — considering dexterity and ease of use 
issues; inclusive design; rehabilitative adaptations 

Shift working 

For workers aged 45-50+, extend recovery periods; minimise 
exposure to long shifts (e.g. 12 hours), night work and rotating 
shifts 

Costa and Sartori (2007), 
Costa and Di Milie (2008) 

Flexible work 

Where possible increase the availability of: 

hours of work 

part-time work 

flexi-time 

annualised hours 

compressed hours 

job-sharing 

home working 

unpaid leave 

Widely cited. See, for example: 

NPAW (2000), Watson et al. 
(2003), Davey (2007), Lewin 
Group (2009), Capita (2011), 
Philipson and Itzin (2012), 
Smeaton et al. (2012), DWP 
(2013) 

special leave (e.g. for caring responsibilities) 

phased retirement 

Involve employees’ representatives in devising options (all ages) 

Mixed-age teams 

NPAW (2000), Siegenthaler 
and Brenner (2008), Tikkanen 
(2012)  

Survey on employees’ views on attractive options (including 
demographic differences) 

Siegenthaler and Brenner 
(2008) 

Training and development 

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Women and the ageing workforce – Implications for OSH 

Occupational health and well-being 

Source 

Equalise opportunities by age — lifelong learning 

Take a managed, bespoke, individualised approach to increase 
participation rates 

Migrate older workers to mentoring roles for younger employees 

Walker (1999), Dworschak et 
al. (2006), Cedefop (2012) 

NPAW (2000), Davey (2007), 
Renkema and van der Kamp 
(2012), Tikkanen (2012) 

Saba et al. (1998), Lewin 
Group (2009) 

Opportunities for promotion (including part-time staff) 

Saba et al. (1998) 

Carer change re-training options 

Dworschak et al. (2006), 
Larsen (undated) 

Refresher courses for returning workers 

Watson et al. (2003) 

Train managers (in particular line managers/supervisors) in 
managing older worker issues 

Recruitment and retention 

Formal individualised (whole) career planning — linked with staff 
review procedures 

Collate reasons for quitting — exit interview data 

Embed extending working life (EWL) in broader equal 
opportunities/diversity policies 

Walker and Taylor (1998), 
NPAW (2000), Murray and 
Syed (2005), Philipson and 
Smith (2005), Armstrong-
Stassen (2008), Smeaton et al. 
(2012), DWP (2013) 

Saba et al. (1998), Walker and 
Taylor (1998), Buck and 
Dworschak (2003), Clas and 
Heymans (2006), Dworschak 
et al. (2006), Siegenthaler and 
Brenner (2008), Larsen (2012), 
Philipson and Itzin (2012), 
Smeaton et al. (2012), 
Tikkanen (2012), DWP (2013), 
Larsen (undated) 
Shacklock et al. (2005), Capita 
(2012) 

Walker and Taylor (1998), 
Smeaton et al. (2012), 
Tikkanen (2012) 

Remove age barriers in recruitment procedures 

Walker (1999) 

Focus on contextual (psychosocial and socio-technical) 
elements — not just (individual) capacity to work 

Clas and Heymans (2006), 
Ilmarinen (2012), Tikkanen 
(2012) 

Remove redundancy options that target older workers 

Capita (2011) 

Well-defined opportunities for horizontal moves and voluntary 
down-shifting — by profession/job role 

Dworschak et al. (2006), 
Smeaton et al. (2012) 

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Women and the ageing workforce – Implications for OSH 

Organisational culture and learning 

Visible senior management commitment to EWL policies 

Walker and Taylor (1998), 
Siegenthaler and Brenner 
(2008) 

Barometer measure(s) of employee EWL aspirations, intentions  Shacklock et al. (2005) 

Barometer audit measure(s) of adherence to good practice 

NPAW (2000), Philipson and 
Itzin (2012) 

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Women and the ageing workforce – Implications for OSH  

The  European  Agency  for  Safety  and 

Health  at  Work  (EU-OSHA)  contributes  to 

making  Europe  a  safer,  healthier  and  more 

productive  place 

to  work.  The  Agency 

researches, develops and distributes reliable, 

balanced  and  impartial  safety  and  health 

information  and  organises  pan-European 

awareness-raising campaigns. Set up by the 

European Union in 1994 and based in Bilbao, 

Spain, 

the  Agency 

brings 

together 

representatives 

from 

the 

European 

Commission,  Member  State  governments, 

employers’  and  workers’  organisations,  as 

well  as  leading  experts  in  each  of  the  EU 

Member States and beyond. 

European  Agency  for  Safety  and  Health  at 
Work  

Santiago de Compostela, 12 – 5th Floor 

48003 Bilbao, Spain 

Тel. +34 944-358-400 

Fax +34 944-358-401 

E-mail: information@osha.europa.eu 

http://osha.europa.eu 

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1