A review of the evidence of women’s health and occupation commissioned by the Industrial Injuries Advisory Council
Source: gov.uk (2025-10-30)

The Industrial Injuries Advisory Council (IIAC) commissioned the Institute of Occupational Medicine to carry out a scoping review of the published literature on women’s health and occupational malignant and non-malignant respiratory diseases.

The proportion of women in work in the UK has increased steadily over the last few decades. Over 70% of women are now in paid employment compared with only about 50% in the 1970s. Patterns of employment differ between males and females with fewer women employed in manufacturing, construction and transport, and more women in education and human health.

There is a range of health outcomes that might differ between men and women relating either to biological differences or to differences in their exposure to particular activities or agents. Because of this, the Industrial Injuries Advisory Council (IIAC) sought to examine the issue of women’s ill health and the potential for specific workplace exposures.

IIAC commissioned the Institute of Occupational Medicine (IOM) in Edinburgh to prepare a report using existing published reviews and key studies to identify the industries, occupations and occupational exposures associated with non-malignant occupational diseases that occurred only in women or where women were at greater risk than men when both were similarly exposed. The aim was to identify any areas that might need further in-depth investigation.

The review was based on 306 previously published review articles and covered 15 occupational groups and 5 main health outcomes. The evidence for increased risks in women was generally limited, with difficulties in interpreting much of the available evidence.

IIAC noted a very high reported prevalence of some conditions such as urinary incontinence in up to 76% of female athletes. Musculoskeletal problems were present in up to 76% of hairdressers, 73% of physical therapists, and in over 70% of female surgeons and physicians practising interventional radiological procedures. In conditions specific to females, reproductive issues featured significantly and were potentially associated with a range of physical and chemical exposures. However, many of the problems did not fall within the scope of the Industrial Injuries Disablement Benefit (IIDB) legislation as they related to effects on children rather than mothers.

Although not a matter within IIAC’s remit, the Council noted with concern the high reported prevelences of violence and sexual harassment amongst health care staff. Together with exposure to traumatic events this is likely to lead to stress at work. Suicide is a potential marker for other psychiatric and psychological problems and IIAC noted relatively high suicide rates in medical and veterinary staff with some evidence that females are more affected than males. However, mental health problems pose particular challenges for the IIDB scheme because of the lack of objective measurements that might assist with diagnosis or quantification of disability. Post traumatic stress and related conditions arising as a consequence of an accident are potentially open to claims under the Accident Provision.

In some cases, the problems encountered by women appeared to be due to workplace equipment that was designed principally for men. These matters should be addressed by employers on account of the increasing participation of women in the workplace. Obesity and related conditions such as diabetes were associated with sedentary or office work. This is noted as a potential major public health concern.

IIAC noted that relatively few of the studies reported results by sex, and that the terms ‘sex’ and ‘gender’ were often used interchangeably. There did, however, appear to be some differences between sexes with women more susceptible to some musculoskeletal and psychological problems, the effects of noise, and metabolic problems. IIAC noted the difficulty in attributing differences in some health outcomes to work because of potentially confounding effects of non-work circumstances on women’s health.

For IIAC to recommend prescription of a disease for IIDB based on epidemiological evidence the risk associated with the exposure or occupation should be at least doubled. Few of the review articles allowed quantitative assessments of the magnitude of the risks associated with the various exposures or employments. Where these were reported, few of the risks were doubled or more than doubled.

This review was intended to identify topics that might require further investigation rather than provide a comprehensive evaluation of any particular exposure or condition. It highlighted a number of health issues present in women in the workplace, but there was none that clearly pointed to a need for further evaluation or a potential change in the list of prescribed disease. The findings do however highlight the opportunity to improve health in a number of workplaces for both men and women, particularly in relation to musculoskeletal disease, mental ill health and obesity.