OCCUPATIONAL DISEASES IN PORTUGAL: CONTRIBUTIONS OF A GENDER APPROACH BASED ON THE ANALYSIS OF WORKING CONDITIONS ON A LOCAL LEVEL

Carla Barros, Liliana Cunha & Marta Santos

CPUP, University Fernando Pessoa; [email protected]

CPUP; University of Porto; [email protected]

CPUP, University of Porto; [email protected]

STATISTICS ON OCCUPATIONAL DISEASES IN PORTUGAL 2005 . 2012 TOTAL OF OCCUPATIONAL DISEASES PER GROUPS OF DISEASES

(Barros-Duarte, & Moreira, 2014) 15% Noise diseases caused by physical agents

15 % 10% Respiratory diseases 10 %

 Yearly average of

reports

of suspected occupational disease:

3677 4 %

4% Skin diseases and others  Yearly average of

recognitions

of occupational diseases:

3328 69 % 69% Musculoskeletal injuries

STATISTICS ON OCCUPATIONAL DISEASES IN PORTUGAL 2005 . 2012 TOTAL OF OCCUPATIONAL DISEASES BY GENDER AND YEAR OF RECOGNITION

(Barros-Duarte, & Moreira, 2014)

2500 2000 1500 1000 500 0 2005 2006 2007 2008 2009

Year of recognition F M

2010 2011 2012

 

women: 58,5 % men: 41,1%

REPORTS OF OCCUPATIONAL DISEASES IN LISBON AND VALE DO TEJO 2003 . 2004 TOTAL OF OCCUPATIONAL DISEASES BY GENDER AND YEAR OF RECOGNITION

(Santos, Castro & Moreira, 2006)

1600 1400 1200 1000 800 600 400 200 0 Lisboa Santarém Setúbal RLVT 2003 Women 108 16 92 216 2004 288 45 613 946 2003 43 5 111 159 Men 2004 235 35 172 442 2003 Total: RLVT 2004 151 21 203 523 80 785 375 1388

OCCUPATIONAL DISEASES AND GENDER 2005 . 2012 WOMEN

(Barros-Duarte, & Moreira, 2014) Musculoskeletal injuries Skin diseases and others Respiratory diseases

86%

3% 2%

1º 2º 3º 4º 5º 6º 7º 8º 9º 10º 11º 12º

Paralisias (dir) Epicondilite (dir) Paralisias (esq) Periartrite escapulo- humeral (dir) Tendinites (dir) Epicondilite (esq) Periartrite escapulo-humeral (esq) Tendinites (esq) Dermites de contacto Tendossinovites (dir) Asma profissional Tendossinovites (esq)

18% 14% 14% 12% 8% 7% 6% 5%

3%

2%

2%

1%

OCCUPATIONAL DISEASES AND GENDER 2005 . 2012 MEN

(Barros-Duarte, & Moreira, 2014) Musculoskeletal injuries Respiratory diseases Physical agents – Noise Skin diseases and others

38%

26% 22% 2%

1º 2º 3º 4º 5º 6º 7º 8º 9º 10º 11º 12º

Hipoacusia bilateral Fibrose pulmonar Epicondilite (dir) Periartrite escapulo-humeral (dir) Epicondilite (esq) Periartrite escapulo-humeral (esq) Tendinites (dir) Asma profissional Paralisias (dir) Granulomatose pulmonar com insuficiência respiratória Paralisias (esq) Dermites de contacto 6% 4% 3% 3% 3%

22%

21% 12% 7% 3% 2% 2%

TOTAL NUMBER OF REPORTS OF OCCUPATIONAL DISEASES IN LISBON AND VALE DO TEJO 2003 . 2004 MEN

(Santos, Castro & Moreira, 2006) Perturbações oculares Efeitos irritantes na pele e nas membranas mucosas Perturbações hepáticas

Musculoskeletal injuries

Malária Perturbações da audição/surdez profissional Perturbações respiratórias Trombocitopenia Perturbações neurológicas Manifestações agudas neurodegenerativas Outro diagnóstico Missings Total _ _ 18 1 _ 0 216

2003 MEN 2004

27 27 11 1 16 0 142 26 1 167 0 178 37 0 2 1 2 1 442 _ _ 12 0 _ 0 159 1

WOMEN 2003 2004

1 11 0 129 1 5 18 0 889 0 5 30 0 0 0 1 2 946 _ _ 30 1 _ 0 375

TOTAL 2003 2004

28 28 22 1 145 1 147 44 1 1056 0 183 67 0 21 1 3 3 1388

OCCUPATIONAL DISEASES AND GENDER 2005 . 2012 OCCUPATIONAL RISK FACTORS

(Barros-Duarte, & Moreira, 2014)

WOMEN

Musculoskeletal injuries Skin diseases and others Respiratory diseases

86%

3% 2% 1 st

Overloading tendons and tissues

2 nd

Pressure on the nerves from applied force, position, rhythm or use of tools

3 rd

Physical, chemical and biological agents

OCCUPATIONAL DISEASES AND GENDER 2005 . 2012 OCCUPATIONAL RISK FACTORS

(Barros-Duarte, & Moreira, 2014)

MEN

Musculoskeletal injuries Respiratory diseases Physical agents – Noise Skin diseases and others

38%

26% 22% 2% 1 st

Overloading tendons and tissues

2 nd

Noise

3 rd

Silica

INSAT 2010 INSAT: health and work survey

(Barros-Duarte, C., Cunha, L. & Lacomblez, M., 2010)

INSAT 2010 preceding surveys

 ESTEV (1990, 1995) and VISAT (1996)  SIT (2000/01)  Sumer (2002/03)  Evrest (2001)  European Working Conditions Surveys (EWCS)

INSAT 2010 anchor points

 Assessment of working conditions and their effects on health  Emphasis placed on the viewpoint of the worker  Approach grounded on the real work activity  Integrated analysis of results under the principle of "open statistics" (Volkoff, 2010)

USING INSAT: VARIOUS SECTORS OF ACTIVITY 2010 relationship between musculoskeletal disorders and influencing factors: Vibration Painful postures Intense physical exertion women

4.10% (OR=3.758) 24.4% (OR=2.600) 11.9% (OR=2.098)

men

11.8% (OR=3.140) 30.8% (OR=3.455) 26.6% (OR=1.950)

Having to hurry Overdemand

66.5% (OR=1.863) 64.7% (OR=1.567)

n.s.

n.s.

Intimidation Exposure to other people's suffering

27.9% (OR=1.428) 69.8% (OR=1.635)

n.s.

n.s.

USING INSAT: CASE STUDY 2010 Branch of activity:

Manufacture of Electrical and Electronic Components N= 417 workers 68% women 32% men

USING INSAT: CASE STUDY 2010 % Women % Men Administrative staff

62,1 37,9

Qualified industry workers

0,0 100,0

Assembly and machine operators

73,5 26,5

USING INSAT: CASE STUDY 2010 Results show a higher number of musculoskeletal problems in women (26.1% compared to 23.3% in men) such as:

 backache (W = 50.6%; M = 45.3%);  chronic muscle pain (W = 9.2%; M = 3.3%);  varicose veins (W = 51.0%; M = 9.3%);  frequent numbness of the limbs (W = 28.5%; M = 11.3%).

USING INSAT: CASE STUDY 2010 Such problems are related to:

 the need to stand for a long time (W = 28.4%; M = 12.4%);  repetitive movements (W = 32.9%; M = 27.4%);  exposure to the risk of intimidation (W=11.4% ; M = 7.6%).

HOW DO WE MAKE THE DIFFERENTIATED IMPACT OF WORK ON WOMEN'S HEALTH MORE VISIBLE ...?

2010 Occupational disease statistics are crucial, but they need to be complemented by a closer analysis of the work setting...

establishing relationships between: … working conditions and all health problems … specificity of the work activity … the type of work organization

… WHILE TAKING INTO ACCOUNT THE INSTRUMENTS THAT MEDIATE THE ANALYSIS OF THIS IMPACT?

2010 INSAT as a privileged mediator:

 it is a boundary object (Molinié & Leroyer, 2011), creating conditions to bring together the various actors of HSW on the diagnostic level;  it goes beyond the mere releasing of information by adding to its diagnostic approach a concern for intervention on work.