Primary school teachers in Québec suffer psychological distress, as shown by the Québec Health Survey (M. Gervais, 1993; Santè Québec, 1995). The authors applied and extended the French model (F. Guérin, A. Laville, F. Daniellou, J. Duraffourg, & A. Kerguelen, 1991) of analysis of work activity to observing classroom teaching (14 women in 10 classrooms for a total of 48 hr 24 min) to identify stressful elements. The authors observed a rapid sequence of actions, eye fixations of short duration, little physical or mental relaxation, multiple simultaneous activities, and uncomfortable temperature and humidity levels. Teachers use many strategies to teach, to create a learning environment, and to maintain attention in classrooms under adverse conditions. Examination of these strategies led to recommendations to improve relations between the teachers and their supervisors and to make the classroom an easier place to teach.
Over 90% of 91 day care centers in greater Montréal, Québec exceeded 1000 ppm of CO2 during January through April 1989. Four variables were independent positive predictors of CO2 levels: the density of children in the center; presence of electric heating; absence of a ventilation system; and building age. High levels of CO2 are associated with respiratory tract and other symptoms. Clear standards and inspection policies should be established for day care center air quality.
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A questionnaire concerning environmental conditions, work organization, and health-related symptoms was administered to 209 male and female workers in fish-processing plants in Quebec. Jobs in these factories were "ghettoized," with 88.9 percent of job titles held primarily (more than 75 percent) by members of one sex. In general, significantly more women than men reported that their work sites exposed them to environmental aggressors such as noise and cold. Women also reported significantly more often that their jobs were uninteresting, that they could not move around, and that their work speed was fast. Women reported fatigue, stress, insomnia, digestive problems, and aches and pains significantly more often than did men (analysis controlled for age). When the effects of work speed were examined specifically, it was found that a fast work speed was associated with fatigue, stress, insomnia, and digestive problems in both sexes, and with aches and pains in women. It is suggested that women are required to work at a faster speed than men, and that this is a factor in the greater prevalence of health-related symptoms among women. Our interpretation of these data calls into question the commonly held belief that men and women are assigned to sex-specific jobs in order to protect the health of "the weaker sex."
The mutagenic effect of occupational exposure to antineoplastic agents was studied in chemotherapy nurses and pharmacists using the T-lymphocyte clonal assay. A significant increase in mutant frequency was observed compared to controls. However, in the present study, cloning efficiency without selection (CEU) was significantly reduced in exposed personnel raising the possibility of an overestimation of the calculated MF. Changes in lymphocyte populations and clonal potential of T-cells were also observed following exposure. CEU was related to % CD4 cells but CE with selection (CETG) was not. Differences in clonal ability of T-cells under selective and unselective conditions coupled with differential lethal effect of antineoplastic agents on lymphocyte subsets may result in inaccurate estimation of MF.
In the epidemiological approach to occupational cancers, large bodies of data must be analyzed to find rare cases of cancer. The exposure status of workers must therefore be assessed. Inaccuracies will lead to bias toward the null value in certain cases. Job title has often been used as a proxy for exposure status. This study was undertaken to examine content (ie, tasks and activities) associated with job title among men and women in a large Québec municipality. Occupational accident reports were studied for 1589 accidents, and 113 men and women workers were interviewed about job content. Women and men did not seem to have the same accident rates. From interview data, it appeared that women and men with the same job title did not perform the same tasks. Thus, they might have different exposures. The data reported here support caution in using job title to estimate exposure for both genders if the job-exposure matrix has not previously been validated separately by gender. In addition, it may be unwise to adjust relationships between job title and cancer incidence for gender, thus treating gender as a confounder when it may be a proxy for specific exposures.
Feminist researchers have contrasted the caring provided by women in hospitals with a more fragmented "curing" approach, which they identify with the predominantly male professions of medicine and surgery. The author spoke with hospital cleaners about their jobs and their health. Several themes emerged: the invisibility of the cleaning function, lack of respect for cleaners, representations of cleaning as undemanding, and assumptions that women's work in cleaning is particularly easy. Cleaners use various strategies to combat these stereotypes but receive little help from administrators or fellow employees. There is a hierarchy in the status of Québec hospital workers with curing (doctors) at the top, followed by caring and healing (nurses, therapists, and attendants), and hygiene (cleaners, sterilizers, and launderers) at the bottom. Authority hierarchies in health care are not related to gender in a simple way, although there is discrimination against women cleaners. The fact that cleaning, especially cleaning performed by women, is invisible to managers, other hospital personnel, and patients has important consequences for cleaners' and for patients' health.
Using the clonal HPRT-mutant frequency assay, mutant frequencies of humans have been shown to rise following exposure to large doses of mutagens during radiotherapy, chemotherapy or after an atom bomb explosion. Success in relating mutant frequencies to exposure to high levels of mutagens has encouraged researchers to examine the effects of lower doses, such as those found among workers exposed at their jobs. In order to relate low doses of mutagens to biological effects, accurate characterization of exposure is critical, but most occupational studies are forced to use gross measures of exposure derived from job title or professional judgments as to potential exposure. Mutant frequencies and other relevant lymphocyte characteristics of 58 industrial workers were related to exposure status in two ways. When workers were classed as "exposed" or "unexposed" to ionizing radiation, no difference in any biological variable was seen between the two groups. When dosimeter readings were used as the exposure indicator, significant relationships appeared between dose and mutant frequency and CD4/CD8 lymphocyte subpopulation ratios. Mutant frequency was also positively related to age and smoking status. The time course of exposure and of appearance of mutant cells is discussed and it is suggested that this relationship receive attention in occupational studies of genotoxic effects.
North American workers usually stand while working, and prolonged standing is associated with discomfort and cardiovascular problems. Since prolonged sitting is also associated with health problems, and standing postures differ as to mobility and access to seating, it is desirable to identify an optimal mix of postures. As a step towards this identification, it is desirable to develop indicators of potential health effects that respond to changes in work requirements. We observed 65 subjects who usually stood at work, in four types of workplaces. Pressure-pain threshold (PPT) recorded on the plantar surface was used as an indicator of discomfort and arterial blood pressure was used as an indicator of cardiovascular effects. PPT after work was significantly lower than that before work. Sitting for even a small part of the day appeared to be protective. The effects of static vs. dynamic work on PPT and arterial blood pressure may differ.
This paper reviews briefly recent developments in research on women's occupational health and safety in five areas: documenting the unexpectedly heavy physical and mental workload involved in occupations traditionally assigned to women; showing the consequences for women's health of their precarious relationship to the work force; demonstrating the health effects of the double workday; studying the effects of work on those aspects of biology that are sex-specific; suggesting ways to remove ergonomic barriers to women entering non-traditional jobs which have been designed in relation to the typical male body. Suggestions are made for future research in these areas, in response to the needs of working women. This paper serves as an introduction to the volume of Women and Health dealing with women's occupational health and safety.