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Table 3 Description of the 30 studies included in the systematic review

From: Gender inequalities in occupational health related to the unequal distribution of working and employment conditions: a systematic review

First author, year

Main objective

Main findings

Relevancy for the review

Quality score

Gadinger 2010, [25]

To investigate cross-sectional associations between main, interactive and gender-dependent effects of the demand–control–support (DCS) model and subjective health in managers

Job demands appear to have a higher impact on psychosomatic complaints than job control and social support. No significant main effect of gender was observed in the prediction of psychosomatic complaints and self-rated health. High social support and male gender were found to buffer the increasing prevalence of psychosomatic complaints resulting from high work demands. In contrast, no significant two-way interaction was found in the prediction of self-rated health

This study analyses the differences between female and male managers in exposure to job strain and how it impacts differently on their health. It concluded that high job control and high social support may buffer adverse health effects that are associated with demanding jobs and that special attention should be given to isolation in women

6/8

Persson 2009, [26]

To examine whether men and women with the same job tasks exhibit differential physiological and psychological activation to manual and repetitive labour

Men and women respond to the work situation in a similar way. Only with regard to reports of positively valued high activity states, did men and women show a differential response. Accordingly, while men reported lower energy scores at the end of the work shift, women showed only a slight decrease

The interest of this study lays in the fact that it analyses the differential effect that exposure to the same job tasks has on women and men, not only psychological, but also physiological activation

8/8

Taiwo 2009, [27]

To determine if female workers in a heavy manufacturing environment have a higher risk of injury compared with males when performing the same job and to evaluate sex differences in type or severity of injury

Female workers in this industry have a greater risk for sustaining all forms of injury than male. This excess risk for female workers persisted when injuries were dichotomized into acute injuries and musculoskeletal disorder related injuries

This study provides evidence of a sex disparity in occupational injury with female workers at higher risk compared with their male counterparts in a heavy manufacturing environment

6/6

Hooftman 2009, [28]

To determine whether there are gender differences in the effect of exposure to work-related physical and psychosocial risk factors on low back, neck, shoulder, or hand-arm symptoms and related sickness absence

Except for the effect of bending the wrist and the neck backwards, men generally have a higher risk of symptoms with equal exposure

Although women are expected to be more vulnerable to exposure to work-related risk factors, the results of this study showed that, in many cases, men are more vulnerable. Thus, this study could not explain gender differences in musculoskeletal symptoms among workers

5/6

Hooftman 2009, [29]

To determine whether men and woman with equal tasks perform these tasks in the same way

When level, duration and frequency of exposure were analyzed at the same time, men and women had slightly different exposure patterns. However, these differences were not found when duration and frequency were analyzed separately.

This study conclude that gender differences in the exposure to ergonomics hazards within the same task cannot alone explain gender differences in musculoskeletal symptoms

7/8

Galanakis 2009, [30]

To examine gender differences in occupational stress, taking into consideration the role of marital status, age and education

Women appear to experience significantly higher levels of occupational stress. But when age, marital status and educational level are controlled for, there is no significant gender difference in occupational stress

This study shows that gender differences in stress do not stem from a genetic or biological difference. Gender differences in stress seem to reflect social and psychological differences associated with age, marital status and education. As environmental demands outside the family have pronounced effects related to stress in the family, the opposite is also true. Stress experienced in the family crosses over to the workplace

7/8

Alterman 2008, [31]

To collect baseline prevalence data on the work-related health problems faced by minority, white and female farm operators

Men and women of the same race or ethnicity showed statistically significant differences in the prevalence of many health conditions. Women reported more respiratory symptoms and musculoskeletal diseases in contrast to men, who had greater impairment of hearing acuity

The article focuses on how women and men of the same race/ethnic group present different work-related health problems

5/8

Kim 2008, [32]

To examine whether nonstandard workers reported poorer health compared to standard workers and assess whether there are gender differences in the association between employment status and chronic health outcomes

Male nonstandard workers exhibited a strong association with musculoskeletal disorders and liver disease, while women showed an association between nonstandard work and mental health disorders

The article focuses on how poor working employment conditions affects differently women and men’s health

8/8

Lin 2008, [33]

To provide an epidemiological basis for gender-specific work-related accident prevention programs

The male fatality rate from occupational accidents is almost eight times higher than in females. Females injuries were more common in such industries as construction, manufacturing and services, while male injuries were more common only in construction and manufacturing, but not in services

This study adds the gender perspective to the analysis of work-related accidents. It compare male and female occupational deaths and injuries and the type of industry where the accident occurs

7/8

Magnusson 2008, [34]

To investigate the association between demand, control, support and conflicts, downsizing and emotional exhaustion in men and women in a representative sample of the working population in Sweden

Work-related psychosocial hazards are prospectively associated with emotional exhaustion, but with differences between women and men. For men, lack of support from superiors seemed more predictive of exhaustion, while the opposite tendency was seen for women

The interest in this study is based in the fact that it analyses the different distribution of work-related psychosocial hazards between women and men and its differential impact on their mental health

6/6

Artazcoz 2007, [35]

To analyze gender differences in the impact of long workhours on a variety of health outcomes and health-related behaviour in salaried workers in Catalonia

Health factors associated with long workhours differed by gender. Whereas among the men, long workhours were only associated with a shortage of sleep, among the women they were related in addition to: poor mental health, hypertension, job dissatisfaction, smoking and lack of leisure-time physical activity. This consistent pattern among the women was only partially accounted for by domestic work

This study focuses on how long workhours are differently distributed between women and men and the differential impact on women and men’s health and health behaviour. Furthermore, it highlights the importance of also analysing domestic environment in these kinds of studies

8/8

Li 2006, [36]

To analyse the association between work stress, measured by job strain and effort-reward imbalance, and health in a sample of hospital-based Chinese physicians

Job strain and effort-reward imbalance were associated with impaired health functioning in women and men, but effort-reward imbalance showed a stronger association. Men’s job control was pronouncedly higher, and was related to men’s physical health; whereas women perceived relatively higher reward, which predicted women’s mental health

The interest of this study is based on the fact that it analyses the different distribution of work-related psychosocial hazards between women and men and its differential impact on their mental and physical health

8/8

Peter 2006, [37]

To investigate whether occupational gender segregation moderates the association between job stress in terms of effort-reward imbalance and the risk of myocardial infarction

The strongest association between myocardial infarction and overcommitment was found among women working in male-dominated jobs. Moreover, a significant multiplicative interaction of overcommitment and male domination in relation to myocardial infarction was observed in women

This study analyses the different distribution of work-related psychosocial hazards between women and men and its differential impact on myocardial infarction and how it is modulated by male and female-dominated jobs

6/6

Aittomaki 2005, [38]

To test whether higher age is associated with a lower prevalence of physically demanding work; and whether physically demanding work is more strongly associated with limited functioning in older employees than their young counterparts from a gender perspective

Among women, physical workload was more strongly associated with limitations in daily activities among older than younger employees. However, among men, the opposite was observed. It is possible that fewer men than women are still employed in physically demanding occupations at high age. Physical workload and possibilities to adapt to lower work capacity among older employees probably involve gender differences that are so far unknown

The study introduces the gender perspective in the exposure to physical demanding work in older workers

8/8

Leijon 2005, [39]

To investigate if and how exposure to sitting/standing, awkward arm and trunk postures and movements are associated with occupational gender segregation

The association between exposure and occupational gender segregation was strongest within female-dominated jobs. Workers with a low status/ authority in these jobs had the highest overall exposure levels

The study analyses differences between women and men in the exposure to awkward work postures and occupational gender horizontal and vertical segregation

8/8

Ludermir 2005, [40]

To investigates the gender difference in the association between employment status and common mental disorders

The relationship between unemployment and common mental disorders was stronger among females than among males. Additionally, the association between informal work and common mental disorders appears to be absent in males, while it was high for females

This study is one of the few that provides some evidence of a gender difference in the association between informal work and common mental disorders

8/8

Artazcoz 2005, [41]

To analyze the impact of flexible employment on mental health and job dissatisfaction; and to examine the constraints imposed by flexible employment on men’s and women’s partnership formation and people’s decision to become parents. For the two objectives the potentially different patterns by sex and social class are explored

Whereas non-fixed term contracts and working with no contract were associated with poor mental health status, no association with fixed term temporary contracts was seen. The effect of flexible contractual arrangements, other than fixed term temporary contracts, on mental health was higher among less privileged groups (women and manual male workers) and the impact of flexible employment, either fixed term or non-fixed term contracts, in family formation was more pronounced among men

This study is one of the few which examine the impact of flexible employment on workers’ health and wellbeing in Spain, the country with the highest rate of temporary contracts in the EU-15. In contrast with many studies based on self perception of job instability, this study focuses on an objective indicator, type of contract

8/8

Borrell 2004, [42]

To analyse the association between self-reported health status and social class and to examine the role of work organization, material standards and household labour as potential mediating factors in explaining this association from a gender perspective

Among men, work organisation seems to be an important mechanism that translates higher working class positions into better health. Among women, the association between poor health and working class position seems to be accounted for not only by hazardous forms of work organisation but also by household characteristics, household material standards and excessive amounts of uncompensated household work

In this study household labour and household standards of living have been included together with work organisation as possible mediating mechanisms of the relation between social class and health of the working population

8/8

Lallukka 2004, [43]

To analyse whether unfavourable working conditions are associated with diet, physical activity, alcohol consumption and smoking

Job strain was associated with all the studied health behaviours among women, but not among men. Low job strain was associated with healthy diet, high physical activity and nonsmoking

This study analyses the different distribution of exposure to work-related psychosocial and physical hazards between women and men, and how this different distribution in the exposure influences their health behaviours

8/8

Melamed 2004, [44]

To explore the possibility that exposure to noise at work might interact with job complexity and gender to affect the incidence of occupational injury among industrial employees

In high noise and high job complexity women showed higher risk from injury relative to those women in the less noise and less job complexity. The corresponding risk in men in high noise and high job complexity was less than half

This study analyses from a gender perspective the differences in the exposure to an environmental risk factor in occupational health to which men have traditionally had higher exposure than women

8/8

O’Campo 2004, [45]

To explore the conceptualization and measurement of gender inequality in the workplace and how these inequalities may impact health by the creation of indicators of gender inequality in the workplace

Wide gender inequalities between women and men within occupational categories were found in terms of pay, position of power, supervisory responsibilities, jobs with high strain and jobs that are passive. In general, women are more likely to have passive jobs, to receive lower pay, to occupy jobs with fewer policy-making responsibilities and jobs with fewer supervisory responsibilities

This is one of the first studies to describe gender inequalities in terms of pay, power and job stress within occupational categories for the purpose of examining associations with women’s health status

7/8

Cortès 2004, [46]

To analyze inequalities in mental health in the working population by gender and professional qualifications, and to identify psychosocial risk factors and employment conditions related to the mental health of this population

Women were more likely to report poor mental health status than men, although sex differences were greater among manual workers. Differences according to qualifications were found among women only in those working in manual jobs compared to women working in non-manual jobs, while no differences were found among men according to qualifications. Mental health is worse in women, and a relationship with professional qualifications is observed only in this group; women with less skilled occupations have poorer mental health status

This study is one of the few that analyses the association of working and employment conditions and mental health from a gender perspective while taking into account occupational social class

7/8

Muhonen 2003, [47]

To investigate the main and the interaction effects of the demand-control-support model on women’s and men’s health in a Swedish telecom company

Demands had main effect for women’s health symptoms, whereas both demands and lack of social support acted as predictors for men’s health symptoms. Control did not predict health either for women or men

This study focuses mainly in the differences between women and men in exposure to the demand-control-support model and how this impacts women’s and men’s health

8/8

Bildt 2002, [48]

To examine how working conditions in 1993 influenced the occurrence of poor mental health in 1997 among women and men

Shift work, job strain, no education at the employer’s expense, low occupational pride, low stimulation at work and poor social support were related to poor mental health among women, while among men, only shift work and low occupational pride were found as risk indicators of poor mental health

Interesting study focusing on how the different distribution of employment and working conditions impacts on women and men’s mental health

7/8

Karlqvist 2002, [49]

To describe working conditions and the prevalence of musculoskeletal symptoms among male and female visual device units operators, and to assess associations between work-related physical and psychosocial exposures, respectively, and neck and upper limb symptoms, and whether these associations differed between women and men

More women compared to men were exposed to organizational, physical and psychosocial working conditions that have been recognised as harmful conditions in previous studies published in occupational health scientific research

This study analyses the different distribution of exposure to work-related physical and psychosocial hazards between women and men; and how it impacts differently women’s and men’s physical health

8/8

de Zwart 2001, [50]

To analyse the association between gender and upper extremity musculoskeletal complaints, among the general working population and in various occupational groups. To test whether the higher risk in women in the general working population for these types of complaints can be explained partly by differences in the distribution of male and female workers in occupations with different risks for the onset of upper extremity musculoskeletal complaints

Female workers showed a consistently higher risk of complaints of the upper extremities among the general working population as well as in many occupational social classes. Gender differences in musculoskeletal disorders are independent of the type of occupation. On the other hand, the theory of gender segregation in work tasks among employees in the same job title may also still be a plausible explanation for our findings

This study confirmed the presence of gender differences in upper extremity musculoskeletal complaints among working populations as well as within several occupational classes, with women reporting a higher number of symptoms. The results, however, do not lend support to the hypothesis that women suffer more musculoskeletal complaints due to gender segregation of the labour market, which places women in occupations with higher risk of being exposed to musculoskeletal hazards. Potentially, it can be attributed to differences in work-related and non-work-related factors between sexes

7/8

Ibrahim 2001, [51]

To explore the association, for working women and men, of high strain jobs with self-rated health in the 1994/1995 Canadian National Population Health Survey

The job strain and poorer self-rated health relationship was consistent across both levels of poorer health. The relationship was weaker for women than men despite the fact women reported higher psychosocial demands and lower control than men

This study mainly analyses how differences in the exposure of women and men to job strain and job insecurity impacts on their self-perceived health

7/8

Islam 2001, [52]

To examine the overall work-related injuries in an exclusively state-funded workers compensation system that allows comparison of compare injuries/illness rates, types, causes, and effects in major occupations and industries between males and females

Among the compensable injury/illness cases, a greater proportion of females than males had back, ankle, hand, neck, shoulder and wrist injuries. The incidence of musculoskeletal disorders was significantly higher in females than males working in the service industry

This study analyses the different distribution of work-related injuries and illnesses between women and men

7/8

Dosemeci 1999, [53]

To analyse gender differences in the risk of renal cell carcinoma and occupational exposures to chlorinated aliphatic hydrocarbons

More men than women were exposed to organic solvents in general. However, the risk of renal cell carcinoma was significantly elevated among women exposed to all organic solvents combined. Among men exposed to any of the organic solvents, no significant excess risk was observed

This is one of the first studies to introduce the gender perspective in analysing how differences between women and men in the exposure to a chemical hazard can explain its different impact on a specific occupational illness

5/6

Emslie 1999, [54]

To examine gender differences in minor morbidity among men and women working in similar circumstances, and to test whether the relation between reported working conditions and health is similar for men and women

Female university employees reported more physical symptoms and more malaise symptoms than male employees, but mean scores on measures of minor psychiatric morbidity did not differ by gender

This study concludes that the gender differences observed in health complaints is due to gender differences in the exposure to worse working conditions, rather than to a differential vulnerability between sexes.

8/8