It was in 2008 that the big bisphenol A (BPA) scare got serious. Since the 1950s, this synthetic chemical had been used in the production of clear, durable plastics, and it was to be found in millions of consumer items from baby bottles to food cans to main water pipes.1 By 2008, 2.7 million tons of BPA was being produced globally every year, and it was so ubiquitous that it had been detected in the urine of 93% of Americans over the age of six.2 And then a US federal health agency came out and said that this compound that we were all interacting with on a daily basis may cause cancer, chromosomal abnormalities, brain and behavioural abnormalities and metabolic disorders. Crucially, it could cause all these medical problems at levels below the regulatory standard for exposure. Naturally, all hell broke loose.
The story of BPA is in some ways a cautionary tale about what happens when we ignore female medical health data. We have known that BPA can mimic the female hormone oestrogen since the mid-1930s. And since at least the 1970s we have known that synthetic oestrogen can be carcinogenic in women: in 1971 diethylstilbestrol (DES) – another synthetic oestrogen which had been prescribed to millions of pregnant women for thirty years – was banned following reports of rare vaginal cancers in young women exposed to DES while in their mothers’ wombs.3 But BPA carried on being used in hundreds of thousands of tons of consumer plastics: by the late 1980s, production of BPA in the United States ‘soared to close to a billion pounds per year as polycarbonates found new markets in compact discs, digital versatile discs (DVDs), water and baby bottles, and laboratory and hospital equipment’.4
But the story of BPA is not just about gender: it’s also about class. Or at least it’s about gendered class. Fearing a major consumer boycott, most baby-bottle manufacturers voluntarily removed BPA from their products, and while the official US line on BPA is that it is not toxic, the EU and Canada are on their way to banning its use altogether. But the legislation that we have exclusively concerns consumers: no regulatory standard has ever been set for workplace exposure.5 ‘It was ironic to me,’ says occupational health researcher Jim Brophy, ‘that all this talk about the danger for pregnant women and women who had just given birth never extended to the women who were producing these bottles. Those women whose exposures far exceeded anything that you would have in the general environment. There was no talk about the pregnant worker who is on the machine that’s producing this thing.’
This is a mistake, says Brophy. Worker health should be a public health priority if only because ‘workers are acting as a canary for society as a whole’. If women’s breast-cancer rates in the plastics industry were documented and recognised, ‘if we cared enough to look at what’s going on in the health of workers that use these substances every day’, it would have a ‘tremendous effect on these substances being allowed to enter into the mainstream commerce’. It would have a ‘tremendous effect on public health’.
But we don’t care enough. In Canada, where women’s health researcher Anne Rochon Ford is based, five women’s health research centres that had been operating since the 1990s, including Ford’s own, had their funding cut in 2013. It’s a similar story in the UK, where ‘public research budgets have been decimated’, says Rory O’Neill. And so the ‘far better resourced’ chemicals industry and its offshoots have successfully resisted regulation for years. They have fought government bans and restrictions. They have claimed that certain chemicals have been removed voluntarily when random testing has shown that they are still present. They have dismissed studies and other evidence of the negative health impacts of their products.6 between 1997 and 2005, 115 studies were conducted on BPA in labs all over the world; 90% of those funded by government found the BPA had effects at exposures at or below the reference dose. Of the eleven studies funded by industry, none reported any effects.7
The result is that workplaces remain unsafe. Brophy tells me that the ventilation he found in most auto-plastics factories was limited to ‘fans in the ceiling. So the fumes literally pass the breathing zone and head to the roof and in the summertime when it’s really hot in there and the fumes become visible, they will open the doors.’ It’s the same story in Canadian nail salons, says Rochon Ford. ‘It’s a Wild West here. Anyone can open a nail salon. It’s only recently that you even needed a licence.’ But even this is ‘pretty lax’. There are no ventilation requirements, there are no training requirements. There is no legislation around wearing gloves and masks. And there is nobody following up on the requirements that do exist – unless someone makes a complaint.
But here we run into another difficulty: who is going to make a complaint? Certainly not the women themselves. Women working in nail salons, in auto-plastics factories, in a vast range of hazardous workplaces, are some of the most vulnerable, powerless workers you can find. They are poor, working class, often immigrants who can’t afford to put their immigration status at risk. And this makes them ripe for exploitation.
Auto-plastics factories tend not to be part of the big car companies like Ford. They are usually arms-length suppliers, ‘who tend to be non-unionised and tend to be able to get away with more employment-standard violations’, Rochon Ford tells me. It doesn’t help that Windsor, Ontario, the heart of the auto industry in Canada, has one of the highest unemployment rates in the country. The result is that workers know that if they demand better protections the response will be ‘Fine, you’re out of here. There’s ten women outside the door who want your job.’ We’ve heard factory workers tell us this in the exact same words,’ says Rochon Ford.
If this sounds illegal, well, it may be. Over the past hundred years or so, a framework of employee rights has been established. They vary from country to country, but they tend to include a right to paid sick and maternity leave, a right to a set number of hours, and protection from unfair and/or sudden dismissal. But these rights only apply if you are an employee. And, increasingly, many workers are not.
In many nail salons, technicians are technically independent contractors. This makes life much easier for the employers: the inherent risk of running a company based on consumer demand is passed on to workers, who have no guaranteed hours and no job security. Not enough customers today? Don’t come in and don’t get paid. Minor accident? You’re out of here, and forget about redundancy pay.
In 2015 the New York Times reported the story of manicurist Qing Lin, forty-seven, who splashed some nail-polish remover on a customer’s patent Prada sandals.8 ‘When the woman demanded compensation, the $270 her boss pressed into the woman’s hand came out of the manicurist’s pay’, and Lin was fired. ‘I am worth less than a shoe,’ she said. Lin’s story appeared in a New York Times investigation of nail salons which revealed ‘all manner of humiliation’ suffered by workers, including constant video monitoring by owners, verbal, and even physical abuse.9 Lawsuits filed in New York courts include allegations of sixty-six-hour weeks at $1.50 an hour and no pay at all on slow days in a salon that charged manicurists for drinking the water.
Following the publication of the New York Times investigation a licensing system was introduced in New York. Workers there must be paid at least the minimum wage, and nail salons must display a ‘bill of rights’ in multiple languages.10 But workers elsewhere in the US, and elsewhere in the world, are less lucky. In the UK, regulation and licensing of nail bars is largely voluntary11 – which in practice means largely non-existent. A 2017 report described the predominantly female Vietnamese workforce as ‘victims of modern slavery’.12
Nail salons are the tip of an extremely poorly regulated iceberg when it comes to employers exploiting loopholes in employment law. Zero-hour contracts, short-term contracts, employment through an agency, these have all been enticingly rebranded the ‘gig economy’ by Silicon Valley, as if they are of benefit to workers. But the gig economy is in fact often no more than a way for employers to get around basic employee rights. Casual contracts create a vicious cycle: the rights are weaker to begin with, which makes workers reticent to fight for the ones they do still have. And so those get bent too. In the UK, which has seen one of the fastest growths in precarious work in the EU,13 TUC research uncovered a work environment that was rife with employers using casual contracts to illegally undermine workers’ rights.14
Naturally, the impact of what the International Trade Union Confederation (ITUC) has termed the ‘startling growth’ of precarious work has barely been gender-analysed.15 The ITUC reports that its feminised impact is ‘poorly reflected in official statistics and government policies’, because the ‘standard indicators and data used to measure developments on labour markets’ are not gender-sensitive, and, as ever, data is often not sex-disaggregated, ‘making it sometimes difficult to measure the overall numbers of women’. There are, as a result, ‘no global figures related to the number of women in precarious work’.
But the regional and sector-specific studies that do exist suggest ‘an overrepresentation of women’ in precarious jobs. In the UK, the trade union Unison found that by 2014 women made up almost two-thirds of low-paid workers,16 and many were ‘working multiple jobs on precarious contracts to make up lost hours’.17 According to a recent Fawcett Society report, one in eight British women is employed on a zero-hours contract.18 In London that figure is nearly one in three.
And although we often think of precarious work as being relegated to the less ‘prestigious’ end of the job market it increasingly appears in all sectors and at all levels.19 According to the UK’s University and College Union, tertiary education, usually considered an elite profession, is the second highest user of casual labour.20 The UCU’s data is not sex-disaggregated, but according to the UK’s Higher Education Statistics Agency,21 women are more likely than men to be on shorter, fixed-term contracts, and statistics from Germany and Europe show the same.22
More broadly, across the EU most of the increase in women’s employment over the past decade has been through part-time and precarious work.23 In Australia, 30% of women are in casual employment, compared to 22% of men, while in Japan, women make up two-thirds24 of non-regular workers. A Harvard study on the rise of ‘alternative work’ in America between 2005 and 2015 found that the percentage of women in such work ‘more than doubled’, meaning that ‘women are now more likely than men to be employed in an alternative work arrangement’.25
This is a problem because while precarious work isn’t ideal for any worker, it can have a particularly severe impact on women. For a start, it is possible that it is exacerbating the gender pay gap: in the UK there is a 34% hourly pay penalty for workers on zero-hours contracts, a 39% hourly pay penalty for workers on casual contracts, and a 20% pay penalty for agency workers – which are on the increase as public services continue to be outsourced.26 But no one seems interested in finding out how this might be affecting women. An analysis of pay policy in Europe criticises the outsourcing trend for seeming ‘to have been implemented with little or no reference to their gender effects’.27 And existing data suggests that those gender effects are plentiful.
There is, to begin with, ‘limited scope for collective bargaining’ in agency jobs. This is a problem for all workers, but can be especially problematic for women because evidence suggests that collective bargaining (as opposed to individual salary negotiation) could be particularly important for women – those pesky modesty norms again. As a result, an increase in jobs like agency work that don’t allow for collective bargaining might be detrimental to attempts to close the gender pay gap.
But the negative impact of precarious work on women isn’t just about unintended side effects. It’s also about the weaker rights that are intrinsic to the gig economy. In the UK a female employee is only entitled to maternity leave if she is actually an employee. If she’s a ‘worker’, that is, someone on a short-term or zero-hours contract, she isn’t entitled to any leave at all, meaning she would have to quit her job and reapply after she’s given birth. A female worker is also only entitled to statutory maternity pay if she has worked for twenty-six weeks in the last sixty-six and if her average wage is at least £116 per week.
And this is where the problems can kick in. Not being entitled to return to her job meant that Holly, a research associate at a UK university, ended up dropping two pay grades after giving birth.28 Maria, also a university researcher, had her hours suddenly and mysteriously cut in half six weeks before she was due to give birth; conveniently for her employee, the amount of maternity pay she was owed dropped correspondingly. The same thing happened to Rachel, who works in a pub restaurant: her hours suddenly dropped when she told her employer she was pregnant. She now might not even qualify for statutory maternity pay at all.
After giving birth, Maria ended up on a new university contract for just under three hours a week – the only hours on offer. She can, and does, work extra hours to cover staff absences, but the extra hours are often at short notice. And here we run into the second major problem that disproportionately impacts on female workers: unpredictable, last-minute scheduling.
As we’ve seen, women still do the vast majority of the world’s unpaid care work and, particularly when it comes to childcare, this makes irregular hours extremely difficult. This is partly because, in another case of having the data but failing to use it, British childcare provision has not caught up with the reality of how women are working. We know that 75% of UK families on low to middle incomes now work outside standard hours, but most formal childcare is still only available between 8 a.m. and 6 p.m. It must be booked and paid for well in advance, which is difficult if you don’t know when you’re going to need it. This problem is particularly acute for single parents (90% of whom in the UK are women29) a group that has seen a 27% increase in temporary work.30 And given Britain has one of the highest childcare costs in Europe, it’s also an expensive one.31
The scheduling issue is being made worse by gender-insensitive algorithms. A growing number of companies use ‘just in time’ scheduling software, which use sales patterns and other data to predict how many workers will be needed at any one time. They also respond to real-time sales analyses, telling managers to send workers home when consumer demand is slow. ‘It’s like magic,’ the vice president for business development at Kronos, which supplies the software for a number of US chains, told the New York Times.32
It probably does feel like magic for the companies that use his software to boost profits by shifting the risks of doing business onto their workers. It probably also feels pretty great for the increasing number of managers who are compensated on the efficiency of their staffing. It feels less great, however, for the workers themselves, particularly those with caring responsibilities. Jannette Navarro, a barista at a Starbucks in San Diego, showed the New York Times her upcoming algorithm-produced schedule.33 It involved working until 11 p.m. on the Friday, reporting again at 4 a.m. on Saturday, and then starting again at 5 a.m. on Sunday. She rarely learned her schedule more than three days in advance, causing havoc for her childcare arrangements – and forcing her to put her associate degree in business on hold. It’s another example of how the introduction of Big Data into a world full of gender data gaps can magnify and accelerate already-existing discriminations: whether its designers didn’t know or didn’t care about the data on women’s unpaid caring responsibilities, the software has clearly been designed without reference to them.
A Starbucks spokesperson told the New York Times that Navarro’s experience ‘was an anomaly, and that the company provided at least a week’s notice of work hours, as well as stable schedules for employees who want them’. But when journalists spoke to current and former workers ‘at 17 Starbucks outlets around the country, only two said they received a week’s notice of their hours; some got as little as one day’. And although a few cities have introduced laws regulating the minimum advance notice of a shift an employer can give their workers,34 there is no nationwide regulation in America – nor is there in many other countries, including in the UK. It is not good enough. The work that (mainly) women do (mainly) unpaid, alongside their paid employment is not an optional extra. This is work that society needs to get done. And getting it done is entirely incompatible with just-in-time scheduling designed entirely without reference to it. Which leaves us with two options: either states provide free, publicly funded alternatives to women’s unpaid work, or they put an end to just-in-time scheduling.
A woman doesn’t need to be in precarious employment to have her rights violated. Women on irregular or precarious employment contracts have been found to be more at risk of sexual harassment35 (perhaps because they are less likely to take action against a colleague or employer who is harassing them36) but as the #MeToo movement washes over social media, it is becoming increasingly hard to escape the reality that it is a rare industry in which sexual harassment isn’t a problem.
As ever, there is a data gap. The TUC warns of a ‘paucity of up-to-date, quantitative data on sexual harassment in the workplace’, a problem that seems to exist worldwide, with official statistics extremely hard to come by. The UN estimates (estimates are all we have) that up to 50% of women in EU countries have been sexually harassed at work.37 The figure in China is thought to be as high as 80%.38 In Australia a study found that 60% of female nurses had been sexually harassed.39
The extent of the problem varies from industry to industry. Workplaces that are either male-dominated or have a male-dominated leadership are often the worst for sexual harassment.40 A 2016 study by the TUC found that 69% of women in manufacturing and 67% of women in hospitality and leisure ‘reported experiencing some form of sexual harassment’ compared to an average of 52%. A 2011 US study similarly found that the construction industry had the highest rates of sexual harassment, followed by transportation and utilities. One survey of senior level women working in Silicon Valley found that 90% of women had witnessed sexist behaviour; 87% had been on the receiving end of demeaning comments by male colleagues; and 60% had received unwanted sexual advances.41 Of that 60%, more than half had been propositioned more than once, and 65% had been propositioned by a superior. One in three women surveyed had felt afraid for her personal safety.
Some of the worst experiences of harassment come from women whose work brings them into close contact with the general public. In these instances, harassment all too often seems to spill over into violence.
‘He picked her up, threw her across the room, pounded her face and there was blood everywhere.’
‘This is when he grabbed me and hit me with the glass. I slumped to the ground and he was still pounding me. [. . .] I fought him all the way down the hall. He put my head through the wall. There was blood on the walls from my elbows, my face.’
If this doesn’t sound like just another day in the office for you, be grateful that you’re not a health worker. Research has found that nurses are subjected to ‘more acts of violence than police officers or prison guards’.42 In Ontario in 2014, the number of workplace injuries that required time off work from the healthcare sector ‘greatly outnumbered those in other sectors surveyed’. A recent US study similarly found that ‘healthcare workers required time off work due to violence four times more often than other types of injury’.43
Following the research he conducted with fellow occupational health researcher Margaret Brophy, Jim Brophy concluded that the Canadian health sector was ‘one of the most toxic work environments that we had ever seen’. For their 2017 paper on the violence faced by Canadian healthcare workers the Brophys held focus groups where ‘people would regularly say, “Every day I go into work and I’m confronted with this.”’ When the Brophys pulled them up on this claim – surely ‘every day’ was hyperbole, they meant often? ‘And they would correct us. “No, we mean every day. It’s become part of the job.”’ One worker recalled the time a patient ‘got [a] chair above his head’, noting that ‘the nursing station has been smashed two or three times’. Other patients used bed pans, dishes, even loose building materials as weapons against nurses.
But despite its prevalence, workplace violence in healthcare is ‘an under-reported, ubiquitous, and persistent problem that has been tolerated and largely ignored’. This is partly because the studies simply haven’t been done. According to the Brophys’ research, prior to 2000, violence against healthcare workers was barely on the agenda: when in February 2017 they searched Medline for ‘workplace violence against nurses’ they found ‘155 international articles, 149 of which were published from 2000 to the time of the search’.
But the global data gap when it comes to the sexual harassment and violence women face in the workplace is not just down to a failure to research the issue. It’s also down to the vast majority of women not reporting.44 And this in turn is partly down to organisations not putting in place adequate procedures for dealing with the issue. Women don’t report because they fear reprisals and because they fear nothing will be done – both of which are reasonable expectations in many industries.45 ‘We scream,’ one nurse told the Brophys. ‘The best we can do is scream.’
The inadequacy of procedures to deal with the kind of harassment that female workers face is itself likely also a result of a data gap. Leadership in all sectors is male-dominated and the reality is that men do not face this kind of aggression in the way women do.46 And so, rather like the Google leadership not thinking to put in pregnancy parking, many organisations don’t think to put in procedures to deal adequately with sexual harassment and violence. It’s another example of how much a diversity of experience at the top matters for everyone – and how much it matters if we are serious about closing the data gap.47
The Brophys warn that gender is also ‘typically [. . .] absent in analyses of health sector violence’. This is unfortunate. According to the International Council of Nurses, ‘nurses are the healthcare workers most at risk’ – and the vast majority of nurses are women. The absence of gender analysis also means that most of the research doesn’t factor in the chronic under-reporting of sexual violence: the Brophys found that only 12% of the workers in their study reported it. ‘We don’t report sexual violence because it happens so frequently,’ explained one woman who had been ‘grabbed many times’. But an awareness that the official data is ‘believed to grossly underestimate the incidence due to widespread underreporting’ just isn’t in the literature, Brophy tells me. This meta data gap goes unremarked.
The violence nurses face at work is not helped by traditional hospital design. The long hallways isolate workers, explains Brophy, scattering them far away from each other. ‘Those hallways are terrible,’ one worker told Brophy. ‘You work way over there – and you can’t communicate. I would prefer a full roundabout circle.’ This would be an improvement, Brophy points out, because it would enable staff to support each other better. ‘If the area was rounded, workers wouldn’t be off on one end. If there was two people one would hear something going on.’ Most nursing stations don’t have protective shatterproof barriers or exits behind the desk, leaving nurses vulnerable to attack. Another worker told Brophy about the time her co-worker was sexually assaulted by a patient. ‘[Th]e inspector recommended that they put glass up. The hospital fought them on it. They said it stigmatises the patients.’
Both the workers Brophy interviewed and the US’s Occupational Health and Safety Administration have highlighted several design features of traditional hospitals (‘unsecured access/egress; insufficient heating or cooling; irritating noise levels; unsecured items’) that compound the safety issue – all of which could be addressed without stigmatising anyone. Governments could also reverse policies that result in routine understaffing – an issue that Brophy ‘heard in every group in every location’, with workers identifying wait times as ‘a trigger’ for violent behaviour directed towards staff. ‘If you don’t have the staff to immediately address their issue – if they’re kept waiting – they are more likely to escalate in their behaviour,’ explained one worker.
Redesigning hospital layouts and increasing staffing levels of course don’t come cheap – but there’s likely a cost argument that could be made given the amount of time off from injuries and stress workers are taking. Unfortunately, this data is not being ‘adequately collected’, Brophy tells me. But, he continues, ‘I can tell you there’s not a doubt in my mind that that is a very high stress work environment and that the demand on people and the limited amount of control they have is the perfect scenario for job burnout.’
And then there’s the cost implications of training people who then leave the profession, which came up repeatedly in the focus groups the Brophys conducted. ‘We had nurses with twenty-five to thirty years’ seniority saying “I’m gonna become a cleaner,” or “I’m gonna work in the kitchen because I can’t deal with it any more. I can’t handle the lack of support and the danger and the risk and coming in every day and facing these things and then being negated and unsupported.”’
But even without taking this more long-term view there are plenty of lower-cost options, some of them dazzlingly simple. Consistently charting and flagging patient violence; making reporting procedures less onerous – and having supervisors actually read the reports; ensuring alarms make different noises depending on their purpose: ‘[I]n one instance, the patient call bell, bathroom assist bell, Code Blue for respiratory or cardiac arrest, and staff emergency alarms all made the same sound in the nurse’s station’ (fans of British 1970s TV will recognise this problem with alarms as the plot of an actual Fawlty Towers episode).
Signs making it clear what behaviour is and isn’t acceptable would also be inexpensive. ‘I notice at the hospital coffee shop they have a sign that says they won’t tolerate any type of verbal abuse,’ one woman told the Brophys. ‘But there’s no signs on our units that say that. [. . .] There is a poster about if you’re widowed and lonely, here’s a singles website. But you won’t put up a violence sign for us?’
Perhaps most staggeringly simple, participants in the Brophys’ research ‘suggested that they be permitted to have their last names removed from their name tags – at their employer’s expense – as a safety measure’. This would avoid incidents such as when a visitor to the hospital told a female worker, ‘Very nice to meet you, [her name]. And you know, you shouldn’t have your last name on your badge because I can just look you up and find out who you are and where you live.’
Women have always worked. They have worked unpaid, underpaid, underappreciated, and invisibly, but they have always worked. But the modern workplace does not work for women. From its location, to its hours, to its regulatory standards, it has been designed around the lives of men and it is no longer fit for purpose. The world of work needs a wholesale redesign – of its regulations, of its equipment, of its culture – and this redesign must be led by data on female bodies and female lives. We have to start recognising that the work women do is not an added extra, a bonus that we could do without: women’s work, paid and unpaid, is the backbone of our society and our economy. It’s about time we started valuing it.