Policy case study. Sweden. Women’s work environment and MSDs prevention.

Swedish statistics show a gradual decline in the rate of occupational ill health over the last 15 years for both men and women. A more detailed analysis showed that the rate of ill health among women was higher than that for men and that more women than men ended their working lives early for health reasons, especially because of musculoskeletal disorders (MSDs).The national occupational safety and health (OSH) strategy in Sweden can be seen against a background of efforts in the late 1990s towards achieving gender equality and ‘mainstreaming’ the gender aspect in all policies. With the concept of mainstreaming pervading all government thinking, gender and work therefore emerged as a theme reflecting this wider perspective.Against this background and the demonstrable gender inequality in health problems, the Swedish Work Environment Authority (SWEA — Arbetsmiljöverket) was assigned a task to investigate ‘women’s work environment’ and the causes of higher sickness rates in women, leading to their early exit from the labour market. The assignment encompassed knowledge generation and disseminating that knowledge to key players, including labour inspectors, to build an evidence-based course of action.The assignment encompassed generating knowledge in relation to women’s occupational health (including their higher risk for developing MSDs) awareness raising, and developing better methods of highlighting the gender inequalities at work that are putting women at increased risk of developing MSDs. The knowledge generated and the increased awareness was expected to lead to greater gender sensitivity in workplaces and an improved working environment for both men and women.The assignment was implemented through a programme comprising two projects. Activities included research, awareness-raising and dissemination activities, training of inspectors and targeted inspection campaigns. The programme started with a survey of employers that provided benchmark measurements as a starting point. This revealed a low level of awareness of MSDs and gender issues and that only a small proportion of employers were giving equal consideration to men and women’s prerequisites in allocating tasks.The knowledge generation covered gender-specific issues related to the work environment and the organisational and psychosocial factors for work-related and health-related outcomes.Targeted inspection campaigns formed an integral part of the programme, and inspectors were given training on adopting a gender perspective in assessing MSD risks and on techniques developed during the project. Some campaigns covered a broad range of sectors, while others included workplaces where manual handling or repetitive work occurred; workplaces within health care and social care settings with a focus on the assessment of risks for MSDs during patient transfer; and work environments where male- dominated technical administration jobs were compared with female-dominated home care services. These inspections were aimed at increasing the employers’ knowledge about the risks of MSDs and their prevention.Dissemination of knowledge was also part of the initiative. As well as the research reports, conferences helped to disseminate the findings. The SWEA also developed a set of materials including brochures for employers and two films. In addition, dialogue with employers on the gender perspective in systematic work environment management provided a more comprehensive picture of the risks and shortcomings of the work environment for both women and men.The challenges for the success of the initiative appear primarily to have been a lack of knowledge and inflexibility of thinking, especially within male-dominated sectors. Providing information appears to have borne fruit (e.g. as shown by the actions reported by municipalities that took part in one strand of the work).