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The menopause - a workplace issue

With increasing numbers of women in the workforce, and two thirds of women in the UK between 50 and 59 in employment, more women - not just older women - are now working through and beyond the menopause. Occupational health and safety and health promotion policies therefore become increasingly important for these women.

There are currently 70% of women aged 45-59, and 27% of those aged 60-64, in the UK labour force, by 2006 these figures are projected to rise to 73% and 40% respectively. Women now make up nearly half the UK workforce and the proportion of older women in the workforce is also on increase - there are two and a half million women working between the ages of 50 and 59. Older women also work longer hours than women aged between 16-44, with about half those aged 45-65 employed full time in 1998 compared with only 40% of those aged between 16-44.

What is the Menopause?
Menopause - often called ’the change of life’ - is not usually associated with the workplace or with workers’ health and safety. Although many experience few problems around this time, others do. These problems can sometimes arise from the ways work and working conditions affect women’s health around the menopause

Strictly speaking, ’menopause’ is the medical term given to the date of a woman’s final menstrual period. This normally occurs in women around the age of 51, although it can happen much earlier in some people - 1 in 100 women experience menopause before they are 40, some even in their teens or twenties. A normal part of ageing, the menopause involves gradual changes in the years leading up to the menopause (this is called the ’peri-menopause’).

The changes involved affect different women in different ways. Some experience few or no symptoms, and find the menopause a liberating experience. Others will experience mild to severe symptoms. Recognising these changes can help in linking between workplace health and safety and the problems some women experience working through the menopause.

Menopause is not as some will suggest an illness. Changes in oestrogen levels can result in intermittent symptoms around this time including ’hot flushes’, sweating, increased susceptibility to anxiety, fatigue and stress and sometimes short-term memory problems.

Some women require medical advice and treatment and seeking medical advice about menopause-related symptoms may mean time off from for medical appointments and/or treatment.

Normally menopause is a natural process involving gradual change. Sometimes, however, it can be sudden and acute result from medical intervention - for example, hysterectomy involving removal of the woman’s ovaries, or certain cancer treatments. Women who have sudden menopause following serious illness or surgery tend to experience more severe problems than others, and may require treatment and/or post-operative care afterwards to prevent further problems.

Information and research about work and menopause can be hard to find and that advice which is available on menopause-related issues rarely includes advice on work-related issues.

The Menopause and Work can affect women working through the menopause in various ways, especially if they cannot make healthy choices at work. Employers need to consider this when carrying out and implementing health and safety risk assessments, i.e.
  • poor ventilation,
  • high working temperatures,
  • unsuitable clothing or uniforms, and
  • some protective equipment
can all aggravate common menopausal symptoms such as hot flushes and sweating, affecting workers’ comfort and health.

A woman’s body temperature can rise by up to 5 degrees during a hot flush and with increased sweating can cause embarrassment for women dealing directly with clients or the public. Hot flushes usually only last for a few minutes but can range from a fraction of a second to an hour.

Another common menopausal symptom is dry skin and eyes, which can be aggravated by heat and poor indoor air quality at work, leading to increased risks of irritation and infection. Simple measures such as having suitable clothing (layered and loose, not synthetic), access to cold drinking water, adjustable workplace temperature control, adjusting relative humidity and additional ventilation (using fresh air or a fan) or flexible rest breaks can all help.

There are additional risks of stress, fatigue and stress-related ill health for women working through the menopause - susceptibility can be affected by hormonal changes. Some women also experience panic attacks at this time.

Workplace culture, policies and practices can also affect the situation. Lack of adequate rest breaks or excessive working hours may also increase risks of ill health, fatigue and stress for women working through the menopause. Tiredness and night sweats (also a common symptom) can make women temporarily more susceptible to fatigue and stress at work, which are linked to risks of reduced immune response and increased susceptibility to infection.

Work environments and shift patterns may prevent access to natural light - an important part of a healthy environment for all workers. Lack of natural light can affect the body’s ability to absorb calcium, and can also affect moods. Calcium is essential for health in later life and can help prevent osteoporosis - a potentially life-threatening condition - by strengthening bones. Bone density loss is fastest in the decade following menopause (i.e. before retirement age) and some women are at particular risk of developing osteoporosis.

Working in restricted positions for long periods may cause health problems for some women. Lack of exercise and/or a sedentary lifestyle is linked to increased risks of osteoporosis, cancer, diabetes and cardio-vascular disease in older women.

The working environment may affect women if they experience symptoms such as nausea and vomiting. Some women report that Hormone Replacement Therapy (HRT) makes them more sensitive to smells at work, increasing the risks of nausea and discomfort.

Ready access to suitable washing and toilet facilities is important for women, particularly during peri-menopause. For some, menstrual bleeding can be heavier and more unpredictable at this time. Adequate workplace sanitary facilities with private washing and changing facilities are therefore important.

Some women going through the menopause experience problems with ’urgency’ (needing to pass water urgently) and can be vulnerable to urinary infections at this time. This can be aggravated if toilet breaks are restricted or if they cannot access toilet facilities when needed.

TUC Survey Identifies Significant H&S Problems
A recent TUC survey of 500 safety reps, exploring the workplace health and safety implications of the menopause, found that there are significant occupational health safety and welfare problems faced by women working through the menopause.

The survey suggested that one of the main problems is the lack of information that surrounds the subject in the workplace (only 1 in 5 employers provided information about the menopause and only 2% said health and safety policies covered menopause-related issues) and highlighted the key areas of concern as:

Problems with the work environment:
  • Uncomfortable working temperature
  • Poor ventilation
  • Inadequate sanitary, washing and changing facilities (or difficulty accessing these)
  • Difficulties accessing drinking water or healthy eating options at work.
Problems with working time arrangements and work activities
  • Pressures of work such as workloads, deadlines etc. leading to stress
  • Difficulties getting time off for medical treatment or advice
  • Lack of rest breaks, inflexible working hours / shift patterns.
Problems with management policies and practices and workplace culture
  • Lack of recognition / awareness of the issues
  • Lack of management information / training
  • Lack of suitable risk assessments
  • Lack of management support and understanding
  • Poor workplace culture and negative attitudes to menopause / older women
  • Communication barriers - embarrassment and silence surrounding the subject
  • Problems with sickness absence monitoring and control.
For the women concerned, there were additional problems associated with their own information and communication needs including:
  • Lack of health promotion information about the menopause
  • Not having access to a competent workplace advisor / occupational health service
  • Feeling unable to talk to others at work about menopause-related issues or women’s health issues
  • Difficulties encountered because of attitudes to menopause, or embarrassment (their own or other people’s) in talking about it at work.
Employers need to be aware of these and other relevant issues when assessing and controlling risks to women working through the menopause.

Conclusion
There is no excuse for the silence, embarrassment, confusion, and inaction around the menopause; something which all women go through. The health of women in later years depends very much on their health when they are working through the menopause and most employers should be doing more to protect women employees.

Despite the fact that women make up nearly half the UK workforce, their concerns about health and safety issues, both inside and outside the workplace, are not being properly addressed.

TSSA representatives should therefore raise the issue of the menopause with employers, where appropriate, thereby helping to ensure that:
  1. women going through the menopause are treated with respect,
  2. the employer develops a menopause policy in consultation with trade union representatives,
  3. risk assessments are sensitive to the needs of women passing through the menopause, and
  4. employers review their procedures (especially sickness absence and disciplinary procedures) to eradicate possible discrimination against women experiencing the menopause
TSSA representatives are also encouraged to raise the general awareness of menopausal issues amongst fellow workers, supervisors and managers in an attempt to change any outdated attitudes that may exist and reduce any unnecessary embarrassment.

The TUC report, which includes detailed case studies, recommends employers provide better welfare facilities, rest breaks, and a lot more forethought and understanding.

The TUC website contains the full report and a campaign summary.
 
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