"Gender and sex matter when it comes to occupational health and safety (OSH). To better protect women's rights at work, we need to understand the particular risks to which they are exposed and take appropriate remedial measures. How exactly we go about this, however, can be a complex and sensitive question. It is the question at the heart of Karen Messing's Bent Out of Shape, a mustread for anyone interested in OSH, gender equality at work, and women's health.
Messing, a professor of biology specialising in genetics and ergonomics, has dedicated her career to improving women's occupational health, working together with trade unions both in her native Canada and elsewhere. In this book, she provides an engaging and accessible account of the challenges faced by women workers, drawing on case studies that she, her students and other researchers have conducted in a wide range of workplaces and jobs. It is both a scholarly rigorous and deeply personal and honest account – of successes and failures, of disappointment and frustration at the lack of action or even overt hostility regarding these questions, but also of solidarity and support between women, and of brilliant and dedicated researchers who want to see change.
Given Messing's background in biology, the book explores OSH risks primarily through the medium of the body. She is nevertheless intent on illuminating how this physical dimension relates to societal gender roles, to the pressures and emotional demands placed on women, to the psychological consequences of these demands, and more broadly to psychosocial risks. In this regard, the book highlights the distinction between sex, which refers to certain biological differences, and gender, which refers to a social construct linked to certain norms and expectations.
Messing shows, though numerous studies, how both sex and gender play a role in OSH. For instance, she explains that because women's bodies tend on average to be smaller, those in jobs traditionally occupied by men can be exposed to a risk of workplace injury or illness as a result of ill-fitting equipment designed for the average male body. An example might be a tool belt or medical mask that is too wide to fit properly. Women and men can also be subject to different physical demands and environmental factors in the same workplaces, and even when they technically occupy the same jobs. One example discussed is that of assembly lines divided along gender lines, with men working with big machines and heavy loads, and women manually wrapping individual items with repetitive movements – these different tasks entail different risks.
At the same time, the studies remind us that sexual harassment and violence, as well as gender stereotyping, remain serious workplace concerns for many women. Worklife balance issues also disproportionately put pressure on women, who continue to perform a greater share of unpaid care work on top of their paid job. Jobs and sectors traditionally considered female, such as care or cleaning, are often undervalued and underpaid, and workers are particularly exposed to repetitive movement and uncomfortable contorted positions, as well as emotional demands. But the requirements of these jobs are underestimated, and health and safety issues are often not taken seriously. This point comes up throughout the book: occupational health issues that particularly affect women are not only poorly studied, but often also not acted upon.
Three points are particularly striking in Messing's narrative. The first is women's silence about problems they face at theworkplace as women, from violence and harassment, to inappropriate equipment and lower pay. Not infrequently, there is a denial that these issues are related to gender discrimination, as well as a perception (often leading to a sense of shame) that this is ‘their own fault' and that ‘nobody would believe them anyway.' Women workers often do not want to be perceived as having different abilities and needs from their male colleagues. Second, in most case studies described in the book, the findings of scientific analyses are met with denial, inaction or hostility. Mostly this has come from employers, but at times also from government agencies, fellow scientists or even trade unionists. Messing notes that, in general, mentioning gender explicitly has a tendency to create controversy, backlash from employers and at times even division among workers.
This brings us to the third point, which is the dilemma between explicitly pointing to gender/sex differences when it comes to occupational risks in order to better protect women's health, and the desire to avoid further gender stereotyping and disadvantages at the workplace, including employers' unwillingness to hire women. In a spirit of intellectual honesty, the author admits that framing her findings and recommendations in terms of gender has not always led to the best results for workers in practice, for all of the abovementioned reasons.
Messing's account of her experiences and those of other researchers and unions seeking to improve women's health at work shows how complex it is to navigate this field, in both technical and political terms. In her words, ‘it is hard to take on gender issues at the workplace, and it makes us feel uncomfortable.' To move forward, she stresses that we need to acquire a better understanding of the ways in which gender and sex are relevant to occupational health in a particular job or workplace, including the role of any biological differences between the sexes as well as societal gender norms and expectations. At the same time, researchers need to think carefully about the best approach to take in order to help women without encouraging further stereotyping.
Perhaps the most important message is that little progress can be achieved if workers stand alone. Solidarity, mutual support and the collective voice of women workers – through women's committees within unions, amongst other ways – are essential. The book is thus also a call for women workers to come together and fight for gender equality and health at the workplace – a fight that, as the Covid-19 pandemic has shown us, is far from over. - Kalina Arabadjieva."

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