The most common image associated with workplace chemical exposure usually involves a man, perhaps clad in a lab coat or a coverall, carefully interacting with lethal compounds. For decades, however, women have been moving into a host of jobs that bring them into regular contact with toxic chemicals, from hair styling to housekeeping to firefighting.

Now, several nonprofit health groups including Commonweal, Breast Cancer Action, and Breast Cancer Fund, have joined forces to begin to take on this problem. Working with the San Francisco Fire Department, they recently released a study to determine the health impacts of firefighting on women.

The study was the result of mounting concern at the high incidence of pre-menopausal breast cancer among women in the fire department. As of 2012, 10 out of 117 female San Francisco firefighters between the ages of 40 and 50 had contracted breast cancer, and one had died. That put the department’s breast cancer rate at 8.5% – nearly six times the national average for women in the same age bracket.

The San Francisco initiative is one of a limited body of research that specifically studies the impact of jobs on women’s health. While gender equality has advanced in the workforce ranks, research on the impact different work environments may have on women’s health has all too often failed to keep up. It’s a problem because, for various biological reasons, some workplaces and chemicals may be more dangerous to women than to men.

The National Institute for Occupational Safety and Health has conducted a Firefighter Cancer Study since 2010, but only began incorporating female subjects in 2012. It has only included a few women – less than 1% of total subjects. In the summary of its findings, the institute reported: “In women, there is statistical evidence of excess female bladder and breast cancers, but only bladder cancer mortality and incidence reach significance.”

The report stated that there is little evidence linking female breast cancer to workplace exposure, but noted that longer shifts may be a risk factor. It concluded that the findings on female firefighters should be interpreted cautiously, due to the small sample size and “lack of confirmatory results”.

The San Francisco biomonitoring collaborative will look more closely at the impact of various exposures on women in the hopes of finding ways to protect them from mammary carcinogens. But while the San Francisco study is groundbreaking, it’s still in its infancy, and is unlikely to affect policy or health outcomes for quite some time.

Making workplaces safe for everyone

Under existing US Occupational Safety and Health Administration worker-protection regulations, manufacturers must supply safety data sheets about the products used in workplaces, and employers must inform and train their workforce accordingly. OSHA also issues guidance on what to do if workers are exposed to specific hazardous compounds, such as cadmium and asbestos.

But while OSHA’s safety data sheets must cover all the potential dangers of a chemical or material, the agency doesn’t look specifically at gender differences.

Among other differences, women have more fat tissue where some chemicals accumulate. They also tend to have lower body weight, which can reduce the amount of chemical exposure that is safe. Moreover, females have a different balance of hormones than men, which can affect how those hormones interact with some chemicals. In short, workplace chemicals can impact women differently than men, and in some cases may pose a larger threat.

“There’s not a lot of differentiation between genders in the materials we have,” said OSHA spokeswoman Laura McGinnis. “As far as OSHA is concerned, a hazard to a worker is a hazard to a worker, whether it’s a man or a woman.”

Critics argue that OSHA’s perspective doesn’t reflect reality. “As women have moved into less traditional jobs, the study of the impact those workplaces have on their health has not kept up,” said Nancy Buermeyer, senior policy strategist for the nonprofit Breast Cancer Fund. “OSHA tends to focus on the 32-year-old white male standard and assume exposure is the same. And it’s not.”

Shifting the perspective

Part of the problem is the high cost of regulation. OSHA and its state partners have approximately 2,200 inspectors who are responsible for the safety of 130 million workers – that’s one inspector for every 59,000 workers.

Given the size of its job and the paucity of its resources, it’s not surprising that OSHA is less focused on regulating workplaces than on ensuring that workers know what they are being exposed to. It requires that manufacturers update and republish their materials if testing on a chemical reveals new information. In the workplace, the agency places the onus on employers to adequately train and inform employees, to ensure that safety data sheets are up to date and to guarantee that OSHA guidance documents are being followed.

OSHA itself does not review safety data sheets unless it receives a complaint. It does, however, issue specific guidance around particular workplace safety issues. The agency’s staff looks for emerging risk trends, and listens to concerns from industry groups, unions and advocacy groups.

A combination of these factors came into play with OSHA’s guidance on toluene, an industrial solvent that is commonly found in nail products.

OSHA has long been aware of toluene’s dangers, which can include memory loss, loss of hearing, loss of appetite, loss of color vision and even death. However, the organization hasn’t historically done much to alert beauty workers, who often come into contact with the chemical, about these dangers. For example, it hadn’t made an effort to ensure that nail salons had safety data sheets or that information was available in multiple languages, which is key given that many nail workers speak English as a second language.

Last year, Women’s Voices for the Earth, a nonprofit working to eliminate the use of toxic chemicals, also began working with OSHA to update its guidance to reflect women’s exposure to toluene, particularly nail salon workers.

“We said this is something we really need to worry about with nail workers,” said Alexandra Scranton, the nonprofit’s executive director. “They really heard that, and had us help them change the fact sheets, which were really geared toward male-dominated professions.”

The White House’s initiative on American Asian Pacific Islanders has been working with OSHA, the Environmental Protection Agency and the labor department to create multi-language safety materials and web resources for nail salon workers.

Two sides

Across the board, research on occupational health hazards faced by women is hard to come by. An International Agency for Research on Cancer report released in 2007 bore this out. It correlated night shift work with a higher risk for breast cancer, but its guidance on the subject suggested that there was a general indication that shift work is probably carcinogenic to humans, not that it was a particular risk for women.

In reality, night shift work may have specific dangers for women. A study by researchers in Canada found that night shift work has a high correlation with breast cancer in women. By disrupting the body’s circadian rhythms, researchers found, night work upsets the body’s hormonal cycles. The same report correlated painting work and firefighting with significant cancer risks, but didn’t address how these jobs affected gender-specific ailments like breast cancer and reproductive cancers.

Another example of potential oversight was revealed by a 2012 research review, funded by Health Canada, that found a high cancer risk for women who work in plastic manufacturing. In its conclusion, the study’s authors noted the need for research that takes gender into account. “Our review indicates that women are at disproportionate risk due to the types of jobs they perform in the plastics industry and their particular biological vulnerabilities,” they stated.

In addition to the female firefighter study, Breast Cancer Fund will also be releasing a comprehensive report on occupational health for women later this year.

“There hasn’t historically been enough women in these jobs to have statistical relevance, but that’s changing,” Buermeyer said. “A lot of work really needs to be done on occupational health.”

• This article is part of a series about women’s health and chemicals.