Andrea Oates gives an overview of the latest developments from trade unions on the campaign to make PPE that fits well available to everyone.

The campaign for “inclusive” personal protective equipment (PPE), including for women and global majority workers, has been gathering steam over recent months. It received a further boost recently when GMB general union safety rep Martina Vrajitoru won the 2024 TUC health and safety award at this year’s Congress. Her union nominated her for “outstanding campaigning using equality and health and safety to create change and improve standards at Hinkley Point C.”

Vrajitoru told her union’s annual conference earlier this year that while women are now joining the ranks of the historically male-dominated construction industry, “health and safety standards have been playing catch-up.”   

Women at the biggest construction site in Europe “had to wear men’s clothing and safety boots,” she told delegates, explaining that “there is no such thing” as unisex clothing and PPE as they are “fundamentally designed with men’s needs and anatomy as the standard.”

Ill-fitting PPE increases the risk of slips, trips, falls and entanglement. It can limit movement and dexterity and impair vision. Injuries can include suspension trauma and circulation damage from ill-fitting harnesses and long-term health problems from poorly fitting safety boots, such as plantar fasciitis and tendonitis. The Health and Safety Executive (HSE) warns that “a poor fit will significantly reduce the protection the RPE [respiratory protective equipment] can provide you. Any reduction in protection can put your life in danger or may lead to immediate or long-term ill health.”

Union negotiations at the Hinkley Point C site led to improvements, including new safety boots that “provide the necessary support at the right places” and women no longer have to wear three pairs of socks all year round to stop their feet “swimming around in men’s boots,” Vrajitoru reported.

But this problem is not unique to Hinkley Point C or the construction industry. Highlighting the work of Unite general union safety rep Maria Boyle, who has also been pushing for better women’s clothing and PPE at the Hinkley Point C site, the union said many women face similar issues in agriculture and food production. Some women have even had to buy their own PPE so that it fits properly, despite this contravening health and safety law, it added. As well as causing health and safety problems, the union pointed to a study highlighting the gender gap in offshore wind. It said this showed that a lack of female-specific workwear deters women from entering or remaining in technical roles in the energy sector.

In April, the Women’s Engineering Society (WES) published the results of its latest PPE survey, based on nearly 1,500 respondents, and concluded that “PPE for women does not fit”.  It found little has changed since its first PPE survey in 2009.

“PPE is still based on male body types with 60 per cent of men reporting comfortable or perfect fitting PPE, and only 26 per cent of women saying the same,” it reported. “This means women are either having to wear items that don’t fit, risking their health and safety, or potentially give up working altogether.”

According to WES, “women are being ignored when it comes to providing safe and effective PPE, resulting in dangerous working practices for women and a lack of equality within the workplace.” It highlighted climbing harnesses, lifejackets and air systems that do not work for women’s bodies, “increasing risk to life” and PPE that is too big, resulting in women making modifications against HSE guidance.

A key finding is the lack of maternity PPE, with 61 per cent of pregnant women not being provided with the correct items to allow them to work safely. And it found that when women raised concerns, in more than half of cases nothing changed, compared to just 9 per cent who said their concerns were fully addressed.

Healthcare

In the health sector, the Chartered Society of Physiotherapy (CSP) has highlighted the problem of ill-fitting RPE. Giving evidence to the Scottish COVID-19 inquiry, CSP senior negotiating officer Claire Ronald said that a key area of physiotherapists’ work is in respiratory care. During COVID they worked in intensive care units and acute medical wards to assist with chest clearance and breathing techniques, for example. But PPE “was a huge issue” – in terms of both securing appropriate levels of PPE and sizing.

“The majority of PPE is made for a default male body and face and that is not the default in the health service,” she reported. “Many staff faced repeated fit testing and only had one brand of mask they could safely wear so it limited where and when staff could be in areas. Gowns were often too long, and gloves were not always available in small sizes, so staff had to accommodate themselves to the equipment rather than the other way round.”

The union’s motion to this year’s Scottish Trades Union Congress called on unions “to work collectively to ensure PPE providers stop using Caucasian male as the default that they design around especially when it is not the default in the services they provide to.”

According to the CSP, the Scottish healthcare workforce is predominantly (77 per cent) female, and a third of the workforce is non-white. It pointed to research showing that females are twice as likely to fail fit tests than males and a 2021 Royal College of Emergency Medicine report showing that 48 per cent of Black and minority ethnic respondents failed fit testing at one institution.

In 2020, at the height of the COVID pandemic, the British Medical Association (BMA) reported hearing that Sikh and Muslim doctors, who wear beards for religious reasons, were facing difficulties getting alternative respirators like PAPR powered air-purifying respirator hoods when filtering facepiece FFP3 masks could not be fitted.

Looking to the future

The CSP said the Scottish government and NHS employers must be held to account for how they spend their money and ensure they are demanding that the equipment is fit for purpose.

WES said it intends to work to change practices by measuring thousands of women to develop proper-fitting PPE and engaging with manufacturers and government “to produce safe and effective PPE for all.”

And at the GMB, Vrajitoru’s campaign is being evaluated for adaptation to become a national health and safety campaign. The union believes the Personal Protective Equipment at Work Regulations 1992 should be updated to include specific references to inclusivity on gender grounds.

The new Labour government has committed to “review health and safety guidance and regulations with a view to modernising legislation and guidance where it does not fully reflect the modern workplace.”

Earlier this year the Labour MP Emma Hardy – now Parliamentary Under-Secretary of State for Water and Flooding – secured a debate on inclusive PPE and pointed to “overwhelming evidence” that the Personal Protective Equipment at Work Regulations 1992 are not currently effective for large numbers of workers. While they have been reviewed seven times since coming into force, they do not make specific mention of women. And while guidance to the Regulations contains reference to the Equality Act 2010, this is not statutory. Well-fitting PPE should not be seen as best practice, it should be the minimum standard, she told MPs.

Andrea Oates is a freelance writer who writes on current affairs from a trade union perspective and specialises in health and safety at work and work-based learning and training.