#Expert – Blog series: How to create a gender-just healthy planet
by Arn Sauer, Jürgen Arning, André Conrad, Małgorzata Dębiak, Marike Kolossa-Gehring, Nadja Steinkühler – Umweltbundesamt – German Environment Agency
Engagement with the role of sex and gender in chemicals management is not a new phenomenon either internationally or in the German context, but it is persistently complicated. The relevance of sex (physical/biological) and gender (social/behavioural) aspects to chemical risk assessment and management is usually discussed in three ways: 1) in relation to sex/gender and exposure; 2) in relation to sex/gender and issues of impact assessment and 3) in relation to the issue of gender balance and equal participation of women and men in chemicals management decision-making. The embodiment approach, based on epigenetics, developmental biology and neuroscience, has added to this discussion yet another dimension, in which the debate of “nature vs. nurture” has been reconciled. Social, cultural and physical environments influence gene activation and physical processes; hence, biology is not destiny in the sense that an individual’s biological characteristics are not pre-determined, but are rather the co-products of genes and the individual’s own experiences as well as those of past generations. Despite these long-term and recently emerging, ongoing discussions, sex/gender or embodiment approaches have not yet arrived in the oft-cited mainstream chemicals policy.
Although these topics have not yet been tackled in a structured manner within the German Environment Agency (Umweltbundesamt – UBA), the agency has had some initial experience in this area in the form of a pilot study on cleansing agents. Results of the pilot study showed that impacts on women were significantly higher as compared to men, due to the higher exposure of women to cleansing agents. This higher level of exposure can be attributed to a gender-role typical division of household labour, in which women perform more household cleaning, have a more predominant role in choosing cleansing products, and are thus exposed to more advertising for these products. That the interrelationship of sex and physical susceptibility to chemicals beyond pregnancy in humans remains an under-explored topic cannot be attributed solely to a lack of awareness, but rather chiefly to inconclusive data, data gaps and governance issues within chemicals management. It appears difficult to gain insight into the importance and relevance of sex and gender issues in all sectors of chemicals management (research, policy design and governance), which calls for heightened attention to these topics, and when they are found to be relevant, decisive action. But why is gender in chemicals management so “toxic” and complicated? What do we know and what do we have yet to learn?
What we know and how it is relevant
A recently finished project “GeUmGe-Net” (an interdisciplinary research network on sex/gender in environmental health) demonstrated in a systematic review of publications in environmental toxicology, environmental medicine, environmental epidemiology and public health that sex/gender aspects are still widely ignored in these disciplines. There are some things, however, that we do know: The established risk assessment schemes for chemicals are based on animal experiments and/or in vitro observations. Epidemiological data or other human data are used only in exceptional cases. It is hypothesised, and some indicative evidence exists to suggest, that different population sub-groups are more susceptible to chemicals than others either because they are exposed more due to habits, due to their different environments and professions (the gender dimensions) or because they exhibit higher chemical sensitivities (sex). The chemical exposure and the chemicals’ effects on the target organism might depend on various factors, e.g. geographical location (nearby releases of chemicals from industries like petrol stations or refineries), behavioural patterns (i.e. usage of cosmetics, cleansing agents or paints), age (esp. in utero, in childhood and at a young age), nutritional status (e.g. due to the influence of nutrition on the immune system), biological effects (e.g. metabolism, endocrine systems, pregnancy) or the burden of chemicals within each individual body, as a mixture of different chemicals are always present and effective in each individual’s body at the same time.
The aforementioned early UBA pilot study on chemicals in cleansing and washing agents addressed the difference in chemical burdens on women and men and possible consequences for chemical risk assessment. Statistical data taken in 2001/2002 from the initial study showed that women spent seven times longer cleaning clothes, three times longer cleaning the living space and two-and-a-half times longer cleaning dishes, than men. The second statistical update of the German time study based on data taken in 2012/2013 indicates that, even today, differences between women and men— especially in households with children— remain significant. Despite some equality gains and the increased participation of women in the labour market, traditional roles and responsibilities have changed only marginally, particularly in family constellations. Socialisation theory is as prevalent as ever: The persisting division of labour between women and men at home, the labour market segregation with regards to different occupational choices as well as differences in spare time activities or consumer choices affect chemical exposure and safety. We know, moreover, that even performing the same tasks might make a difference and results in differences between women and men. For instance, it has been shown that the mortality rate in the cleaning industry in Belgium was higher for men than for woman if compared to non-manual workers of the respective sex.. The authors discuss as possible explanations of the higher male mortality factors such as: the higher employment rates of men in highly-exposed industrial cleaning jobs, or the greater number of women working part-time, but also their greater readiness to leave jobs when experiencing health problems because they contribute less to the family income. This study poses a range of open questions; among others, it does not address whether the disparity in mortality rates could be attributed to a lower chemical risk awareness among men (who perhaps unconsciously adhere to constructions of invulnerable masculinity?), when handling cleansing agents. What is a certain and persistent finding in this and in other studies is that exposure to different materials, precautionary measures taken during exposure, as well as duration of exposure may vary according to gender. In combination with physical factors and different metabolic reactions to toxins between women and men (sex), these findings point to the need for a gender- and sex-sensitive chemical risk management.
Differences in external and internal exposure to chemicals that are due possibly to the influence of gender can be observed in environmental health monitoring studies: UBA’s German Environmental Survey (GerES), for instance, showed a higher average indoor air concentration of limonene in bedrooms of girls. A possible explanation for this result is that girls use products like scented candles, fragrances or cleansing agents more often. In the German Environmental Specimen Bank (ESB), copper levels in blood plasma are substantially higher in women, which can be explained by the use of oral contraceptives.
In terms of perceived health impacts, the UBA’s environmental awareness study shows that women are more aware of health-related environmental risks. Thus, women tend to feel more exposed to environmental factors, such as chemicals in products and plastic particles in drinking water and food. These gender differences may be related to the fact that women generally have a higher awareness of the environment but also of their own health, whereas men (on average and along with other intersectional factors) are more negligent of their own health and do not attribute the same importance to environmental risk as do women.
What we do not know (yet) and how to tackle it
With regards to sex, toxicological research appears to focus mainly on endocrine-disrupting chemicals. Some ubiquitous chemicals such as phthalates, used as plasticisers, and the plastic ingredient Bisphenol A have an impact on the endocrine systems of test organisms, and it is assumed that they can also disturb the endocrine systems of women and men. What is known from environmental toxicology is that synthetic estrogens and other chemicals acting as endocrine disruptors demonstrate adverse effects on environmental species such as, for example, impacting life-cycles and reproductive success or by altering the sex ratio in fish. In the heyday of high doses of contraceptives, women who were taking the “the pill” were thus advised to collect their urine separately and to dispose of it as hazardous waste in order to avoid impacting the environment. Compounds such as ethinyl estradiol (EE2) present in these medications are not, in fact, easily filtered out or degraded in our water treatment plants. Current contraceptives contain much smaller estrogen doses; however, the basic problem of insufficiently treated waste water and the addition of EE2 to the total environmental burden of estrogenic active chemicals remains. At the same time it stays unclear to what extent the estrogenic burden in surface water might result in relevant drinking water contamination with endocrine disruptors, with potential impacts on the human reproductive system, i.e. on male semen quality.
Discussions within chemicals management around how to effectively tackle emerging issues such as endocrine disruptors have not yet come to a convincing conclusion. The Organisation for Economic Co-operation and Development (OECD) is developing adequate testing and assessment methods for these chemicals of emerging concern as well as approaches for how to evaluate them. Such chemicals of emerging concern are amongst others hormones, pharmaceuticals and hormone mimetic synthetic chemicals and their activity as endocrine disruptors. Regarding endocrinologically active chemicals, regulations like the ones for biocidal and plant protection products have classified certain chemicals as endocrine disruptors based on well-established scientific criteria accepted across the EU. Still, our knowledge of endocrine disruptors is limited and confined to certain endocrine pathways (such as sex steroids and substances that affect the thyroid) and to only very few vertebrate species besides humans (mainly fish, amphibians and rodents). Thus, the regulation of endocrine disruptors in the environment still suffers from gaps in scientific knowledge and uncertainties, as well as from a lack of widely-accepted criteria for the identification of such chemicals across all relevant legislative frameworks. To tackle these issues, more research and the development of new or the amendment of existing endocrine-sensitive test methods are needed. Additionally, on the policy level, a consensus on the classification of endocrine disruptors based on well-substantiated science must be reached, irrespective of the regulatory consequences this classification may have for single substances under different legal frameworks.
Gender Balance and Participation in Decision-making within Chemicals Management
Last but not least, and similar to all science- and technology-dominated fields, chemicals management has much room for improvement in terms of the number of women in decision-making bodies. The target of gender balance seems hard to meet, but some promising initiatives have recently sprung up. The Quick Start Programme, for example, which funds small projects in developing countries, requires an ex-post evaluation of the gender balance in decision-making bodies. UBA research funding does not yet engage in similar activities; however, the UBA has a successful gender equality strategy for its own staff and is currently catching up fast in its last remaining field of gender imbalance on the managerial level. The UBA currently has its first female president, Maria Krautzberger, and in terms of top-level managers, the UBA has achieved gender balance. Steady improvement in gender representation within middle and lower management, with 40% female and 60% male managers overall in 2018, show that the UBA is closing in on its ultimate goal of equality, which it wants to reach during the next gender equality plan 2020-2023 (earlier than 2025, as demanded by the current coalition government).
Sex and gender issues in chemicals management may have been “toxic” in the past, in the sense that they did not receive (enough) attention from various scientific communities and responsible agencies, but they cannot remain so in the future. The need for change is why it is so crucial that SAICM draws attention to sex and gender issues as it does in its paper “Gender and the sound management of chemicals and waste.” This paper will also be discussed in the UBA with regard to how susceptibility and exposure are influenced by sex/gender, how these interactions affect domestic life as well as occupational health and what we can learn from these insights for future research and policy advice. The 2030 Agenda with its Sustainable Development Goals (SDG) provides a window of opportunity to mainstream awareness of the gendered effects also into chemicals use and chemicals management. The cross-cutting SGD 5 “Gender Equality” in particular, in combination with many other relevant SDGs, will raise awareness of the need for integrated approaches and the adequate involvement of all sectors, stakeholders, and societal groups, and will also be relevant to the sound management of chemicals beyond 2020.
As a country of the Global North, Germany’s main areas of concern with regards to chemical safety and sex/gender could be related to chemicals in products (e.g. cosmetics and beauty products) and endocrine-disrupting chemicals together with environmentally-persistent pollutants, as these are either not being filtered (completely) by water treatment plants or persist and accumulate in fatty tissue. Yet another potential area of inquiry is determining the toxicological endpoints of chemicals (with regards to germ cell mutagenicity, reproductive toxicity, organ toxicity and carcinogenicity) and their possible sex/gender interactions and differences, as attested by the Scientific Group on Methodologies for the Safety Evaluation of Chemicals (SGOMSEC). Some of the open questions in toxicology and exposure science might hopefully be answered in UBA research projects. The UBA is already taking part in the collaborative research project INGER (Integrating Gender into Environmental Health Research), aiming the conceptualisation of gender theories in human biomonitoring studies. The UBA’s department for toxicology and environmental health has also designed a governmental founded project for the statistical analysis of toxicological studies according to sex related differences in toxicity in rodents that should start in 2019.
In terms of research governance, and independent from chemicals management like in the current SAICM processes, the UBA has introduced a gender mainstreaming strategy, according to which all newly designed research projects are subject to a gender relevance test. If gender is found to be relevant to the project, a full gender impact assessment should be performed in order to integrate sex and gender issues into research questions, methods and results. Accordingly, in 2018, the UBA has introduced a gender relevance tick box: once ticked, the UBA gender quality officer will then be involved through the course of the project. She and her research officer for gender mainstreaming are thus able to give feedback and support, if needed, in developing the research concept. In the environmental research funding programme of the UBA, for example, a total of 16% of all submitted proposals in 2018 were earmarked as gender relevant. This general research quality assurance mechanism will hopefully also contribute to more gender- and sex-sensitive chemical and toxicology research in the future.
What could be improved with regard to participation in chemicals management is the involvement of women’s organisations and female experts in conducting such research and providing policy advice. Here, a gender balance in all key commissions and scientific boards is already required by law, and now needs to be carried out in practice. In terms of equal opportunities and the participation of women in chemicals management, the UBA has made great advances in the past and will continue to do so, due to its gender equality plan and established quotas therein.
Arn Sauer, Jürgen Arning, André Conrad, Małgorzata Dębiak, Marike Kolossa-Gehring, Nadja Steinkühler from the German Environment Agency (Umweltbundesamt).
 Acknowledgements: This article benefited immensely from discussions with Dr. Petra Greiner, Caren Rauert and Dr. Hans-Christian Stolzenberg. We also thank Kai Egener for editing the article.
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 Funded by the German Federal Ministry of Education and Research.
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 The collaborative research project INGER is funded by the Federal Ministry of Education and Research (01GL1713) and consists of the project partners University of Bremen, Institute of Public Health and Nursing Research, German Environment Agency, department of toxicology and health-related environmental monitoring, Helmholtz Centre Munich, Institute of Epidemiology, and Humboldt-University of Berlin – Gender and Science, see https://www.uni-bremen.de/en/inger/.
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