Working capacity and health : what women workers of the garment industry think

| This study investigated how women operating the garment industry in Divinópolis, Minas Gerais, understand and relate to the perception of work ability and health. We applied qualitative methodology to analyze their statements on the basis of social representations theory. The results suggested that work ability depends on factors such as training, social support, profession at home, job satisfaction, health and aging. Furthermore, it is Capacidade para o trabalho e saúde: o que pensam as trabalhadoras da indústria de vestuário Working capacity and health: what women workers of the garment industry think Capacidad para el trabajo y salud: que piensan las trabajadoras de la industria de vestimenta Viviane Gontijo Augusto, Rosana Ferreira Sampaio, Lorena Magda Ferreira, Renata Noce Kirkwood Estudo desenvolvido na Fundação Educacional de Divinópolis da Universidade Estadual de Minas Gerais (UEMG) – Divinópolis (MG), Brasil. Universidade Federal de Minas Gerais (UFMG) – Belo Horizonte (MG), Brasil. Universitat Autònoma de Barcelona (UAB) – Barcelona, Espanha. Fundação Educacional de Divinópolis da UEMG – Divinópolis (MG), Brasil. Queen’s University – Kingston, Canadá. Programa de Pós-Graduação em Ciências da Reabilitação da UFMG – Belo Horizonte (MG), Brasil. affected by many influences external to the worker, who in turn, must constantly adapt to changes. The results highlighted the need for reflection on the role of working conditions and employment, organizational rigidity and loss of control over work, in health and work ability of operators in the garment industry.


INTRODUCTION
The number of women in the labor market is continuously growing, reaching 40% of the working class of several countries.The work of women is frequently restricted to manual, repetitive and monotonous activities, which demonstrates that this part of the population is unequally incorporated to the market as a result of the social and sexual division of labor 1 .
In Brazil, women almost completely occupy the garment industry, which stands out in the country's economy since it is present in basically all of the states, thus generating work and income 2 .Part of the women who work in the garment industry, known as seamstresses, are sub-hired, work from their own houses and get paid on production.Such precarious work configuration was a strategy adopted by many companies in order to reduce expenses and avoid tributary and labor taxes 3 .
Following a national tendency, the number of mid and large-sized companies has reduced.In 2008, in the Central-West region of Minas Gerais, there were more than 3 thousand micro and small enterprises, and 600 of them were located in Divinópolis, which began to be recognized as a clothing area.The great number of garment industries in the city favored the insertion of women in the market, however, in a precarious way, marked by low salaries and by the intense work rhythm, thus leading these workers to become sick easily 4 .
Recent studies try to explain the factors related to work and the economic context that could cause illnesses and reduced work ability (WA).In occupational health, WC is a result of the balance between personal and environmental resources, and it cannot be separated from the life outside of work, since it may change in relation to factors such as household and family care, especially among women [5][6][7] .
The objective of this study was to investigate the WT social construction and its relationship with health, from the perspective of women working in the garment industry in the city of Divinópolis, Minas Gerais.
This study is based on the social representations theory, which consists of knowledge modalities whose role is to produce behaviors and communication between individuals.Knowledge is elaborated from a symbolic and practical content and, in order to be considered as social representation, it should be part of the daily life of people by means of common sense 8 .

METHODOLOGY
Open interviews were conducted from October 2010 to May 2011, based on the theme "For you, what is work ability and how is it related to health?", which worked as a guide for interlocution.
The selection of participants was conducted from key informants and the number of interviews was defined by the information saturation criterion.Saturation was considered as the moment to interrupt data collection after new information became rare 9 .
The women workers were contacted by telephone or personally after the indication of colleagues.Interviews took place in their houses after they were enlightened as to the objectives and methods used in the research.All of the interviews were recorded, transcribed and sent for posterior confirmation.The study was approved by the Research Ethics Committee of Fundação Educacional de Divinópolis, Universidade Estadual de Minas Gerais (FUNEDI/UEMG), report n.30/2010, and participants signed the informed consent form.
The analysis began with an immersion into the set of collected information, in order to let the senses work, without separating data into categories or themes, at first.Afterwards, maps of idea association were created with the definition of general categories that reflected the social representations of workers concerning WC and its relation with health.

Characterization of participants
Seventeen women workers participated in this study, aged between 19 and 54 years old; nine of them were married with at least one child.Five women had finished elementary school and the others had complete or incomplete high school.Ten participants worked in 3 companies and 7 of them worked from their households, and experience in the garment field ranged from 1 to 30 years.
After the initial analysis of statements, the identified categories were divided into five themes, which were discussed based on literature and the reports of the participants, who were given fake names in order to preserve their identities.

Capacitation/qualification
Among the women in this study, the meaning of WC is connected to the qualification of the workers to perform their tasks, as well as the quality of the provided service.
Oh! I think capacity is something like this: we are trying to know more, to get more information, to have more capacity; we need to take more courses.( Janice, 26 years old).At first, it is possible to see the understanding of the construction "work ability" based on professional skills and abilities, apart from biological aspects.Even if the negative impact of age has been mentioned, it is recognized that it can be eased by professional experience.
With time, we lose capacity.I can no longer keep up with youth, like: a 25 year-old girl, with the energy she has.But in terms of perfection, I am not scared, I think I can keep up with anyone.That is my opinion: if Jane Doe can do it, so can I. (Bernadete, 47 years old).The work ability does not depend only on individual characteristics, such as age or health, but also on the type of performed activity.Studies related to WC have shown that, even though age is an important aspect for its reduction, it can be affected by other factors, such as performed activity and professional experience 8,9 .
Ana, who participated in the study, talks about how the opportunity to be more qualified is a strong predictor to sustain WC, and that experience is important to learn, evolve and improve work ability.
Work ability is evolution, right?That is why I am always evolving, with the experience that I have… and I have been in this field for many years.(Ana, 37 years old).So, the evaluation of WC involves objective and subjective capacities, and the latter consists of the conception of the workers about their performance concerning working skills, that is, whether or not the worker believes in his or her work influences the use of their objective capacity potential, such as physical resistance strength 10 .
It is a known fact that in the industrialization process, the workers lost control over their activities, the needs of their body, time and conditions to execute the tasks, so, only their qualification and experience for the performance of the activity can be a differential 11 .With such statement in mind, it is possible to consider an inconsistency in relation to the focus of interventions to maintain WC, since they are always addressed to improving individual functional capacity, thus taking factors related to work and interpersonal relations for granted.

Social support
Seamstresses pointed out that the relationship at work can reflect positively or negatively on WC, depending on how such interpersonal relationships are established.
I quit because I couldn't take it, I couldn't stand some employees there, some seamstresses.I thought the way the boss treated people in there was very wrong.Do you know how she talked?'if you are not happy here, go away!Get lost!Screw you!' This is absurd!(Bernadete, 47 years old).It is our psychologist, because when we are on vacation for 30 days, at home, we are dying to go back to work, to talk to our colleagues, to know how things are going, because one of them tells a family story, her problems, so we accept more, we gain experience, and this can help us a lot in life.(Regina, 46 years old).Support seems to work as a protective agent facing the risk of stress induced diseases 12 .On the other hand, the perception of lack of support in the work place has been mentioned as a strong predictor of medical leaves.It is worth to mention that the way the worker looks at organizational support is influenced by frequency, intensity and sincerity of compliments, besides job enrichment and the possibility to interfere in organizational policies 13 .
The relations established in the workplace shape the perceptions of the employees about the treatment they receive, thus being essential to sustain or not the idea that the support at work may contribute to promote well-being.Therefore, social support appears as a mediator in health protection, and this has been reassured by the interviewed workers.However, it is worth to mention that the level of association between health and social support cannot be analyzed alone, since it depends on various circumstances of the studied population and the measures used to assess this indicator 13 .

Satisfaction with work
Perceptions and experiences of the employee may influence health, performance and satisfaction with work, which, in turn, is a complex phenomenon.It is hard to define, variable from person to person, according to the circumstances and with time, and it is also subject to the influence of factors that are internal and external to work 13 .
In this study, satisfaction with work is associated with the differences between their performance at home and in the companies.Therefore, seamstresses tend not to feel satisfied due to the seasonality of the work offers: Oh! I don't care too much about my job.
Because now it is slow, I practically have no work to do, there is too much competition, and that is why I'm thinking of changing professions.(Ana, 37 years old).On the other hand, among the workers inside companies, the cause for the lack of satisfaction seems to be the rigidity of the organization, especially the control over time and posture.
Things that bother me the most are sitting around all day, there is no way to go out.(Marina, 20 years old).The satisfaction of a person towards his or her job depends on the meaning she sees in the performed function, and on the feeling of responsibility in relation to his or her performance.The latter, in turn, is related to the way the organization offers feedback mechanisms.In the analyzed situation, they seem to be limited to salary compensation.Even if essential for survival, the financial issue only contributes with satisfaction when accompanied by professional recognition 14 .
I like to make pretty things like that (working with fashion).I like new things.Every day you find something new, a new way to make it.I have worked in a factory and it was very tiresome, I worked only with jeans, sewing and inserting pockets, very tiresome… There is a different service.You never work on the same model.You should always make new models, so that is difficult, but the boss makes it up to us with the salary, so nobody complains about it.We like what we do and are happy.(Regina, 46 years old).The workers also considered the development of skills and the pleasure associated with work as predictive factors of good WC.In this case, skills can be understood as the ability to perform a task or a set of tasks according to the standards of the organization, characterized by the acquired, learned and transmitted knowledge.

Working at home
The seven interviewed women who work as seamstresses have been formally related to a company.The main reasons why they decided to leave formal labor were the will to work by themselves and to be able to care for their families.
Something came up, my kid got sick, so I had to be with him in the hospital.After, I stayed with him at home, so I left the company, you see? (Bernadete, 47 years old).Once the job is done at home, the household begins to have two meanings: workplace and family rest, and the latter is not respected by the clients, who impose strict deadlines and so the time dedicated to work invades meal hours, leisure and rest 15 .Even so, some workers find advantages in working like that, such as the lack of fixed hours.
Since I am a seamstress, I can stop whenever I have to stop.I have this flexibility to go out, come back at night… so, not having fixed hours is the best part for me.(Luana, 28 years old).If on one hand the work rhythm can be slow in comparison to a company, once the worker controls it, on the other, she tends to prolong her hours in order to meet the deadlines imposed by the companies who hire her, which leads to physical and emotional overload.
The type of work mentioned here is defined as the production of goods and services by an individual in his or her house, or in a place they choose to be, in exchange for salary, with the specification of an employer or intermediate 15 .This definition emphasizes the subordination of the workers in the contractor-hiring relationship.The fact is that even if the work at home can offer the opportunity to conciliate family and work, women recognize it can be more exhausting.
Being a seamstress is exhausting.I was working with my sister and lost weight.You go in that crazy rhythm and forget to eat, drink water.You make more money, but work too much.In the factory, there are hours; at home, we three times more.(Maria, 24 years old).Being a seamstress demands too much, demands perfection!But the salary is outdated, because the line and the energy go up, but the value doesn't.What I make today is the same as what I made six years ago.After six years, the energy and the line went up, how much?So it depends on where you work… sometimes people say: 'how can you work at night?You can't work at night'.If you don't work at night, you can't work to pay for the line you use.Because at night it is all quiet, so I work up until 11 pm!That is the way it compensates!(Bernadete, 47 years old).The work of seamstresses implies sewing pieces that have already been cut in the industry in their own sewing machines, and there are some characteristics to this activity: low income, payment per produced piece, absence of social security and insecurity at work.These attributes, together with the commitment with part of the production cost, demand that the workers embrace long hours, increasing exposition to the risk of diseases and, in some cases, resulting in retirement for incapacity 4,15 .

Health and aging
Interviewees somehow related WC to health and to aging.
In order to keep the capacity you have to stay young forever, you can't get old, or sick, you should always be ok.I can't say that I'm capable because I'm not ok every day.(Maria, 24 years old).The relationship between health and WC has been discussed, since low WC and medical absence do not depend exclusively the occurrence of diseases, but also on the perception of the individuals over their health and factors such as work demands and the possibility to face them.
In the case of workers indicated in this study, the fact of having a formal job in the industry or working as a seamstress seems to interfere in the relation between health and WC.
Tomorrow if I get sick and say... 'oh!I can't work for you this month, and I need some medicine'.They don't care, there is another seamstress right there, I'll take her.. every day, a company closes; every day there are four, five or even ten seamstresses out in the streets trying to work by themselves.So, those who can't work replace those who can work because factory owners are looking for the cheap price.I do not advise an 18 year-old girl to work as a seamstress.Because now there are too many of them… at the end, as a friend of mine says: you'll die blind, hunchbacked and poor! (Bernadete, 47 years old).
The devaluation and the insecurity of informal labor stand out and compound the reality of health inequalities in the country, generating differential access of the population to services and care in this field.It is consensual that unemployment and informality are connected to worse health conditions 15 .
Aging has a reflex on the aging composition of the economically active population.Health and mobility and autonomy indicators are factors predictive of permanence in the active life at older ages.However, it is possible to observe that the relation between WC and health is measured by other factors, which are external to the worker, such as type of performed activity or the work relationships established between the employee and the employer 16,17 .
In the garment sector, the difficulties faced by the workers are related to the type of performed work, not to mention gender, age and schooling inequality.From the historic point of view, it is possible to say that work for women was organized late, since there was scarce organization of women in unions, besides the tradition of resignation and submission, which favored the permanence of informal labor for a long time 18 .

CONCLUSION
For the workers participating in this study, WC depends on factors such as capacitation, social support, satisfaction with work, development of skills, working at home, health and aging, which have also been shown in quantitative studies as predictive of WC.
The knowledge created in the daily routine of these workers shows that WC suffers influences that are external to the individual, and that the latter must adapt to constant changes.Women seem to look for more control over their work and try to conciliate the work at home with household chores, but matters of safety and health are still a major concern.
Daily experiences lead to the understanding that WC, as well as health, can be changed for better or for worse, according to factors that surpasses the individual and are related to work, to life outside of work, and even macro social issues, since economic changes, for instance, can influence work demands and the ability of the worker to meet them.
The results in this study showed the need to understand the impact of work and labor conditions, organizational rigidity and loss of control over the labor activity, health and the capacity to work of employees of the garment industry.In the case of these industries, in which the workforce is mostly female, it is important to consider gender inequality not only in forms of access to work, but mainly in working conditions, in which women are more exposed to precarious situations.
Efforts to prevent work-related fatalities, lesions and diseases are important considering the high financial and social cost of these events for companies, society and individuals.