International Housekeeping Survey Results

1. Total sample: 1509 housekeepers Argentina: 781 / Brazil: 485 / Spain: 123 / Asia: 120 International Housekeeping Survey Results

2. 123 120 485 781

3. ARGENTINA 48.2% take pain medication 70.6% consider their work repetitive 50.1% have muscular pain in two or three body areas (more than when they began working) 70% sleep less than 8 hours a day. 44.4% can’t concentrate. 60% lack energy 53% suffer from clinical anxiety 3 out of 10 are depressed and 2 is at risk for suicide

4. ARGENTINA • From a total of 10 housekeepers: • 8 consider their work monotonous and repetitive • 6 suffer from fatigue, lack of energy and sleeping disorders • 7 suffer from anxiety disorders, which must be treated with psychotropic drugs and therapy • 5 suffer from lack of concentration and have issues with food • 4 take drugs to relieve muscular pain • 5 have 5-7 body areas with constant pain • 4 take sick leave, 3 of them for MSD • 3 suffer depressive disorder symptoms that must be treated • 2 has suicidal thoughts and is at risk for suicide

5. In Argentina, an injury is considered an occupational disease after three years working in the same place. Therefore, in order to analyze medical leaves and their causes, the sample was divided into two groups: workers employed 3 years or less and workers employed more than 3 years. The results confirm that after a 3 year-period working in the housekeeping sector, there is a 19.6% increase in medical leave rates due to MSD.

6. SPAIN 71.5% take pain medication 69.1% consider their work repetitive 73.2% sleep less than 8 hours a day. 74% can’t concentrate. 83% lack energy 70% have muscular pain in 4-7 body areas 96% suffer from clinical anxiety 4 out of ten are depressed and 2 are at risk for suicide

7. SPAIN From a total of 10 housekeepers: • 9 suffer from clinical anxiety that must be dealt with psychiatric drugs and therapy • 8 have pain in two body areas: dorsal zone, shoulders and arms • 6 have concentration and attention disorders • 6 have pessimistic thoughts about themselves and the world • 4 feel sad and guilty: symptoms of depression • 2 have suicidal thoughts • The summation of these results—physical pain, elevated anxiety, lack of concentration and greater levels of distraction—generates a greater risk of MSD: 74 out of 123 housekeepers took medical leave, 50 of which were diagnosed with MSD.

8. BRAZIL 80.1% consider their work repetitive 47.3% take pain medication 19.7% say they have a poor relationship with their immediate supervisor 64.4% have sleeping disorders. 47.3% are irritable. 58% can’t concentrate 66.6% suffer from clinical anxiety 40.8% cite depression symptoms 4 out of 10 are depressed and 2 are at risk for suicide

9. BRAZIL From a total of 10 housekeepers: • 8 consider their work repetitive • 7 have symptoms of anxiety, which must be treated at a clinic • 6 say their fatigue increased over the course of their work day, • reporting declining concentration and eating problems • 6 sleep 5-8 hours a day, they do not enjoy things as much, they feel • more irritable • 4 feel depressed and take pain medication to cope with muscular pain • 2 confess to having suicidal thoughts with risk for suicide • 2 claim to have a poor relationship with their boss Note: Partial questionnaire as data was not submitted

10. Unlike Argentina or Spain, Brazil’s social environment highly contributes to this “vicious circle.” 19.7% of housekeepers surveyed indicated that they have a bad relationship with their immediate superior or supervisor, which heightens the negative view they have of themselves. Lack of understanding and work overload throughout the day create more pressure, leaving them more vulnerable to suffering anxiety.

11. ASIA PACIFIC 74.8% take pain medication 79% suffer from fatigue 82.7% consider their work repetitive 44.7% suffer from anxiety 27.5% said they have a poor relationship with their immediate supervisor 6 out of 10 suffer from muscular pain in two body areas due to MSD 75% (have taken) medical leave 79.3% say their job makes them sick

12. ASIA PACIFIC (Indonesia, The Philippines and Cambodia) From a total of 10 housekeepers: • 9 suffer from loss of strength and typical MSD symptoms • 8 suffer from neck, shoulder, hip, leg, knee, foot and dorsolumbar pain • 8 claim that her work is repetitive • 7 take pain medication and feel fatigued throughout the work day • 7 report taking medical leave (this figure correlates with their views: they feel exposed and suffer physical ailments due to workload) • 6 claim to not have enough breaks between tasks • 4 have symptoms of anxiety throughout the day; they also suffer from emotional exhaustion • 2 claim they do not have a good relationship with their immediate superior and also mention lack of camaraderie Note: Unofficial HRCT-UTHGRA surveys

13. GLOBAL RESULTS • There is a vicious circle in the housekeeping sector. • Repetitive movements, forced postures and the high pace of work jeopardize worker's physical and mental integrity. • 74.4% consider that their work is monotonous and repetitive. • Housekeeping routine is risky in all the countries analyzed. • Within the first 3 years, housekeepers begin to suffer from physical discomforts (bloating, fatigue, loss of strength, limitation of mobility, tingling, loss of sensation). 49.2% of housekeepers worldwide are prone to work-related injuries. • To alleviate body pain and not miss work, 52% of housekeepers use over-the-counter drugs, this situation masks injuries and future occupational disease. • At the beginning, housekeepers do not consider the pain to be important so they continue to work at the same pace.

14. GLOBAL RESULTS (cont.) • Over time, the involved muscular areas are affected and injured in a chronic manner, and can derive in MSD or RSI. • By masking symptoms and not implementing ergonomic movements, as well as lack of organization at the workplace, injuries are aggravated, leading to MSD. • Due to stressful factors at work, housekeepers do not get a good night's sleep. 61.2% sleeps less than 7 hours per day. At the same time, 59.3% of the global housekeeping population feels fatigue caused by working conditions. • As a result, they feel more irritable and tense, making it difficult to concentrate and pay attention at work. 47.6% of housekeepers have trouble paying attention and concentrating. • Working under constant pressure, making repetitive movements and forced postures can lead to clinical symptoms of anxiety. 63.2% of housekeepers already have these symptoms. • Along with risk factors, if anxiety is not treated in time, it can cause depression. 30% of the housekeepers surveyed reported symptoms of depression.

15. 52% take pain medication 74.4% consider their work repetitive Vicious circle worldwide 63.2% Suffer from Clinical anxiety 79.6% say their jobs are making them sick 64% have more than four body areas with muscular pain (MSD)

16. Medical Leaves due to MSDs Word Data • Most significant MSDs: • Cervical radiculopathy: 53.09% • High and low back pain: 64.08% Body pain rates: • Arms, wrists and hands: 53.4% • Hips and thighs: 35% • Legs: 55.9% • 24.2% of medical leaves requested by housekeepers were due to MSD.

17. The survey was conducted from an integrated perspective: "mind-body" connection as a whole. In this way, we can understand more clearly the "vicious circle” that housekeepers find themselves in on a daily basis. Although risk factors are known and preventive measures are clear on paper, it is necessary to put an end to the vicious circle affecting the sector, bring about change, and take actionable measures to improve housekeepers’ health. For this reason, it is imperative to redesign the workplace through the implementation of good working practices and training; and above all, to establish a work organization: planning tasks and avoiding housekeepers’ exposure to physical hazards. Conclusions