A/HRC/20/15 likely to be exposed to hazardous working conditions. 47 Women are on average paid less than men for the same work, 48 and are more likely to experience violence and harassment in the workplace.49 Further, many occupational exposures are hazardous to reproductive organs, having serious implications for the sexual and reproductive health of female workers.50 For example, women of childbearing age, as well as pregnant women working in agriculture, are exposed to highly hazardous pesticides that risk not only their health but also the health of their children.51 Children born with congenital disorders due to in utero exposure to toxic chemicals endure disabilities for life.52 These problems are compounded by the fact that work-related diseases affecting women are often underdiagnosed and undercompensated as compared to men.53 IV. Obligation to enforce laws and policies towards realizing the right to occupational health A. Accountability 49. Accountability is a central feature of the right to health. It requires States to demonstrate and justify the manner in which it is meeting its obligations under the right to health, and to provide adequate remedies to redress any failures to meet these obligations. Accountability is critical to achieving full realization of the right to health; as indicated by the previous Special Rapporteur, „without accountability, human rights can become no more than window dressing‟. 54 The role of the State in ensuring accountability under the right to occupational health for workers in the informal economy is particularly critical, as these workers do not have access to accountability mechanisms under existing occupational health regimes. 50. Accountability may have both prospective and retrospective components. Prospective accountability means that at all times the State must be able to demonstrate and justify how it is discharging its obligations. States are accountable to explain to all affected parties what steps they are taking to achieve the full realization of the right to health, and 47 48 49 50 51 52 53 54 16 Mary Cornish, “Realizing the right of women to safe work – Building gender equality into occupational safety and health governance,” ILO concept note, XVIII World Congress on Occupational Safety and Health, Seoul, 29 June-2 July 2008, p. 11. Ricardo Hausmann, Laura D. Tyson and Saadia Zahidi, The Global Gender Gap Report 2008, (Geneva, World Economic Forum, 2008). Helge Hoel, Kate Sparks and Cary L Cooper, The cost of violence/stress at work and the benefits of a violence/stress-free working environment. Report commissioned by the ILO (Manchester, University of Manchester, 2001). M.L. Herdt-Losavio and others, “Maternal occupation and the risk of birth defects: an overview from the National Birth Defects Prevention Study,” Occupational and Environmental Medicine, vol. 67 (2010), pp. 58–66. C. Martínez-Valenzuela and others, “Genotoxic biomonitoring of agricultural workers exposed to pesticides in the north of Sinaloa State, Mexico,” Environment International, vol. 35, No. 8 (November 2009), pp. 1155-1159. C. Wattiez, “Links between in utero exposure to pesticides and effects on the human progeny. Does European Pesticide Policy protect health?” Congenital diseases and the environment, P. Nicolopoulou and others, eds., Environmental Science and Technology Library, vol. 23, section 2 (The Netherlands, Springer, 2007), pp. 183-206. Karen Messing, One-eyed science: occupational health and women workers, (Philadelphia, Temple University Press, 1998). Helen Potts, Participation and the right to the highest attainable standard of health (Essex, United Kingdom, University of Essex, Human Rights Centre, 2008), p. 2.