Most people would be amazed to realise that the health hazards of teaching include not only stress, burnout and physical and mental fatigue but many other hidden factors. Indeed, a research project into the health problems experienced by North Queensland women primary teachers, who make up 70% of this work-force, brought to light an unexpectedly wide range of 'problems' including industrial accidents: everything from injuries sustained using improvised tools or faulty or damaged furniture and equipment; to those caused by lifting and carrying resources, books, furniture, and even disabled students; or accidents resulting from falling mobile blackboards, and displays, tripping on swivel chairs, falling down stairs or colliding with school desks, tables and chairs, particularly while carrying school resources or furniture.

Putting up classroom displays, it seems, can become a major atheletic feat, and as such a potentially health endangering exercise. 'You have to put netting and calico up and lots of things for displays but, because each room isn't given a ladder, you've got to improvise by standing on desks or chairs or whatever the case may be. I've hurt my back stepping down off tables, and the castors underneath the OHP have sort of started to roll as I've been stepping on that to try and reach things. I've hurt my back a lot...'

When classroom equipment and furniture is damaged or broken, teachers have to carry out running repairs, sometimes with disastrous results on all fronts. 'I've hammered my thumb many times,' explained one teacher. 'We have chairs that fall apart... good chairs for teachers! Your dress gets caught, you stand up and you rip your dress. I've even got my fingers caught between desks at times.'

The playground is another potentially hazardous place where teachers can be faced with both physical as well as verbal abuse. Some complained about being punched and kicked. All have to be on the lookout for missiles: balls, bats, soft-drink cans, and fists that have the potential for physical as well as psychological damage. Playground duty, for one teacher interviewed, became the most stressful part of the working week. 'I find that I get scared out there, although I'm told that I'm not to get scared. There are hazards from kids hurling things, from trying to break up fist-fights in the playground or on the oval... And with the heat all the tempers rise and the fights are many. Trying to pull them apart, you can cop a fist or a foot as well as a mouthful of cheek. You're lucky if you just get a mouthful of cheek! I had a coke can thrown at me last week.' How does this teacher cope? 'Put it down to prayer. I pray on the days I'm on duty.'

Although sensationalised by the media, it is evident from teacher responses that there has been a steady increase in school violence. And this is not just between students or groups. For the hidden victims are teachers; even at primary school level.

Back in the relative institutional quiet of the classroom, few people realise that this room in a primary school building is, in fact, a 'bacterial soup' rather than the clean office environment they might picture. When teachers are stressed and tired they become even more susceptible to any passing infection or sickness. As one teacher explained, 'I get so low, I usually just get whatever is happening.' A side effect of such infections is that teachers frequently lose their voice, their tool of trade after all, from laryngitis, throat infections or from allergic reaction to chalk or other elements in their environment. Under stress, teachers catch many of the 'things' kids bring into the classroom: not only colds, flu, and racking coughs, but also head lice, impetigo or 'school sores', scabies, parasitic infections, viral infections, hepatitis, tonsillitis, measles, mumps, chicken-pox, shingles, and other, usually under-rated, 'childhood' diseases.

One teacher talked about the unpleasantness of getting head lice and school sores from her students. 'I had a dreadful school sore on my heel that came up in a big welt. Especially with infants lying on the carpet, if you sit down with them, you're susceptible to that sort of infection.' Another pointed out that marking kids' books when they have any sort of infection (impetigo, ring worms, and so on) can also be a problem. 'It is worse with younger kids, they scratch and pick their sores all the time and then they write on their books and give them to you. There's also this sort of skin infection that you get from time to time through stress and tiredness that's a result of interacting with kids.' Interacting on a personal level with a large class of kids all day, it's impossible to keep away from their infections and diseases. 'Kids that sneeze in your face and pick their noses,' complained another teacher. It's physically impossible to avoid such circumstances.

'We get kids vomiting all over the floor. We either clean it up or sprinkle this powdery stuff all over it and have to put up with the stench. What sort of health problems does this cause?' one teacher asked. Another spoke of similar experiences and suggested that once the 'powdery stuff' has dried it is simply vacuumed up. 'But you know that the carpet hasn't really been cleaned.' It is still there in the carpet.

Many teachers also pointed out that, despite the public perception about teaching hours, teaching is simply not a 9 to 5 profession. There is always some extra work to take home because restructuring has increased teachers' work. They are now not only responsible for classroom teaching, playground duty and so on, but also for policy development, program development, curriculum development, and behaviour management. They are expected to attend inservice programs, innumerable meetings, and to be involved in such things as sport coaching, debating, drama, concerts, eisteddfod and so forth. Fund-raising is an additional part of most teachers' duties which impinges not only on teaching time but also family and recreation activities. As one teacher explained, 'They're piling more and more on top of us. There's Social Justice, then there's HRE, then there's LOTE. They just keep piling things on, yet they don't take anything away. You just have to find the time to do it. Then you have to write up all your own programs, and policies'.

Finding ways of dealing with these additional demands on teachers' time impacts on their health both physiologically and psychologically. Quality of teaching clearly suffers, and students' learning becomes a casualty of the intensification of teachers' work. And the harassed teacher feels bad about not giving their best. All the teachers interviewed reported feeling acutely stressed from all the demands on their time, energy and resources. Unlike teachers in some other Australian states, Queensland teachers do not have non-contact time to carry out these extra duties. All lesson preparation, report writing, parent/guardian interviews, inservice, and professional development is done in out-of-school time. Teaching involves countless unpaid hours of work. 'If I want to do anything of a personal nature I've got to go to my diary first. I can't just say 'yes I can do it'. I've got to check up in my diary first because every afternoon is taken up with something for school.'

Teachers interviewed also spoke very specifically of personal physical problems related to basic bodily functions. Many spoke of their 'incredible bladders'. All discussed problems related to going to the toilet, although interestingly, only one had ever talked about this problem with colleagues.

The way schools are structured appears to be part of the problem as are work conditions, and the nature of teaching itself. 'You can't go to the toilet when you'd like to because you are responsible for the kids in the class. Anyone who 'has to go' must do this during morning tea or lunch. At our school this is a problem because, equity wise, we have only one toilet for males and one for females. This is with 10 female teachers and 3 male teachers and that's also for the secretaries, and aides who are females and for student teachers, who are mostly female, when they are at the school on prac. So there's little chance for many women to use the toilet at morning tea time, anyway.' Teachers who 'just have to go' suffer more stress knowing they're responsible for the class 'and if anything happens when we're not in our rooms, well, in this age of litigation, teachers could be sued.'

Problems are multiplied during menstruation, as one teacher vividly described. 'I have a problem with menstruation. You always make sure you wear dark clothes when you've got your periods, either black or dark floral or you could end up being annoyingly embarrassed. There are times during my period that I make sure I don't sit down and just hope for the best until I get to the toilet.' In fact, doctors have attributed many teachers' urinary tract infections, such as thrush, dehydration, diarrhoea, and constipation, to insufficient fluid intake and limited access to toilets. Lack of toilet breaks, associated discomfort, and related health problems reduce teacher efficiency, affect pedagogical practices and students' learning. Teachers identified the need for showers, and more toilet facilities, preferably attached to each classroom, regular relief time, and morning and lunch breaks without duty so that they can 'answer nature's call'. They argued a case for employing community members to do playground supervision and for clean, private toilet facilities with 'quality' paper - in some instances, for paper of any kind - hygienic disposal facilities, and clean towels or electric hand dryers.

Queensland's sun and heat only compound teachers' health problems. Playground duty in this environment can cause sunburn and this can lead to the development of skin cancers. Classrooms are not designed for north Queensland summer conditions nor equipped with airconditioning. One teacher who teaches in a 'demountable' claimed that it had sometimes been 40 degrees in the room, and in summer it would average about 35 in the afternoons. 'We can't teach under those conditions.' Because of the extreme heat, many teachers do not teach after the lunch break but allow children to rest under available fans, go to the library, or do other cool activities. Many teachers even take their own fans to school to make classroom conditions more bearable. All argued for air-conditioning or at least buildings with adequate ventilation and cooling systems, as well as cold-water fountains in every classroom. These are not luxuries, in fact, but basic needs for the climatic conditions in this region.

Teachers' comments on what happens when they get sick are also significant. Many teachers feel guilty if they take time off and rarely take the time recommended by doctors, going back to work early or for continuing to teach when sick. Concern for their students welfare and the guilt associated with interrupting learning was one such factor in their decision. 'I feel a responsibility towards my students so I tend to work rather than take time off; the guilt associated with loading colleagues with additional duties or responsibilities: a guilt compounded if all the school's District Relief Teacher (DRT) days have been used and there is a possibility of 'doubling up', when classes become the responsibility of other teachers in addition to their own students. The effort involved in preparing a program for the relief teacher to work from was another factor. It is easier to continue working than to organise detailed instructions for a relief teacher and to have to settle the children down after a stranger has taken them. Apart from this, there is the knowledge that sick days are limited and that once used must be taken without pay.

A further aspect of taking time off is the incredible guilt imposed on teachers by principals desperately trying to budget the school finances. After the number of allocated DRT days are used, additional days have to be funded out of the school's budget. The cost of a DRT to the school is $176 per day. Teachers are constantly reminded of this cost. The school has to 'buy' DRTs not only when the allocated number of DRT days have been used but also if the sick teacher has not had the foresight to know if she/he was going to be sick by a predetermined time, for example, 2:00pm the day before taking the 'sick' day. Teachers expressed frustration with the logic behind 'foreknowing' the onset of illness and with the guilt they felt if their ill-health cost the school $176 per day. As one teacher said, 'if you go to school and all of a sudden you get a case of diarrhoea or vomiting or you're really sick and it's 10:30, then you stay at school. It's not like an office where you can put everything on your desk and say, 'I'll finish that in the morning'. I've got to know if I'm going to be sick because if I haven't rung up by quarter to eight, then the DRTs aren't available and it costs the school a $176.00. They tell you it costs a $176 for each TRS day.'

For such reasons, teachers commonly spoke of the pressure put on them to be 'very ill' before taking a sick day. That's because of the departmental regulation whereby each school is allocated something like 2.1 sick days per teacher per year (some schools have only 1.8). So, while the public service regulation entitlement is ten sick days per year, the Education Department will only pay for you to be sick for 2.1. 'For a school like ours with ten teachers, the department will pay for something like twenty-one sick days a year. After that, school funds have to buy in supply teachers at one hundred and seventy-six dollars a day to replace us. You're constantly reminded about how many sick days are still left out of those 21 as they dwindle down. You're put into the position of feeling that your colleagues are going to have to bear the brunt of you being unwell.' It's not surprising, given these pressures, that teachers choose to teach when they are ill, regardless of their health condition. Mostly teachers just keep going, making what compromises they can.

Long term effects of remaining on the job whilst ill are yet to be determined. Teachers tend to find ways to cope when they are sick and work hard to minimise infection from students and between students. For example, taking cushions, towels and loose covers home to launder is an additional job several teachers do to reduce cross-infection in the classroom. 'I'm bringing them home to wash all the time. Heaven knows if there are any bugs in the washing machine!! I take all the precautions I can but you'd be wearing rubber gloves and masks to cover everything. You can't do that, it's just one of the hazards of the job.' Supplying students with tissues, hygiene education and frequent hand washing are strategies mentioned by teachers trying to eliminate health risks. 'I'm continually washing my hands and I'm continually trying to get the children to wash theirs,' explained one teacher.

Despite the stress, health hazards, enormous demands on time, energy and personal resources, juggling school and domestic work, all the teachers interviewed, without exception, expressed a love of teaching. The passion that many feel is evident. As one said, 'I just love teaching. I feel like I'm touching them in some way. I see them grow and develop and mature. I like to see them happy with themselves because they have accomplished something.' This is typical of teachers' talking about their jobs.

However, some teachers are becoming disillusioned with teaching. As one woman, with 19 years experience and 18 years of loving her career, admitted that although she 'always loved teaching' for her it just wasn't enjoyable at the moment. 'I feel kids have changed,' she said, 'and the Departmental structure has changed.' A common reason for feeling disillusioned was, many felt, related to the intensification of their work. From my research, I get the impression that there is a whole hidden women's culture, a culture of silence, among women primary teachers which revolves around health, the manipulation of sick days and teaching while sick or under medication.

Teaching is one of the most stressful occupations. The testimony of women teachers suggests that stress and burnout have far more complex dimensions than research has documented. The gendered labour of primary school teaching, the predominance of women and the nurturing/caring nature of primary school today, makes the politics of health for women teachers a primary issue.

Importantly, it is also a pedagogical concern of national importance. Women who teach while sick, or sick children who are sent to school, make for unhealthy classrooms and poor teaching/learning encounters. Students need healthy teachers who are also content in their work and work place.
 

Dianne Loughhead Cooper, James Cook University of North Queensland.