Towards occupational health and safety in sex work.

Krüsi, Andrea; Pearson, Jennie; Stardust, Zahra; Baral, Stefan; Kim, Jules; Cairns, Tyne Baynton; Kielhold, Kirstin; Queta, Magda Lopes et al. · Lancet Public Health · 2026

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Abstract

Sex workers remain overwhelmingly excluded from occupational health and safety (OHS) protections due to continued criminalisation and stigmatisation of sex work. In this Series paper, we examine evidence on sex workers' OHS using an adapted OHS framework. Our findings show how criminalisation undermines comprehensive OHS practices across legislative contexts, but despite criminalisation, sex workers adopt innovative, community-driven strategies to safeguard OHS and place a strong emphasis on community mobilisation and mutual aid. Decriminalisation markedly improves working conditions and facilitates the development of sex worker-led official OHS guidelines. In contrast, legalisation can perpetuate many of the OHS barriers associated with criminalisation. OHS presents novel opportunities to create safer workplaces and advance the health and human rights of sex workers. Implementing OHS practices designed and led by sex workers with local expertise in their specific work environments is a crucial next step in advancing the health, safety, and labour rights of sex workers globally.