A gender-integrated biopsychosocial model to understand cardiovascular risk in women working under environmental hazards: the case of chronic intermittent hypoxia.

Women working in high-altitude (HA) mining environments are exposed to chronic intermittent hypoxia (CIH), a physiological stressor resulting from rotating work shifts between sea level and elevations typically above 3,000 meters above sea level (m.a.s.l). CIH involves repeated exposure to hypobaric hypoxia, imposing significant biological, psychological, and social demands. Despite increasing female participation in the mining sector, the long-term cardiovascular risks specific to women in these conditions remain poorly characterized. This mini-review introduces the Gender-Integrated Biopsychosocial Model (GBM). This conceptual framework integrates biological, psychological, and social dimensions to examine how sex hormones, emotional burden, and gendered occupational exposures shape cardiovascular and autonomic responses to CIH. Unlike existing models that primarily reflect male physiology, the GBM emphasizes the role of natural cycling hormonal fluctuations, contraceptive use, menopause, and structural inequities in modulating cardiovascular adaptation. By advancing a multidimensional, sex and gender informed perspective, the GBM offers a novel approach to understanding women's health in extreme environments and highlights the need for occupational and environmental physiology research to recognize gender not merely as a biological variable, but as a determinant of cardiovascular risk. This article contributes to the understanding of environmental and occupational hazards in extreme workplaces by introducing an integrative model that addresses gendered exposures and physiological responses under chronic intermittent hypoxia.