Women suffer many health problems related to their work, but attempts to improve their situation face obstacles at two levels: recognition of their problems and ability to organize to prevent them. Recognition by occupational health specialists has been delayed due in part to: A perception that women's issues have been included in research focussed on male workers; pressure to deal with more visible issues of mortality and well-established illness; ignorance of women's working conditions; methodological biases and inadequacies. Recognition by unions is slowed when women and their concerns are absent from union membership and/or governing structures. Feminist health advocates have not often participated in these struggles, due to social class differences and difficulties in linking with some male-dominated unions. Also, due to the wide variety of hazardous working conditions, they do not emerge from population-based analyses of health determinants in the same way as do domestic violence, tobacco or poverty. The authors describe three alliances necessary for successful research, policy and practice in women's occupational health: between feminist and working-class organizations; between feminists and occupational health scientists; between researchers and women workers.