Occupational stress

Occupational stress is psychological stress related to one's job. Occupational stress often stems from pressures that do not align with a person's knowledge, skills, or expectations. Occupational stress can increase when workers do not feel supported by supervisors or colleagues, feel as if they have little control over work processes, or find that their efforts on the job are incomensurate with the job's rewards.[1]

A video on workplace stress (see also: Part 2)

Factors Affecting Workers

Overexertion and fatigue of the body may occur after long periods of time standing and repetitive movements. Many factory jobs are highly physical and workers can easily put too much stress on their bodies. In 2011, approximately 3.3 million Americans visited the emergency room due to overexertion injuries. Overexertion is further complicated by high temperatures during the summer months. A worker at a Georgia auto factory died after working in high temperatures on a welding line.

Repetitive Motion Injuries: This type of injury stems from doing the same movement over and over again, such as repeatedly bending over or pulling a lever. Those working in an automotive manufacturing plant are at risk of this injury, especially if they are working on the assembly line. In Georgia, meat packing factories are some of the most dangerous places to work, requiring repeated motions, sharp cutting instruments and the stress of keeping up with conveyors. Repetitive motion injuries can cause permanent damage if not treated promptly.

Body Movement Injuries: Moving the wrong way, such as twisting in awkward positions or improperly lifting heavy objects, can lead to painful injuries, the most common of which is a herniated disc in the spine. A herniated disc injury can cause severe pain and in some cases bowel or bladder dysfunction. Georgia’s carpet and rug mill workers are often at risk for these types of injuries because they frequently lift or lean over heavy rolls of material.

Transportation Incidents: Transportation incidents, such as those involving a forklift, are something all factory workers are at risk for. In fact, it is estimated that about 85 fatal forklift accidents happen each year in the United States. Here in Georgia, workers at soft drink and beer bottling companies, where forklifts are frequently used, may be at risk for this kind of injury. In the past few years, workers at businesses in Riceboro, Atlanta and Austell, GA have all been killed in forklift-related accidents.

Harmful Substance Exposure: Many factories use a variety of chemicals in their manufacturing and cleaning process. This can be extremely dangerous when inhaled or if they come into contact with the skin. For example, working at a Clorox factory would expose workers to sodium hypochlorite, a chemical that can be poisonous when inhaled. In 2010, an explosion at the Forest Park, GA Clorox plant required the evacuation of workers and residents within a ten-mile radius.

Equipment and Object Injuries: Ensnarement, loss of limbs and injuries through crushing are all possible among factory workers. Crushing injuries can be fatal due to the medical complications associated with them, such as systemic infection, kidney failure, reduced oxygen to the brain and hemorrhaging. Accidents can happen quickly and without warning, making the factory environment extremely dangerous. Last year, a quality control inspector at a Rockmart, GA factory was killed in a mishap with an autoclave, a high-pressure sterilization machine. And in 2012, a worker was killed at a Canton, GA chicken processing plant when he got trapped between two pieces of equipment.

Explosions and Fires: Fires and explosions are at risk for many factories, especially when such factories have combustible and flammable materials. Fires and explosions have the risk of causing significant injury, as well as death. And a variety of materials are combustible. In 2008, several workers were killed in a Port Wentworth, GA sugar factory, after sugar dust exploded.

Psychological Theories of Worker Stress

A number of psychological theories[2][3][4] at least partly explain the occurrence of occupational stress. The theories include the demand-control-support model, the effort-reward imbalance model, the person-environment fit model, job characteristics model, the diathesis stress model, and the job-demands resources model.

The demand-control-support (DCS) model is the most influential psychological theory in occupational stress research.[4] The DCS model advances the idea that the combination of low levels of work-related decision latitude (i.e., autonomy and control over the job) and high psychological workloads is harmful to workers. High workloads and low levels of decision latitude either in combination or singly can lead to job strain, the term often used in the field of occupational health psychology to reflect poorer mental or physical health.[5][6] The model has been extended to include work-related social isolation or lack of support from coworkers and supervisors, which also leads to poorer health[7]

The effort-reward imbalance (ERI) model is the secondmost prominent psychological theory of occupational stress. It focuses on the relationship between the worker's efforts and the work-related rewards the employee receives. The ERI model suggests that work marked by high levels of effort and low rewards leads to strain (e.g., psychological symptoms, physical health problems). The rewards of the job can be tangible like pay or intangible like appreciation and fair treatment. Another facet of the model is that overcommitment to the job can fuel imbalance. [8][4]

The person-environment fit model underlines the match between a person and his/her work environment. The closeness of the match influences the individual's health. For healthy working conditions, it is necessary that employees’ attitudes, skills, abilities, and resources match the demands of their job. The greater the gap or misfit (either subjective or objective) between the person and his/her work environment, the greater the strain.[4] Strains can include mental and physical health problems. Misfit can also lead to lower productivity and other work problems.[3]

The job characteristics model focuses on factors such as skill variety, task identity, task significance, autonomy, and feedback. These job factors are thought to psychological states such as a sense of meaningfulness and knowledge acquisition. The theory holds that positive or negative job characteristics give rise to a number of cognitive and behavioral outcomes such as extent of worker motivation, satisfaction, and absenteeism. Hackman and Oldham (1980) developed the Job Diagnostic Survey to assess these job characteristics and help organizational leaders make decisions regarding job redesign.[3]

The diathesis–stress model looks the individual's susceptibility to stressful life experiences, i.e., the diathesis.[9][10] Individuals differ on that diathesis or vulnerability. The model suggests that the individual's diathesis is part of the context in which he or she encounters job stressors at various levels of intensity.[11][12] If the individual has a very high tolerance (is relatively invulnerable), an intense stressor may not lead to a mental or physical problem. However, if the stressor (e.g., high workload, difficult coworker relationship) outstrips the individual's diathesis, then health problems may ensue.[13]

The job demands-resources model model posits that strain is a response to imbalance between demands of one's job and the resources the worker has in dealing deal with those demands.

  • Job demands: the physical, psychological, social, or organizational aspects of a job that require sustained physical and/or psychological effort or skills. Therefore, they are associated with expenditure of time and energy.[14]
  • Job resources: the physical, psychological, social, or organizational aspects of the job that aid in achieving work goals; reduce job demands and the associated physiological and psychological cost; stimulate personal growth, learning, and development.[14]

Origins

Sources of occupational stress come from:[13]

  • a toxic work environment
  • negative workload
  • isolation
  • financial pressures
  • types of hours worked
  • role conflict & role ambiguity
  • lack of autonomy, career development barriers
  • difficult relationships with administrators and/or coworkers
  • managerial bullying
  • harassment
  • organizational climate[13]

These individual sources demonstrate that stress can occur specifically when a conflict arises from the job demands of the employee and the employee itself. If not handled properly, the stress can become distress.[15]

  • Coping: research on the ability of the employees to cope with the specific workplace stressors is equivocal; coping in the workplace may even be counterproductive.[16][4] Pearlin and Schooler[17] advanced the view that because work roles, unlike the roles of parent and spouse, tend to be impersonally organized they are not conducive to successful coping. Pearlin and Schooler suggested that the impersonality of workplaces may even cause occupational coping to make things worse for the employee.
  • Role in the organization: associated with the hierarchical ranking of that particular employee within the organization. Upper management is entitled to oversee the overall functioning of the organization. This causes potential distress as the employee must be able to perform simultaneous tasks.
  • Career development: Security of their occupation, promotion levels, etc. are all sources of stress, as this business market in terms of technology of economic dominance is ever-changing.
  • Interpersonal relationships within the workplace: The workplace is a communication and interaction-based industry. These relationships (either developed or developing) can be problematic or positive. Common stressors include harassment, discrimination, biased opinions, hearsay, and other derogatory remarks.
  • Organizational climate or structure: The overall communication, management style, and participation among groups of employees are variables to be considered. In essence, the resultant influence of the high participation rate, collaborative planning, and equally dispersed responsibilities provides a positive effect on stress reduction, improved work performance, job satisfaction, and decreased psychosomatic disorders.

Prevalence

Distress is a prevalent and costly problem in today's workplace. About one-third of workers report high levels of stress.[11] In 2007, 20–30% of workers employed in a number of different economic sectors in the European Union reported that they believed work-related stress was potentially affecting their health.[18] Three-quarters of employees believe the worker has more on-the-job stress than a generation ago.[19] In Great Britain, one-sixth of the workforce experiences occupational stress every year.[18] Evidence also suggests that distress is the major cause of turnover in organizations.[11] Chronic feelings of work-related distress increase the risk that workers will develop psychological and physical problems and concomitantly decrease worker motivation.[13] The amount work control over job tasks and the level of workload are key factors that influence job stress.[20] Occupational stress and its sequelae represent the majority of work-related illnesses causing missed work days.[18] Those in the protective services, transportation and materials moving, building grounds cleaning and maintenance, and healthcare are more susceptible to both work injuries and illnesses, as well as work-related stress.[21]

Negative health effects

Stress-related disorders encompass a broad array of conditions, including psychological disorders (e.g., depression, anxiety, post-traumatic stress disorder) and other types of emotional strain (e.g., dissatisfaction, fatigue, tension), maladaptive behaviors (e.g., aggression, substance abuse), and cognitive impairment (e.g., concentration and memory problems). In turn, these conditions may lead to reduced productivity or poor work performance, higher absenteeism, or injury.[13][18] Chronically high levels of job stress can exacerbate existing mental and physical health problems (diabetes, hypertension). Chronically high levels of job stress not only diminish the worker's quality of life and increase the cost of the health benefits the employer provides, they contribute to increased injury risk. A study of short haul truckers found that high levels of job stress were related to increased risk of occupational injury.[21] Job stress is also associated with cardiovascular disease.[18][22][4] The Japanese use the term karoshi to reflect death from overwork.

Problems at work are more strongly associated with health complaints than are any other life stressor-more so than even financial problems or family problems.[23] Occupational stress accounts for more than 10% of work-related health claims.[24] Many studies suggest that psychologically demanding jobs that allow employees little control over the work process increase the risk of cardiovascular disease.[4] Research indicates that job stress increases the risk for development of back and upper-extremity musculoskeletal disorders.[25] Other disorders that can be caused or exacerbated by occupational stress include sleep disorders, headache, upset stomach, hypertension, high cholesterol, and autoimmune disease. Stress at work can also increase the risk of acquiring an infection and the risk of accidents at work.[26]

High levels of stress are associated with substantial increases in health service utilization.[11] Workers who report experiencing stress at work also show excessive health care utilization. In a 1998 study of 46,000 workers, health care costs were nearly 50% greater for workers reporting high levels of stress in comparison to “low risk” workers. The increment rose to nearly 150%, an increase of more than $1,700 per person annually, for workers reporting high levels of both stress and depression.[27] Health care costs increase by 200% in those with depression and high occupational stress.[26] Additionally, periods of disability due to job stress tend to be much longer than disability periods for other occupational injuries and illnesses.[28]

Physiological reactions to stress can have consequences for health over time. Researchers have been studying how stress affects the cardiovascular system, as well as how work stress can lead to hypertension and coronary artery disease. These diseases, along with other stress-induced illnesses tend to be quite common in American work-places.[29] There are four main physiological reactions to stress:[30]

  • Blood is shunted to the brain and large muscle groups, and away from extremities and skin.
  • An area near the brain stem known as the reticular activating system goes to work, causing a state of keen alertness as well as sharpening of hearing and vision.
  • Energy-providing compounds of glucose and fatty acids are released into the bloodstream.
  • The action immune and digestive systems are temporarily reduced.

Gender

Frustrated man at a desk


Men and women are exposed to many of the same stressors.[31] Although men and women might not differ in overall strains, women are more likely to experience psychological distress, whereas men experience more physical strain. Desmarais and Alksnis suggest two explanations for the greater psychological distress of women. First, the genders may differ in their awareness of negative feelings, leading women to be more likely to express and report strains, whereas men more likely to deny and inhibit such feelings. Second, the demands to balance work and family result in more overall stress for women that leads to increased strain.[31] Women are also more vulnerable to sexual harassment and assault than men.[32] In addition, women, on average, earn less than their male counterparts.[33]

Causes

Job stress results from various interactions of the worker and the environment of the work they perform their duties. Location, gender, environment, and many other factors contribute to job stress. Job stress results from the interaction of the worker and the conditions of work. Views differ on the importance of worker characteristics versus working conditions as the primary cause of job stress. The differing viewpoints suggest different ways to prevent stress at work. Differences in individual characteristics such as personality and coping skills may predict whether certain job conditions will result in strain although the evidence regarding the impact of workplace coping is weak at best.[17][4] Some prevention strategies focus on ways to help worker cope with demanding job conditions although the evidence is ambiguous.[11]

Working conditions

Although the importance of individual differences cannot be ignored, scientific evidence suggests that certain working conditions are stressful to most people. Such evidence argues for a greater emphasis on working conditions as the key source of job stress, and for job redesign as a primary prevention strategy.[11] Large surveys of working conditions, including conditions recognized as risk factors for job stress, were conducted in member states of the European Union in 1990, 1995, and 2000. Results showed a time trend suggesting an increase in work intensity. In 1990, the percentage of workers reporting that they worked at high speeds at least one-quarter of their working time was 48%, increasing to 54% in 1995 and to 56% in 2000. Similarly, 50% of workers reported they work against tight deadlines at least one-fourth of their working time in 1990, increasing to 56% in 1995 and 60% in 2000. However, no change was noted in the period 1995–2000 (data not collected in 1990) in the percentage of workers reporting sufficient time to complete tasks.[34]

Workload

In an occupational setting, dealing with workload can be stressful and serve as a stressor for employees. There are three aspects of workload that can be stressful.

  • Quantitative workload or overload: Having more work to do than can be accomplished comfortably.
  • Qualitative workload: Having work that is too difficult.
  • Underload: Having work that fails to use a worker's skills and abilities.[35]

Workload as a work demand is a major component of the demand-control model of stress.[36] This model suggests that jobs with high demands can be stressful, especially when the individual has low control over the job. In other words, control serves as a buffer or protective factor when demands or workload is high. This model was expanded into the demand-control-support model that suggests that the combination of high control and high social support at work buffers the effects of high demands.[37]

As a work demand, workload is also relevant to the job demands-resources model of stress that suggests that jobs are stressful when demands (e.g., workload) exceed the individual's resources to deal with them.[38]

Long hours

A substantial percentage of Americans work very long hours. By one estimate, more than 26% of men and more than 11% of women worked 50 hours per week or more in 2000. These figures represent a considerable increase over the previous three decades, especially for women. According to the Department of Labor, there has been a rise in the number of hours in the work place by employed women, an increase in extended work weeks (>40 hours) by men, and a considerable increase in combined working hours among working couples, particularly couples with young children.[39][40]

Evidence of occupational stress due to an individual's status in the workplace

Status

A person's status in the workplace can also affect levels of stress. While workplace stress has the potential to affect employees of many different statuses, spanning those who have very little influence to those who make major decisions. However, employees who have less control over their jobs are more likely to report psychological symptoms than workers who have more control over their work. Managers as well as other kinds of workers are vulnerable to work overload.[41]

Economic factors

Economic factors that employees face in the 21st century have been linked to increased stress levels. Researchers and social commentators have pointed out that the computer and communications revolutions have made companies more efficient and productive than ever before. This increase in productivity, however, has caused higher expectations and greater competition, putting more stress on the employee.[29]

The following economic factors may lead to workplace stress:

  • Pressure from investors, who can quickly withdraw their money from company stocks.
  • The lack of trade and professional unions in the workplace
  • Inter-company rivalries caused by the efforts of companies to compete globally
  • The willingness of companies to swiftly lay off workers to cope with changing business environments

Bullying

Bullying in the workplace can also contribute to stress. This can be broken down into five categories:[13]

  • Threat to profession status
  • Threat to personal status
  • Isolation
  • Excess work
  • Destabilization, i.e. lack of credit for work, meaningless tasks, etc.[13]

This can create a hostile work environment for employees, which in turn can affect their work ethic and contribution to the organization.[42]

Narcissism and psychopathy

Thomas suggests that there tends to be a higher level of stress with people who work or interact with a narcissist, which in turn increases absenteeism and staff turnover.[43] Boddy finds the same dynamic where there is a corporate psychopath in the organisation.[44]

Workplace conflict

Interpersonal conflict among people at work has been shown to be one of the most frequently noted stressors for employees.[45][46] Conflict has been noted to be an indicator of the broader concept of workplace harassment.[47] It relates to other stressors that might co-occur, such as role conflict, role ambiguity, and workload. It also relates to strains such as anxiety, depression, physical symptoms, and low levels of job satisfaction.[47]

Sexual harassment

Women are more likely than men to experience sexual harassment, especially for those working in traditionally masculine occupations. In addition, a study indicated that sexual harassment negatively affects workers' psychological well-being.[48] Another study found that level of harassment at workplaces lead to differences in performance of work related tasks. High levels of harassment were related to the worst outcomes, and no harassment was related to least negative outcomes. In other words, women who had experienced a higher level of harassment were more likely to perform poorly at workplaces.[48]

Occupational group

Lower occupational groups are at higher risk of work-related ill health than higher occupational groups. This is in part due to adverse work and employment conditions. Furthermore, such conditions have greater effects on ill-health to those in lower socio-economic positions.[49]

Effects

Stressful working conditions can lead to three types of strains: Behavioral (e.g., absenteeism or poor performance), physical (e.g., headaches or coronary heart disease), and psychological (e.g., anxiety or depressed mood).[50][51] Physical symptoms that may occur because of occupational stress include fatigue, headache, upset stomach, muscular aches and pains, weight gain or loss, chronic mild illness, and sleep disturbances. Psychological and behavioral problems that may develop include anxiety, irritability, alcohol and drug use, feeling powerless and low morale.[52][51] The spectrum of effects caused by occupational stress includes absenteeism, poor decision making, lack of creativity, accidents, organizational breakdown or even sabotage.[53] If exposure to stressors in the workplace is prolonged, then chronic health problems can occur including stroke. An examination was of physical and psychological effects of workplace stress was conducted with a sample of 552 female blue collar employees of a microelectronics facility. It was found that job-related conflicts were associated with depressive symptoms, severe headaches, fatigue, rashes, and other multiple symptoms.[54] Studies among the Japanese population specifically showed a more than 2-fold increase in the risk of total stroke among men with job strain (combination of high job demand and low job control).[55] Those in blue-collar or manual labor jobs are more likely to develop heart disease compared to those in white-collar jobs.[56] Along with the risk of stroke, stress can raise the risk of high blood pressure, immune system dysfunction, coronary artery disease.[18][57] Prolonged occupational stress can lead to occupational burnout.[18] Occupational stress can also disrupt relationships.[26]

The effects of job stress on chronic diseases are more difficult to ascertain because chronic diseases develop over relatively long periods of time and are influenced by many factors other than stress. Nonetheless, there is some evidence that stress plays a role in the development of several types of chronic health problems—including cardiovascular disease, musculoskeletal disorders, and psychological disorders.[11][18] Job stress and strain has been associated with poor mental health and wellbeing over a 12-year period.[51]

Occupational stress has negative effects for organizations and employers. Occupational stress is the cause of approximately 40% of turnover and 50% of workplace absences. The annual cost of occupational stress and its effects in the US is estimated to be over $60 billion to employers and $250–300 billion to the economy.[26]

Prevention

A combination of organizational change and stress management is often the most useful approach for preventing stress at work.[11][18] Both organizations and employees can employ strategies at organizational and individual levels.[18] Generally, organizational level strategies include job procedure modification and employee assistance programs (EAP). Individual level strategies include taking vacation. Getting a realistic job preview to understand the normal workload and schedules of the job will also help people to identify whether or not the job fit them.

How an Organization Can Prevent Job Stress[58]

  • Ensure that the workload is in line with workers' capabilities and resources.
  • Design jobs to provide meaning, stimulation, and opportunities for workers to use their skills.
  • Clearly define workers' roles and responsibilities.
  • To reduce workplace stress, managers may monitor the workload given out to the employees. Also while they are being trained they should let employees understand and be notified of stress awareness.[59]
  • Give workers opportunities to participate in decisions and actions affecting their jobs.
  • Improve communications-reduce uncertainty about career development and future employment prospects.
  • Provide opportunities for social interaction among workers.
  • Establish work schedules that are compatible with demands and responsibilities outside the job.
  • Combat workplace discrimination (based on race, gender, national origin, religion or language).
  • Bringing in an objective outsider such as a consultant to suggest a fresh approach to persistent problems.[60]
  • Introducing a participative leadership style to involve as many subordinates as possible to resolve stress-producing problems.[60]
  • Encourage work-life balance through family-friendly benefits and policies

An insurance company conducted several studies on the effects of stress prevention programs in hospital settings. Program activities included (1) employee and management education on job stress, (2) changes in hospital policies and procedures to reduce organizational sources of stress, and (3) the establishment of employee assistance programs. In one study, the frequency of medication errors declined by 50% after prevention activities were implemented in a 700-bed hospital. In a second study, there was a 70% reduction in malpractice claims in 22 hospitals that implemented stress prevention activities. In contrast, there was no reduction in claims in a matched group of 22 hospitals that did not implement stress prevention activities.[61]

Telecommuting is another way organizations can help reduce stress for their workers. Employees defined telecommuting as "an alternative work arrangement in which employees perform tasks elsewhere that are normally done in a primary or central workplace, for at least some portion of their work schedule, using electronic media to interact with others inside and outside the organization." One reason that telecommuting gets such high marks is that it allows employees more control over how they do their work. Telecommuters reported more job satisfaction and less desire to find a new job. Employees that worked from home also had less stress, improved work/life balance and higher performance rating by their managers.[62]

A systematic review of stress-reduction techniques among healthcare workers found that cognitive behavioral training lowered emotional exhaustion and feelings of lack of personal accomplishment.[63]

Signs and symptoms of excessive job and workplace stress

Signs and symptoms of excessive job and workplace stress include:[64]

  • Feeling anxious, irritable, or depressed
  • Apathy, loss of interest in work
  • Problems sleeping
  • Fatigue
  • Trouble concentrating
  • Muscle tension or headaches
  • Stomach problems
  • Social withdrawal
  • Loss of sex drive
  • Using alcohol or drugs to cope

Both yoga and mindful-based stress reduction have been shown to reduce work-related stress.[65][66] Nurses who participated in cognitive behavioral interventions had less perceived stress, a greater sense of coherence, and increased mood.

Expanding research on stress: Contemporary opinions hold that jobs designed to support skill variety, task identity, significance, autonomy, and feedback, while providing for existence and growth needs, will sustain a healthier, greater satisfied workforce.

For team-oriented work environments, Patrick Lencioni's The Five Dysfunctions of a Team[67] profiles the behavior of cohesive teams:

  • They trust one another.
  • They engage in unfiltered conflict around ideas.
  • They commit to decisions and plans of action.
  • They hold one another accountable for delivering against those plans.
  • They focus on the achievement of collective results.

For immediate individual stress management, rudimentary mental coping strategies may be adopted in the work environment.

See also

References

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