Richard Graveling, Institute of Occupational Medicine, Edinburgh UK
Traditionally, the focus of occupational safety and health has been on physical and chemical hazards in the workplace. Many of these are the subject of individual EU OSH Directives (as provided for under the Framework Directive 89/391/EEC), creating a common approach to hazards such as noise, vibration and dangerous substances. However, there has been a growing awareness that not all hazards have a physical presence. Psychosocial factors, shorthand for the psychological, economic and social influences on workers, can also have an impact on both physical and mental health and well-being.
It is important to recognise that psychosocial factors at work can influence the health and wellbeing of workers. These factors, which are linked to the way work is designed, organised and managed, can potentially lead to an increased level of work-related stress and a deterioration of work performance and of mental and physical health. Research carried out over the last several decades has identified those work characteristics (‘psychosocial risk factors’) that may result in stress in workers, independently of individual dispositions, occupation or cultural background. Further, it is widely recognised that economic and technological developments across the world are creating changes in the pressures and demands on working people. Although some of these changes can be beneficial they can also have adverse effects leading to an increase in psychosocial hazards (or risk factors) which, in turn, can result in an increase in problems such as those encompassed by the use of the word ‘stress’.
In common with a number of other health problems, such as musculoskeletal disorders, psychosocial factors that can have a negative effect on health can be present in the workplace, but are not necessarily purely work-related and can result from domestic and wider social influences. However, that should not be regarded as an excuse for inaction by employers.
Stress is one of those words which everybody uses, but they often mean different things when they talk about it. For example, some people talk about being exposed to stress, rather like the load on a steel girder. Others talk of suffering from stress as if it is an illness or response to that exposure or load. Still others use the word stress to relate to the demands and challenges they face – in work and in everyday life. Here we call this ‘pressure’. Stress is different from pressure, which is a natural part of life. None of these uses are ‘right’ or ‘wrong’ – just different.
Within the occupational safety and health, the term occupational or work (or work-related) stress is widely used to describe what people experience at work when they perceive that there is an imbalance between the demands made of them by their work and the physical and mental resources they have available to cope with those demands. To put it more simply, stress is not being able to cope. For a more detailed description of these terms and their use see the EU-OSHA e-guide on managing stress and psychosocial risks.
Estimates of the extent of the problem vary widely. The 2013 Labour Force Survey (LFS) found that about a quarter of those questioned in the EU-28 (28 EU Member States) reported exposure to psychosocial risk factors that could adversely affect their mental well-being (severe time pressure or overload of work; violence or threat of violence; harassment or bullying). In contrast, in a 2013 pan-European poll of workers aged over 18, almost three-quarters considered psychosocial factors such as ‘job reorganisation or job insecurity’ as the most common causes of work-related stress and over a half stated that work-related stress was either ‘very common’ or ‘fairly common’ in their workplace.
Extensive research over many years has identified a variety of factors potentially leading to psychosocial risks to health in the workplace. These include:
- Excessive workloads
- Conflicting demands and lack of role clarity
- Lack of involvement in making decisions that affect the worker and lack of influence over the way the job is done
- Poorly managed organisational change, job insecurity
- Ineffective communication, lack of support from management or colleagues
- Psychological and sexual harassment, discrimination, third party violence
There are many different perspectives on these factors in different countries leading to them sometimes being ‘packaged’ or presented slightly differently. However, the core issues remain the same. Further OSHwiki articles provide more detailed perspectives on specific aspects of the psychosocial work environment and their potential impact on the workforce; emotional labour, understanding and managing conflicts at work, organisational justice.
For many years, psychosocial risks and stress were seen as a specifically ‘white collar’ problem (with terms such as ‘executive stress’). However, it has long been recognised that, although the influence and relative importance of different risk factors may vary, stress is a problem across all sectors (construction, public administration, agriculture, services), and groups of workers.
How do they affect workers and businesses?
Although stress itself is not an illness, prolonged exposure to stress can lead to physical or mental ill-health such as burnout, anxiety or depression. It can also cause negative emotional or behavioural changes, impair what is called ‘cognitive performance’ (concentration, memory, decision-making, etc.). Individuals can become irritable or withdrawn leading to relationship problems with colleagues as well as violence, harassment or aggression. Some of these effects, such as bullying can be both a sign of stress and a cause of stress in others.
As with many physical and chemical hazards in the workplace, not all workers are equally affected by psychosocial risk factors. This has resulted in some people regarding suffering ill-health from such factors as a sign of weakness, rather than recognising the importance of individual susceptibility, as is the case with hazards such as respiratory sensitisers.
From a business perspective there is research evidence that work-related stress can be expensive. A recent UK study of Labour Force Survey Data identified that, in 2015/16, stress accounted for 37% of all work-related ill health cases and 45% of all working days lost due to ill health, resulting in a major burden on employers (as well as the human cost). Evidence such as studies showing stress at work leading to an increase in accidents, longer periods of sickness absence and greater staff turnover all points to increased costs – which can be avoided if the risks are carefully identified and reduced in the same way as those concerning physical hazards.
The e-guide referred to above gives a general guide to the effects psychosocial risks and work-related stress can have, on both individual workers and businesses.
What’s the legal position?
The EU Framework Directive (89/391) creates a legal obligation on employers to protect their workers by avoiding, evaluating and combating risks to their safety and health (without mentioning specific risks). This includes the psychosocial risks in the workplace which can cause or contribute to stress or mental health problems. The Directive also includes a general duty on workers to comply with protective measures determined by their employer.
There are also joint EU ‘Framework Agreements’ agreed by unions and employers, presenting common positions on how to deal with work-related stress and harassment and violence at work. Copies of these can be accessed through the EU-OSHA e-guide on work-related stress.
Reducing psychosocial risks at work is good for business and workers. As with all hazards in the workplace, the assessment and elimination or reduction of risks should take priority. However, a good approach to managing the risk of stress at work is likely to involve a combination of measures such as workplace interventions and management methods. Many of these are simply part of good management practice. Implementing them can improve the efficiency of your business as well as helping to maintain a good psychosocial working environment with healthy, effective workers. Some further OSHwiki articles provide sector-specific guidance that you might find helpful; cleaning sector, education.
Where can I find more information?
As flagged in this article, further OSHwiki articles, linked to this introduction, give more detail on psychosocial risks and their management in the workplace; together with further articles on specific psychosocial issues such as bullying, harassment, violence and discrimination in the workplace as well as wider mental health issues.
In addition, the EU-OSHA e-guide provides a practical guide to managing stress and psychosocial risks. It is available in national versions for almost all the EU-28 and some other European countries.
- E-guide to managing stress and psychosocial risks https://osha.europa.eu/en/tools-and-publications/e-guide-managing-stress-and-psychosocial-risks
- Persons reporting exposure to risk factors that can adversely affect mental well-being by sex, age and factor. http://ec.europa.eu/eurostat/web/lfs/data/database
- Common causes of work-related stress. http://www.slideshare.net/euosha/paneuropean-opinion-poll-on-occupational-safety-and-health-2013
- Clarke, S., 2010. An integrative model of safety climate: linking psychological climate and work attitudes to individual safety outcomes using meta-analysis. Journal of Occupational and Organizational Psychology 83, 553–578.
- Coomber B, Barriball KL (2007) Impact of job satisfaction components on intent to leave and turnover for hospital-based nurses: A review of the research literature. International Journal of Nursing Studies, 44, 297–314.
- De Gieter S, Hofmans J, Pepermans R. (2011) Revisiting the impact of job satisfaction and organizational commitment on nurse turnover intention: An individual differences analysis. International Journal of Nursing Studies, 48, 1562–1569.