Psychosocial risks and vulnerable groups

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Liz Yeomans, Health & Safety Laboratory, UK

Introduction

This article will describe the key psychosocial risks in relation to vulnerable groups in the workplace. It will explain what is meant by ‘vulnerable workers’, and will, in turn, consider the psychosocial risks in relation to various groups of vulnerable workers, including: young, older, disabled, female, migrant workers, and workers on non-standard employment contracts or in low qualified work. Further, it will discuss the management of psychosocial risks for these vulnerable groups of workers.

Background information

Definition of vulnerable workers

In European Union (EU) policy it has long been recognised that some groups of workers are exposed to more or increased occupational safety and health (OSH) risks than others [1]. These groups or categories of workers are often described as ‘vulnerable workers’. There is no single EU definition of a vulnerable worker. In addition, the groups of workers categorised as ‘vulnerable’ in the EU or Member State reports tend to vary significantly. A 2011 European Parliament report on OSH risks for the most vulnerable workers defines them as those who may be particularly sensitive or over exposed to such risks, in comparison to the general working population[1]. This report considers seven vulnerable groups: women (including expectant mothers), young workers, workers whose jobs are precarious (e.g. temporary workers, contractors, or the self-employed), older workers, workers with disabilities, low-qualified workers, and migrant workers [1]. The EU guidance on risk assessment at work considers additional groups as vulnerable, including: pregnant women and nursing mothers, untrained and inexperienced workers, immuno-compromised workers (e.g. those diagnosed with cancer or HIV/AIDS), workers with pre-existing ill-health, workers receiving medications which might increase their vulnerability to risk, maintenance workers, and people working in confined or poorly ventilated areas [2]. In contrast, the Health and Safety Executive (HSE) in Great Britain considers five groups of workers to be vulnerable to increased risks: migrant workers, female workers, workers with disabilities, older and younger workers, and new recruits [3]. This article will consider the seven categories of vulnerable groups described in the 2011 European Parliament report [1], as these are the groups most commonly considered in the literature as groups of workers who may be more susceptible or exposed to additional risks. What is clear from looking at the groups of workers who are considered to be particularly sensitive to risks is that some groups are more susceptible because of their personal, biological or cultural characteristics or circumstances (e.g. women, older, younger, migrant or disabled workers); whilst other groups may be vulnerable because of the nature of the employment or the employment contract that they are engaged in (e.g. temporary workers, new recruits, those employed in low-skilled jobs) [4]. Workers can be vulnerable to OSH risks because of one, or a combination of characteristics or circumstances. The literature suggests that it is often the personal vulnerability of individuals in combination with the precariousness of the work they are employed in, which leads to increased OSH risks, including psychosocial risks [5]. For example, migrant workers may be at increased risk because of: language difficulties; may face additional risks associated with discrimination or harassment; and are more likely to have temporary, low-skilled jobs that are associated with increased psychosocial risks [1].

EU Policy. Strategy, legislation

Attention to vulnerable groups of workers has been an element of EU legislation and policy for OSH for many years. The 1989 Framework Directive (89/391/EEC) requires that employers ensure the safety and health of all their workers and that particularly sensitive groups of workers be protected against dangers which specifically affect them. Employers are required to carry out risk assessments, eliminate risks and adapt work and the workplace to individual workers [6].

Changing world of work

The OSH risks faced by vulnerable workers are of particular importance in light of the social and economic changes to work and the workforce in Europe [7]. These observed changes mean an increase in the number of workers who could be considered vulnerable as they include: an ageing workforce, more women (including expectant mothers) entering the workforce, and greater numbers of employed migrant workers [1] [8]. Between 1990 and 2010, the employment rate for women increased from 50% to 63%, and between 2000 and 2009 the employment rate for older people (those aged 50 to 64 years) increased from 49% to 56%[9]. The prevalence in disabilities increases with age and is highest among people over 55 years of age [10]. Similarly, migration, both from within and outside the EU, has led to a rapid rise in both legal and job inillegal migrant workers[11]. Changes to the organisation of work due to technology and increased globalisation have led to an increase in non-standard employment contracts, such as, for example, temporary work or contracts based on irregular and flexible working time. While these new forms of employment may be beneficial for workers (for example facilitating work-life balance or continuing education), at the same time they may result in increased work intensification and job insecurity. [7] [8] [12]. These changes to the makeup of the workforce and the organisation of work within Europe have led to increasing concerns over the quality of work, the organisation of work and discrimination against some groups of workers [8].

Key psychosocial issues that may affect vulnerable workers

Psychosocial risks are associated with negative health outcomes. This is covered in detail in Psychosocial risks and workers health and in Work-related stress: Nature and management. The following sections will examine some of the factors, which can cause individuals or groups of workers to be susceptible to psychosocial issues such as, for example, work-related stress.

Personal factors

Personal characteristics can lead individuals or groups of workers to be more vulnerable to psychosocial risks. These can include age (young and older workers), disability, race/ethnicity/nationality, gender, religion, sexual orientation, migration status, language, education and family status. For example, women workers (including expectant mothers) may be at increased risk of work-related psychosocial problems due to biological differences (such as, experiencing hormonal changes during pregnancy, breast feeding, menstruation and menopause), which may also affect the ability to cope with occupational stress and anxiety [13]. Ageing is associated with natural changes of physical, sensory and mental capacities) so that some occupational risks workers are exposed to may be modified by the ageing process [14] [15]. Young workers tend to have less confidence, maturity and job experience [1]. This may mean that they lack the ability to deal with difficult social situations (e.g. angry customers) and can have more difficulty dealing with work pressure and tight deadlines leading to higher levels of anxiety and stress [16] [17].

Discrimination and abuse of employment rights

Discrimination concerns the less favourable treatment of one person compared to another due to the person’s age, gender, race, religion, sexual orientation or disability for example. Discrimination has been shown to cause stress and negatively impact on mental health [18]. Despite the existence of legislation against discrimination, it still appears to be widespread. The Special Eurobarometer survey carried out in 2012 in the EU found that an estimated one-fifth of Europeans (17%) reported that they had personally experienced discrimination or harassment within the past 12 months of the survey[19]. The prevalence of discrimination by work colleagues or employers is greater for older workers, women, workers with disabilities and migrant workers despite legislation against discrimination [5] [19]. The 2012 Eurobarometer report on discrimination in the EU concluded that discrimination is still considered to be common in the EU Member States. The three most widely perceived grounds for discrimination were ethnic origin (56%), disability (46%) and sexual orientation (46%) [19]. In general, migrant workers are more likely than the general workforce to face discrimination [5]. For example, a study of French job-seekers found that workers with native sounding names were five times more likely to be called for job interview than those with non-native names with equivalent qualifications and experience [5]. Migrant workers are often employed on non-standard contract (such as temporary or agency work) and are also less likely to be trade union members [5]. This means that they are more likely to have low levels of employment protection under employment legislation and may be vulnerable to exploitation and abuse of employment rights [5]. A EU-OSHA literature review on migrant workers found that studies of the health of migrant workers carried out in Ireland, the UK and Sweden, as well as studies in the United States of America, suggest that higher rates of stress and burnout have been reported by non-white or migrant workers than by white or native workers as a result of discrimination and exploitation[20] [21].

Poor interpersonal relationships

Poor interpersonal relationships at work are recognised as a psychosocial hazard. Workers may experience social or physical isolation, poor relationships with superiors, interpersonal conflict, lack of support, harassment (bullying, mobbing), and violence at work due to their personal characteristics [8]. Poor interpersonal relationships, workplace violence and harassment have been shown to cause stress and negatively impact on mental health [18]. Workers may be more vulnerable to poor work relationships because of personal characteristics, such as having a disability, being older, or being from a minority racial or ethnic background [1]. Women, migrant and young workers are more likely to experience violence and harassment than the general workforce. On average, more women than men suffered from all forms of violence (7% women, 5% men), harassment/bullying (11% female, 9% men), and sexual harassment and victimisation (4% female, generally young females; 1% men) [1] [18] at work. One of the reasons for this is that violence and harassment are more prevalent in the service sectors, in which women are over-represented. For example, the 2010 European Working Conditions Survey (EWCS) found that adverse social behaviour (defined as verbal abuse, unwanted sexual attention, threats, humiliating behaviour, physical violence and harassment) was reported by 23% of workers from the health sector [22]. Jobs in the [[Psychosocial Issues in the Service Sector | service sector]] often involve interaction with parents, patients and customers and are associated with potential confrontational situations which can be a source of stress, anxiety and depression [1]. In the EU Member States some migrant workers, such as nurses or domestic workers from ethnic minorities, are especially at risk of racial harassment by employers, work colleagues or third parties (clients, patients) [18] [21]. Like women workers, young workers are over-represented in some parts of the service sector where violence, abuse and harassment are more prevalent [16] [18]. Many younger workers are employed in the hotel and restaurant sector (link to E-Facts) or in call-centres, often in seasonal or student jobs, and exposure to violence, confrontational situations and harassment is also high in these type of workplaces [16] [23]. Young, female workers in these sectors are also most likely to experience sexual harassment [24].

Work organisation

Career prospects and training opportunities

Some groups of workers may face increased psychosocial risks because of a lack of equality in career prospects and learning opportunities. As well as leading to frustration and job dissatisfaction, a lack of training and opportunities for learning may leave some workers without the skills to cope with the increases in the mental and emotional demands of their work [18]. Several studies have shown that whilst the proportion of older workers in the workforce is increasing, they may have fewer opportunities than younger workers for professional development and training which may result in increased levels of stress [8]. The Fifth EWCS found that, in 2010, in the EU-27 older workers received less employer paid training than younger workers, with 30% of those aged over 50 receiving training compared to 36% of workers 30-49 [9]. Workers on permanent contracts receive more training (paid for by the employer) than workers in non-standard arrangements such as temporary, part-time and agency work [9]. In 2010, 39% of permanent employees were able to access employer paid training, as compared to an estimated 26% of employees with other types of employment contracts [9].

Work conditions

Psychosocial working conditions refer to working hours, workload, time pressures, lack of challenging or satisfying work, and monotonous and repetitive tasks. Changes to work due to technology and increased globalisation have led to an intensification of work. This is associated with high workload and high pressure for workers, which can lead to an increase in work related stress as the increased demands are shared between fewer workers [12] [18]. Work-related stress is a major cause of health problems for both men and women. Some studies show that women, report more work-related stress than men as the work that they tend to carry out exposes them to disproportionately more stress factors than work predominantly carried out by men. For example, many female dominated occupations are characterised by monotonous or repetitive work with low autonomy and control (such as cleaning), emotionally demanding work (such as nursing or teaching), or work where there may be poor relationships with superiors, unclear and conflicting work demands (such as clerical work) [13]. Studies indicate that fewer women than men are employed in managerial positions and that women are more likely to be employed in unrewarding jobs and to perform more monotonous and repetitive tasks [9] [13] [25]. Studies also suggest that young workers report a lower job satisfaction than the general population, due to having less autonomy and fewer responsibilities in work [1] [16]. Migrant workers may be vulnerable to stress from low job satisfaction as they are often over-qualified for the work in which they are employed, but have been unable to get employment that matches their qualifications and experience [11]. This can lead to frustration and job dissatisfaction. Similarly, migrant workers are often employed in low-skilled work with little autonomy or control over their work [21].

Work-life balance

Poor work-life balance has been identified as one emerging psychosocial risk [18]. Work-life balance refers to the extent to which an individual is equally engaged in and equally satisfied with his or her work role and private life [26]. Studies have found that increased work- life conflict is associated with increased levels of stress and burnout, and decreased job satisfaction [26] [27] [28]. There is an increasing number of women participating in the European labour market and research indicates that women in employment tend to work longer hours than men because of the ‘double role’ they often hold. This ‘double role’ refers to the paid work that women do combined with the hours of unpaid work that women often carry out in the household [25]. Where women are in paid employment but also experience work-life conflict, this has been found to increase levels of dissatisfaction and stress [18] [28].

Low-skilled work

Low-skilled work refers to jobs that do not require qualifications, training or familiarisation to acquire competence in the job [29]. This type of work is found mainly in elderly social care, food processing, construction, hospitality and catering, agriculture, wholesale and retail, and domestic work [29]. Workers in low-skilled positions tend to have less autonomy, less responsibility and lower wages than workers in skilled or semi-skilled positions [30]. As a result they tend to experience lower job satisfaction than workers in higher skilled employment [1]. These factors can lead to stress, anxiety and negative health consequences for workers in low-skilled positions. Migrant workers are over-represented in these low-skilled jobs, as they are often employed in agriculture, construction, healthcare, household, transport, and food sectors. This means that they may be vulnerable to psychosocial issues associated with low-skilled employment [5] [21]. As discussed in Section 3.4.2, migrant workers are often over-qualified for the positions they are employed in, which can lead to feelings of frustration and depression [1] [11]. Women are more often employed in low-skilled, low-status, monotonous jobs with low autonomy and little responsibility; which may lead them to experience increased levels of work-related stress [13]. Workers with disabilities and young workers are other vulnerable groups who are often employed in low-skilled work [16] [31]. Low-skilled work is usually (but not always) carried out by low-qualified workers. It is suggested that low-qualified workers may be more vulnerable to the psychosocial risks associated with low-skilled work as they tend to have fewer resources to deal with stress (such as, social support from colleagues or managers) than workers in higher qualified positions [1]. Individuals in many low-skilled positions may be offered non-standard forms of contract, such as: temporary, agency or part-time work [30]. As discussed below, this type of work is considered precarious and is associated with psychosocial risks.

Precarious or non-standard employment

Precarious or non-standard work has been defined as work which involves: a low level of certainty over the continuity of employment; low control over work (working hours, working conditions, income); a low level of protection (social, protection against unemployment, protection against discrimination); and/or insufficient income or economic vulnerability [18]. It includes temporary, seasonal, part-time, on-call, day hire, casual or short term contracts; as well as self-employment, home working and multiple jobs [4]. Precarious work can also include standard employment contracts where the workers are subjected to organisational change, such as: restructuring,downsizing, privatisation or outsourcing [5]. The proportion of workers on temporary or non-permanent contracts has risen over the last 20 years from 10% in the EC-12 in 1991 to 14% of the EU-27 employees in 2010 [9] [22]. The 5th EWCS reports that precarious employment is found throughout the EU Member States, but is more common in some Member States than others and is slightly more common for women (14.6%) then men (13.4%) [22]. Precarious or non-standard employment is also more common in some sectors than others. For example, temporary or agency contracts are most prevalent in the hotels and restaurant, education, wholesale and retail, construction and agricultural sectors [1]. The evidence suggests that precarious employment is associated with deterioration in occupational health and increased risks of a number of psychosocial issues in comparison to standard forms of employment contract [1] [4] [12] [18] [32]. Precarious workers receive less training, have low promotion prospects, high levels of job insecurity, poor working conditions, less-skilled work, face more discrimination, increased job demands and have less autonomy and control over the work than those working on standard, permanent employment contracts. These issues have been linked with an increased risk of psychosocial issues and negative occupational safety and health outcomes including anxiety, stress, fatigue and depression [1] [5] [12] [18]. For example, studies show that perceived job insecurity is the single most important indicator of a number of psychological symptoms including stress [1] [4] [5] [8] [12]. Some groups of workers are more vulnerable because they are more likely than the general population to be employed in precarious work or non-standard contracts. Young, female and migrant workers are overrepresented among temporary workers, which means that they are exposed to the psychosocial risks associated with temporary work in addition to the risks associated with their personal characteristics [1] [4] [18]. A larger proportion of young, migrant and female workers are employed in the hotel and restaurant, education, and wholesale and retail sectors, which are associated with a high level of precarious employment [18]. In Europe, more women than men hold part-time jobs (31.9% for women compared to 8.7% for men) and more young, disabled and migrant workers hold part time jobs than the general population [1] [22]. Low-skilled work tends to be more precarious than more skilled work and studies suggest that lower skilled manual workers are more worried about losing their job and less confident about finding another job than clerical workers [9].

Management of psychosocial risks for vulnerable groups

The EU recognises that there is a need to address psychosocial issues associated with vulnerable workers specifically in OSH strategies and to raise awareness of the risks they face [1] [33]. In order to manage the psychosocial risks for vulnerable workers, employers should specifically address these risks and these groups of workers in their health and safety actions [20]. One of the main tools for managing psychosocial risks for vulnerable workers is for employers to carry out a suitable and detailed risk assessment, which considers additional or increased risks for vulnerable individuals or groups of workers [20].

Risk assessment

The EU Framework Directive (89/391/EEC) [6] emphasises the need to adapt the work to the individual and the obligation for the employer to be in possession of an assessment of the risks of safety and health at work, including: those risks facing groups of workers exposed to particular risks; and that sensitive risks groups must be protected against the dangers which specifically affect them [20]. The first stage in the prevention and management of psychosocial issues is for an inclusive risk assessment to be carried out [23]. An EU-OSHA report on diversity and inclusive risk assessment suggests that key issues for carrying out an inclusion-sensitive risk assessment and management are [20]:

  • taking diversity issues seriously;
  • avoiding making assumptions about what the hazards are and who is at risk without making appropriate checks;
  • matching the work to the workers;
  • linking OSH into workplace equality actions;
  • providing relevant training and information on diversity issues regarding safety and health risks to risk assessors, managers and supervisors and safety representatives;
  • providing adequate OSH training to each worker with training material tailored to workers’ needs;
  • including workers in the risk assessment;
  • basing the risk assessment on real work situations; and
  • seeking advice from outside, specialist organisations if necessary.

Risk assessments for vulnerable workers should take a broad, holistic approach and should consider risks wider than the usual. For example, for women workers, taking a gender-neutral approach can result in an underestimation or omission of risks to female workers. A gender sensitive risk assessment would need to consider possible differences in risks faced by the workers due to their sex e.g. sexual harassment and discrimination. This will require the people carrying out the risk assessments to be trained in and aware of the risks associated with vulnerable groups, such as: gender, equality and cultural issues [20]. EU-OSHA’s Factsheet 43 [34] has more information on including gender issues in risk assessments. Where migrant workers are employed, employers need to consider how cultural diversity affects working practices, working relationships, values about work and tensions between home and work, as part of the risk assessment [20]. For low-skilled workers, risk assessments should consider the high stress levels that these workers can face due to the low autonomy and control over their work coupled with less support less support and fewer coping skills [1]. Risk assessments which are inclusive of and sensitive to vulnerable workers are more likely to lead to a number of measures aimed at reducing or controlling the risks identified for those vulnerable workers. It is suggested that measures may include adapting the work to the individual, giving appropriate instruction and specific training [20]. However, the EU-OSHA report on diversity and risk assessments acknowledges that there are few practical risk assessment tools available that take account of the specific risks faced by vulnerable workers, and that further research will be needed to provide additional guidance [20].

Discrimination, harassment and violence

Vulnerable workers may be less aware of their rights, especially with regard to discrimination, harassment or violence or, if they are aware of their rights, they may be reluctant to report incidents because of the fear that they will lose their job [35]. Therefore, employers should try to make vulnerable workers aware of their rights to protection and should encourage reporting of all incidents to managers and/or other persons in charge [35]. Consideration should be given to communicating this message to vulnerable groups such as migrant workers who may have language difficulties or be fearful of losing their jobs if they raise concerns [20]. Sexual victimisation and harassment is a high risk for women workers; especially young, female workers in service sectors (such as, hotel and catering). Employers in these sectors should ensure that exposure of their staff to unwanted sexual attention is not considered as part of the job, and should set standards of acceptable behaviour for clients or customers [17]. Young and female workers are often required to work alone or in high-risk situations. This is especially when working in bars or nightclubs or in cleaning work, where they are more at risk of harassment or violence [17] [23]. Prevention strategies include avoiding lone working as far as possible, installing security surveillance equipment, ensuring entrances and exits to work premises are safe and well-light, and providing personal alarms and/or emergency communication systems for all staff. Young workers may benefit from training to recognise, defuse and deal with aggressive or violent customers or difficult and confrontational situations if they work in sectors (such as, hotel and catering) [23]. The following wiki articles contain more information on harassment and violence at work.

Training

Employers should offer training and learning opportunities to all workers, regardless of age, gender, disability, ethnicity and employment status. Special care should be taken that temporary and part-time workers are included in OSH and professional training programmes. Training may need to be carried out in the native language of migrant workers if language difficulties exist [1]. Additionally, vulnerable workers may benefit from stress management training in order to provide them with improved coping mechanisms to deal with the stress levels they are experiencing [23].

References

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Links for further reading

EU-OSHA - European Agency for Safety and Health at Work, Facts 42. Gender issues in safety and health at work, 2003. Available at: [34]

EU-OSHA – European Agency for Safety and Health at Work, E-Facts 51, Managing psychosocial risks with cleaning workers, 2010. Available at: [35]

EU-OSHA – European Agency for Safety and Health at Work, E-Facts 57, Family issues and work-life balance, 2012. Available at: [36]

EU-OSHA – European Agency for Safety and Health at Work, Facts 87, Workforce diversity and risk assessment: ensuring everyone is covered, 2009. Available at: [37]

EU-OSHA – European Agency for Safety and Health at Work, Facts 53, Ensuring the health and safety of workers with disabilities, 2004. Available at: [38]

EU-OSHA - European Agency for Safety and Health at Work, Factsheet 69, Young workers – Facts and figures Youth employment, 2007. Available at: [39]

EU-OSHA - European Agency for Safety and Health at Work, Facts 70, Young workers – Facts and figures. Exposure to risks and health effects, 2007. Available at: [40]

EU-OSHA - European Agency for Safety and Health at Work, Facts 83. Good practice in preventing risks to young workers. Summary of a report, 2009. Available at: [41]

EU-OSHA - European Agency for Safety and Health at Work, Bullying at work Facts 23, 2002. Available at: [42]

EU-OSHA - European Agency for Safety and Health at Work, Violence at work Facts 24, 2002. Available at: [43]

EU-OSHA - European Agency for Safety and Health at Work, Work-related stress Facts 22, 2002. Available at: [44]

Griffiths, A., Knight, A. & Mahudin, M., ‘Ageing, Work-Related Stress and Health: Reviewing the evidence’. Age UK/TAEN –The Age and Employment Network, London, 2009. Available at: [45]

McKay, S., Craw, M. & Chopra, D,, ‘Migrant workers in England and Wales: An assessment of migrant worker health and safety risks’, Health and Safety Executive, HSE Books, 2006. Available at: [46]

Smith, A., Wadsworth, E., Shaw, C., Stansfeld, S., Bhui, K. & Dhillon, K., ‘Ethnicity, work characteristics, stress and health’, Health and Safety Executive, RR308, HSE Books, 2005. Available at: [47]

European Social Dialogue, Framework Agreement on Harassment and Violence at Work, 2007. Available at: [48]