Managing psychosocial risks in the cleaning sector

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Andrew Pinder, Health & Safety Laboratory, UK

Introduction

This article summarises available information on the control and management of psychosocial risk factors among cleaning workers. This kind of work has a particular set of psychosocial risk factors due to its perceived low status and wages and job insecurity that can harm the health of cleaning workers. General principles for prevention of risks to health are set out, specific risk factors and their potential consequences are identified, and possible control measures are listed. Many workers are employed to carry out cleaning tasks across all industrial sectors. Among others, they include:

  • Contract cleaners;
  • Office, school, hospital and catering cleaners;
  • Hotel cleaners / maids;
  • Domestic cleaners (those employed by agencies and sent to homes);
  • Workers carrying out day-to-day cleaning in industry.

The workforce employed in cleaning

Professional cleaning is one of the most common occupations in the European Union (EU). Cleaning is a common task, as it is carried out in all industry groups and all workplaces. Because cleaning workers are not presented as a separate occupational group in EU statistics or in the European Working Conditions Surveys[1], it is difficult to determine their numbers. Any estimate of the number of cleaning workers is likely to be an underestimate, since many are not registered as ‘professional cleaners’. Figures from the European cleaning industry[2] show that:

  • In 2006, cleaning contractors employed more than 3.5 million employees in Europe.
  • In 2006, the sector generated a turnover of EUR 54.4 billion and has recorded almost continuous growth since 1989.
  • Between 1989 and 2006 employment grew by an average of almost 5.6% annually.
  • Office cleaning represents the largest part of the sector in Europe.
  • Cleaning in areas such as industry (including the hygiene of food chains), specialised cleaning services (hospital cleaning, cleaning specific rooms, etc.), cleaning of public transport, cleaning of schools, etc., now represents almost half of the sector’s turnover (47%).
  • In 2006, there were nearly 130,000 companies in the sector, of which more than 88% had fewer than 50 employees and about 73% fewer than 10 employees.
  • About 70% of the employees in the sector work part-time, doing an average of 23 hours per week.
  • A high proportion of workers in the cleaning sector are immigrants (estimated at 30% on average, reaching 67% in Austria), but the true percentage is probably even higher, because some countries do not register the ethnic origin of workers but only their nationality.

Figures from 2009[3] indicate that most workers (76%) in the cleaning sector are females.

The legislative framework

Council Directive 89/391/EEC[4], on the introduction of measures to encourage improvements in the safety and health of workers at work, is often referred to as the ‘Framework Directive’. It has been transposed into law in all Member States. Its key requirements concerning risk assessment and employee involvement apply to cleaning workers as to all other workers. It states that the employer’s duty is ‘to ensure the health and safety of workers in every aspect related to the work’. Daughter and other directives exist on workplaces[5], carcinogens[6], biological agents[7], chemical agents[8], manual handling[9], provision and use of work equipment[10] and personal protective equipment (PPE) [11]. As specified in the Framework Directive:

  • Employers must assess all the risks to workers’ health and safety.
  • In the light of the results obtained from this assessment, employers must take any measures needed to prevent occupational risks.
  • Every employer has to ensure the health and safety of workers in every aspect related to the work.
  • Employees are entitled to be consulted by their employer.
  • Workers are entitled to receive adequate and specialised training in matters relating to health and safety.
  • In a situation of serious and immediate danger which cannot be averted, workers may stop work and leave their workplace.
  • Employees also have a duty to cooperate with the employer on OSH issues and to comply with control measures.

Under Directive 92/85/EEC there is a specific duty to assess workplace risks to pregnant workers, and workers who have recently given birth or are breastfeeding[12]. The Directive provides a non-exhaustive list of agents, processes and working conditions that the employer must consider in a risk assessment. Factors in this list that are relevant to cleaning work include night work chemical agents, and physical agents such as working postures that may lead to mental and physical fatigue. The framework agreement on harassment and violence at work [13]aims to increase the awareness and understanding of workplace harassment and violence and to provide employers, workers and their representatives with a framework to identify, prevent and manage problems of harassment and violence at work.

The hierarchy of control and prevention strategies for psychosocial hazards

In the workplace many factors (‘hazards’) create a possibility (‘risk’) of harm. The most serious hazards can create a risk of death. The likelihood that a particular hazard creates harm can be reduced by preventive measures. Actions against psychosocial hazards should follow the usual hierarchy of control:

Psychosocial factors relate to organisational, physical or social characteristics of the work and the work environment. Some of these, such as poor communication, can create hazardous situations that can harm people’s health, wellbeing and satisfaction. Some, such as good social support, can reduce the risk of hazardous situations arising. It is therefore necessary to assess aspects of work that can create psychosocial hazards, including characteristics as diverse as the work equipment, the physical environment, and the social environment. The risk of harm can be affected by two factors:

  • The type and actual demands of the work, including social influences in the working environment; and
  • The availability or lack of resources for them to deal with these demands successfully.

Psychosocial risk factors in the cleaning sector

There are particular psychosocial factors that can affect the risk of harm to professional cleaning workers[14]:

  • They are often ignored and treated with a lack of respect and recognition for their work.
  • They often belong to vulnerable groups such as:
    • women, particularly older women
    • immigrants.

Difficulties because of language barriers for immigrant workers and sexual harassment of female workers make the situation more complicated. Psychosocial factors at work that can affect health and wellbeing are categorised below using the Demands – Control – (Support) model of Karasek and Theorell [15] [16]. Other categories used are related to issues around Violence and harassment, including bullying and discrimination, and to pay and career prospects.

Demands

  • Shift work, early or late working times due to cleaning work often occurring outside the normal working hours of a workplace;
  • Possible problems based on combining the demands of work and family life due to unsocial working hours;
  • Time pressure, especially the need to do physically hard work in a short space of time, due to the need to complete cleaning tasks within short periods;
  • Monotonous and repetitive tasks giving rise to physical strain on one side or part of the body; awkward postures at work due to the nature of cleaning tasks;
  • Unexpected situations at work such as occupied offices, running out of cleaning equipment or having no access to a room that was planned to be cleaned;
  • Communication problems and, especially for some immigrant workers, language problems;
  • Contradictory demands at work and a lack of transparency in the decision-making process related to work tasks, schedules or organisation ;
  • High (unrealistic) demands in terms of the quality of work and the workload, especially when there is no support.

Control

  • Little influence on working conditions such as work arrangements, work pace, tools, the division of labour or choice of work partner[17];
  • Limited influence on the order in which work tasks are performed;
  • Lack of control over work conditions[18];
  • Fixed work schedules, such as evening work cleaning offices, and fixed methods.

Support

Violence and harassment at work

Violence is a generic term that covers all kinds of abuse. It encompasses all behaviour that humiliates, degrades of damages a person’s wellbeing, value or dignity[19]. It includes both the threat of and actual physical assault ( ‘violence’), and psychological or sexual harassment [13]. Violence and harassment related to work can occur outside an actual workplace. They can be carried out by employees of the same organisation as the victim, or by individuals outside the organisation. Particular issues for cleaning workers include:

Pay and career prospects

  • Poor wages;
  • Limited possibilities to develop professionally.

Harmful outcomes

Work-related stress

Work-related stress is experienced when the demands of the work environment are more than the person can cope with or control. It can lead to physical and/or mental ill health. It can arise as a result of many risk factors, such as those listed above. It is a symptom of an organisational problem and should be managed by the organisation.

Research evidence

Earlier studies of cleaning work focused on the ergonomic and chemical hazards. The high turnover of employees in the sector makes it difficult to do research on the effects of hazards, especially psychosocial hazards, in cleaning work[20]. Exposure to psychosocial risks leads to above-average levels of work-related sick leave; in particular, exposure to violence and harassment can foster long-term absence of 60 days or more[21]. Data from the 2007 Labour Force Survey showed that employees with stress, depression or anxiety were more likely to go on long term sick leave compared to workers with musculoskeletal problems (25% versus 19%), whereas those with musculoskeletal problems were more likely to experience short term sick leave (39% versus 29%)[22]. Studies carried out in various EU Member States and Norway have shown that sick leave among cleaners is significantly higher than the workforce average[3]. High absenteeism is one of the signs that can indicate a problem of work-related stress in an organisation. Further indicators are high staff turnover and frequent interpersonal conflicts[14]. Stress-related mental health problems, such as depression, anxiety and burnout, are common among cleaning professionals[14]. It has been shown that chronic work stress is related to increased mental and physical health problems[23]. The type of leadership and the amount of collaboration with co-workers can affect mental health[1]. Occupational hazards do not exist in isolation, but can worsen existing health problems[2][20]. For example, psychosocial hazards can worsen musculoskeletal problems [24][25][26], which may or may not be work-related.

Prevention and intervention strategies

Strategies for dealing with psychosocial hazards in the cleaning profession can be separated into three levels: those carried out by the individual worker, those carried out by the employer, and those carried out across the cleaning sector[14]. Generally, employers have much more influence on psychosocial hazards than individual workers can have. Initiatives at the sector level such as wage agreements, and agreements between labour unions and employer federations on general working conditions can help solve problems such as time pressure, excessive workloads, lack of information and participation, and poor management.

Employer actions

Employers can mitigate the effects on their employees of factors such as time pressure, conflicting demands, high workload and monotonous work by realistic costing and planning of the required work. They can mitigate the effects of poor management styles by retraining or replacing managers. They can mitigate problems of lack of information by improving communication with the cleaning workers. They can also offer training to help workers to improve their ability to cope with the demands of the work.

Individual actions

Individual cleaners, or groups of cleaners, can mitigate the effects of factors such as isolation, harassment, and violence by maintaining contact with other workers and by reporting incidents of violence and harassment. In order to mitigate the psychosocial risks associated with the physical demands of the job they can approach the employer to change the working practices or to provide new equipment.

Policy context

Cleaning work has many features such as low occupational and educational status, non-standard working hours, part-time work, contractor status, temporary contracts, shortage of staff, under-resourcing, a high workload, lack of control, negative customer attitudes, business rivalry, aggressive customers and lack of training, that make it unattractive as a career choice. As a result, the sector has high staff turnover and difficulties in recruitment. This, in turn, can affect the skills available in the profession or create skills gaps. These negative factors can damage the reputation and perceptions of the occupation and the sector. The challenge is to reverse these negative perceptions by improving working conditions[27]. Moreover, the cleaning industry is very labour-intensive[2], with a high percentage of the total costs being labour. Therefore, changes in social and/or economic legislation in the industry can have a direct impact on the financial state of cleaning professionals. One of the challenges in improving working conditions is to ensure that both employees and employers get involved in the process of managing psychosocial risks. This puts emphasis on social dialogue and the role of the unions. Moreover, cultural differences between countries and regions can lead to differences in enforcement and interpretation. Cultural differences between workers in different regions may also lead to differences in preferences about working conditions. This could present a challenge for worker representatives involved in social dialogue[27].

Conclusions

Professional cleaners are exposed to hazards that must be managed to prevent them getting hurt. These include psychosocial factors such as work organisation, stress, violence and harassment[20] as well as exposure to other OSH risks such as chemicals or poor ergonomics. Cleaning workers generally have limited influence on how they do their work so cannot control many of the psychosocial hazards that affect them, such as the organisation, pace and scheduling of work. They have few opportunities for career advancement, and they enjoy few professional benefits. They often lack support from their immediate supervisors. They should be given more opportunities to take part in planning and developing their work [17] [28] to reduce psychosocial risks and associated health problems.

References

  1. 1.0 1.1 EuroFound – European Foundation for the Improvement of Living and Working Conditions, Fifth European Working Conditions Survey, 2012. Retrieved 3 April 2013, from: [1]
  2. 2.0 2.1 2.2 EFCI – European Federation of Cleaning Industries, The cleaning industry in Europe - an EFCI Survey. EFCI, Brussels, 2008. 2012 edition available as a priced publication at: [2]
  3. 3.0 3.1 EU-OSHA - European Agency for Safety and Health at Work, The occupational safety and health of cleaning workers’, 2009. Available at: [3]
  4. Council Directive 89/391/EEC on the introduction of measures to encourage improvements in the safety and health of workers at work (OJ No. L 183, 29.6.89, p. 1). Available at: : [4]
  5. Council Directive 89/654/EEC (OJ L. 393, 30.12.89, p. 1) concerning the minimum safety and health requirements for the workplace. Available at:: [5]
  6. Directive 2004/37/EC on the protection of workers from the risks related to exposure to carcinogens or mutagens at work (Sixth individual Directive within the meaning of Article 16(1) Directive 89/391/EEC) (OJ L 229, 29.6.2004, pp. 23-34). Available at: [6]
  7. Directive 2000/54/EC on the protection of workers from risks related to exposure to biological agents at work (seventh individual directive within the meaning of Article 16(1) of Directive 89/391/EEC) (OJ L 262, 17.10.2000, pp. 21-45). Available at: [7]
  8. Council Directive 98/24/EC on the protection of the health and safety of workers from the risks related to chemical agents at work (fourteenth individual Directive within the meaning of Article 16(1) of Directive 89/391/EEC) (OJ L 131, 5.5.1998, p. 11). Available at: [8]
  9. Council Directive 90/269/EEC (OJ No. L 156, 21.6.90, p. 9) on the minimum health and safety requirements for the manual handling of loads where there is a risk particularly of back injury to workers. Available at: [9]
  10. Council Directive 89/655/EEC (OJ No. L393, 30.12.89, p. 13) on the minimum safety and health requirements for the use of work equipment by workers at work. Available at: [10]
  11. Council Directive 89/656/EEC (OJ No. L 393, 30.12.89, p. 18) on the minimum health and safety requirements for the use by workers of personal protective equipment at the workplace. Available at: [11]
  12. Council Directive 92/85/EEC on the introduction of measures to encourage improvements in the safety and health at work of pregnant workers and workers who have recently given birth or are breastfeeding (OJ L 348, 28.11.1992, p. 1). Available at: [12]
  13. 13.0 13.1 ETUC, Business Europe, UEAPME and CEEP - European Trade Union Confederation, The Confederation of European Business, European Association of Craft Small and Medium-Sized Enterprises, European Centre of Enterprises With Public Participation and of Enterprises of General Economic Interest, Framework agreement on harassment and violence at work, 26 April 2007. Available at: [13]
  14. 14.0 14.1 14.2 14.3 EU-OSHA – European Agency for Safety and Health at Work (no date), Managing psychosocial risks with cleaning workers, Efact 51. Retrieved on 7 June 2013, from: [14]
  15. Karasek, R. & Theorell, T., Healthy work: stress, productivity, and the reconstruction of working life, Basic Books, New York, 1990.
  16. Johnson, J. V. & Hall, E. M., ‘Job strain, work place social support and cardiovascular disease: A cross sectional study of a random sample of the Swedish working population’, American Journal of Public Health, Vol. 78, 1988, pp. 1336-1342.
  17. 17.0 17.1 Krüger, D., Louhevaara, V., Nilsen, J. & Schneider, T., Risk Assessment and Preventive Strategies in Cleaning Work, Wirtschaftsverlag NW, Bremerhaven, 1997.
  18. Zock, J. P., ‘World at work: Cleaners’, Occup.Environ.Med., Vol. 62, Iss 8, 2005, pp. 581-584.
  19. EU-OSHA - European Agency for Safety and Health at Work, Workplace violence and harassment: A European picture, 2010. Retrieved 7 June 2013, from: [15]
  20. 20.0 20.1 20.2 Gamperiene, M., Nygard, J. F., Sandager, I., Waersted, M. & Bruusgaard, D., ‘The impact of psychosocial and organizational working conditions on the mental health of female cleaning personnel in Norway’, J.Occup.Med.Toxicol., Vol. 1, Article 24, 2006.
  21. EuroFound – European Foundation for the Improvement of Living and Working Conditions, Fourth European working conditions survey, 2007. Available at: [16]
  22. Eurostat, Health and safety at work in Europe (1999–2007) A statistical portrait. Available at:: [17]
  23. Hemingway, H. & Marmot, M., ‘Psychosocial factors in the aetiology and prognosis of coronary heart disease: systematic review of prospective cohort studies’, British Medical Journal, Vol. 318, Iss 7196, 1999, pp. 1460-1467.
  24. Chang, J. H., Wu, J. D., Liu, C. Y. & Hsu, D. J., ‘Prevalence of musculoskeletal disorders and ergonomic assessments of cleaners’, Am.J.Ind.Med., Vol. 55, Iss 7, 2012, pp. 593-604.
  25. da Costa, B. R. & Vieira, E. R., ‘Risk factors for work-related musculoskeletal disorders: a systematic review of recent longitudinal studies’, Am.J.Ind.Med. , Vol. 53, Iss 3, 2010, pp. 285-323.
  26. Hauke, A., Flintrop, J., Brun, E. & Rugulies, R., ‘The impact of work-related psychosocial stressors on the onset of musculoskeletal disorders in specific body regions: A review and meta-analysis of 54 longitudinal studies’, Work & Stress, Vol. 25, Iss 3, 2011, pp. 243-256.
  27. 27.0 27.1 EuroFound - European Foundation for the Improvement of Living and Working Conditions (2003). Preventing violence and harassment in the workplace. Available at: [18]
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Links for further reading

BAuA - Federal Institute for Occupational Safety and Health, Integriertes Managementsystem im Gebäudereiniger-Handwerk, Fourth Edition, 2005. Available at: [19]

Bultmann, U., Kant, I. J., Schroer, C. A. & Kasl, S. V., ‘The relationship between psychosocial work characteristics and fatigue and psychological distress’, Int.Arch.Occup.Environ.Health, Vol. 75, Iss 4, 2002, pp. 259-266.

Charles, L. E., Loomis, D. & Demissie, Z., ‘Occupational hazards experienced by cleaning workers and janitors: A review of the epidemiologic literature’, Work, Vol. 34, Iss 1, 2009, pp. 105-116. Available at doi: 10.3233/WOR-2009-0907

Eurofound - European Foundation for the Improvement of Living and Working Conditions (2013). Eurofound. Retrieved on 7 June 2013, from: [20]

European Cleaning Journal. Available at: [21]

EU-OSHA - European Agency for Safety and Health at Work (2009). Preventing Harm to Cleaning Workers. Retrieved 7 February 2013, from: [22]

EU-OSHA - European Agency for Safety and Health at Work (2009). Workforce diversity and risk assessment. Case 3.2.3.: Reducing stress among female cleaners at a hospital. Retrieved 7 February 2013, from: [23]

EWCO - European Working Conditions Observatory (2013). European Working Conditions Observatory (EWCO). Retrieved on 7 June 2013, from: [24]

Gamperiene, M., Nygard, J. F., Brage, S., Bjerkedal, T. & Bruusgaard, D., ‘Duration of employment is not a predictor of disability of cleaners: A longitudinal study’, Scand.J.Public Health, Vol. 31, Iss 1, 2003, pp. 63-68.

Health and Safety Executive (no date). Work related stress - together we can tackle it. Retrieved on 7 June 2013, from: [25]

Health and Safety Executive UK (2012). Health and safety in the cleaning industry. Retrieved 7 February 2013, from: [26]

Houtman, I., Jettinghoff, K. & Cedillo, L., Raising Awareness of Stress at Work in Developing Countries. Protecting Workers’ Health Series No. 6. World Health Organisation, Geneva, 2007. Available at: [27]

Michie, S., Wren, B. & Williams, S., ‘Reducing absenteeism in hospital cleaning staff: Pilot of a theory-based intervention’, Occup.Environ.Med., Vol. 61, Iss. 4, 2004, pp. 345-349.

Nolting, H.-D., Berger, J., Niemann, D., Schiffhorst, G., Genz, H. O. & Kordt, M., Stress bei Raumpfleger/innen. Berufsgenossenschaft fur Gesundheitsdienst und Wohlfahrtspflege (BGW) & Deutsche Angestellten Krankenkasse (DAK), Hamburg, 2000. Available at: [28]

Unison (2005). Cleaners’ voices. Interviews with hospital cleaning staff. Retrieved 7 February 2013, from: [29]