Scope, Effects and Causes of Work-Related Stress

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1 Scope, Effects and Causes of Work-Related Stress Work-related stress can be defined as the adverse reaction that people have to excessive pressure or other demands placed on them at work. Though not a disease, chronic stress can cause ill-health and may act as a trigger for mental health problems such as anxiety and depression. According to the European Agency for Safety and Health at Work, stress is the second most reported workrelated ill-health complaint, affecting 22% of workers in the 27 EU member states in Stress causes a range of physical and behavioural symptoms in the short-term which can go on to become serious ill-health conditions such as anxiety and depression, high blood pressure (hypertension) and heart disease. The causes of work-related stress can be characterised as: Organisational factors (such as unreasonable pace of work, inadequate managerial support or demanding work schedules). Personal relationships (including bullying/harassment and feelings of isolation). Physical factors in the workplace (such as lighting, noise, temperature, etc.). The UK HSE have developed an approach to stress based on management standards, establishing six standards to be achieved by the organisation under the following headings: demands, control, support, relationships, role and change. Work-Related Stress Work-Related Stress The HSE in the UK defines work-related stress as the adverse reaction people have to excessive pressures or other types of demand placed on them at work. The European Agency for Safety and Health at Work expands upon this by stating that people experience stress when they perceive that there is an imbalance between the demands made of them and the resources they have available to cope with those demands. Stress is not an illness or disease, but a natural reaction to pressure. Unrelieved stress can cause disease. It certainly contributes to poor work performance and absence. Pressure is an inherent part of work, whether it is a deadline that must not be missed, a rate of output that must be maintained, multiple demands that must all be met simultaneously or simply the risk of massive financial loss if work does not go well. Pressure does not necessarily lead to stress. In many circumstances people are able to cope with the pressure they are under. In fact, in many situations pressure is a good thing. It results in a positive performance, maintains motivation and interest and improves health. However, in some instances a person finds themselves unable to cope with the pressure that they are under. This leads to a negative reaction, rather than a positive one. This reaction is psychological in origin, i.e. the negative reaction is in the mind. If the pressure is short term, then the person may show some of the signs and symptoms of stress, but it is unlikely that there will be any significant health consequences. It is a common experience to suffer a few sleepless nights worrying about an exam or an interview; you prepare yourself as best you are able, then afterwards the pressure is relieved and the worry goes away. But if the pressure continues or increases, then the relatively minor symptoms of stress can escalate into physical and/or mental ill-health. Work-related stress should not be confused with anxiety or depression. These are common mental health problems that can and do exist entirely independently of work-related stress. It is estimated that a quarter of the population will suffer some form of mental illness at some stage in their lives. The two most common forms RRC Training Unit IB Element IB8 8-1

2 of mental illness are anxiety and depression. Many of the signs and symptoms of anxiety and depression are the same as those for stress. It is possible to suffer from these mental health problems without being stressed or under any pressure (work-related or not). However, it must be recognised that there is a strong relationship between these mental health problems and work-related stress. The one can trigger or contribute to the other, and vice-versa. Physical and Psychological Effects The physical effects of stress in the workplace can involve a range of symptoms which include: Raised heart rate. Increased sweating. Headaches. Dizziness. Blurred vision. Aching neck and shoulders. Skin rashes. Lowered resistance to infection. These symptoms are usually short-lived, depending on the nature of the stressful condition. As well as physical effects, stress can also cause psychological and behavioural changes such as: Increased worrying and irritability. Increased alcohol consumption. Increased smoking. Difficulty sleeping. Poor concentration. Loss of appetite or overeating. Inability to cope with everyday tasks and situations. Again these symptoms may be short-term in response to an isolated, finite period of excessive pressure. If excessive pressure remains and the individual cannot cope in the long term, then chronic symptoms and disease may occur. Examples of these are: Anxiety and depression. High blood pressure (hypertension). Heart disease. Eczema and psoriasis. Irritable bowel syndrome. Susceptibility to ulcers. Loss of libido, erectile dysfunction (in men) and irregular menstrual cycle (in women). We can see, therefore, that chronic stress may lead to a range of serious ill-health conditions and diseases, and should be treated seriously as a workplace hazard. Causes of Work-Related Stress One of the problems with dealing with stress as an occupational health matter is that different people have different abilities to cope with pressure at work. These abilities vary massively between people and are influenced by many factors such as personality, cultural background, experience, education, motivation, etc. Also, the coping abilities of an individual are not set, but vary over time. Indeed, many people find that the trigger that sets off an inability to cope with work-related stress does not come from within work at all; it comes from outside. Personal bereavement, separation, divorce, family ill-health and other stressors outside of work render the individual unable to deal with work pressures that they would ordinarily cope with. Therefore it is not easy to identify one cause, or even several different causes, responsible for stress. There is a range. In the UK the HSE has focused a great deal of effort on the identification and control of work-related stress and has developed a series of stress management standards. There are 6 identified causes of stress, each with an accompanying management standard: Demands this includes issues such as workload, work patterns and the work environment. Control how much say the person has in the way they do their work. Support this includes the encouragement, sponsorship and resources provided by the organisation, line management and colleagues. Relationships this includes promoting positive working to avoid conflict and dealing with unacceptable behaviour. Role whether people understand their role within the organisation and whether the organisation ensures they do not have conflicting roles. Change how organisational change (large or small) is managed and communicated in the organisation. (Continued) Unit IB Element IB8 8-2 RRC Training

3 These six management standards represent a framework against which an organisation can benchmark its performance through the risk assessment process. For each standard the HSE has set out a description of the standard to be met, along with a description of some of the actions that would be observable within the organisation if the standard were being achieved (indicators that the standard is being met). For example, under the management standard entitled Demands: The standard is that: employees indicate that they are able to cope with the demands of their jobs; and systems are in place locally to respond to any individual concerns. What should be happening/states to be achieved: the organisation provides employees with adequate and achievable demands in relation to the agreed hours of work; people s skills and abilities are matched to the job demands; jobs are designed to be within the capabilities of employees; and employees concerns about their work environment are addressed. Organisations can, therefore, use various methods to benchmark their performance against each of these management standards and then use the result of that benchmarking exercise to identify which standards are being achieved already, which are being approached and which are being missed. This then allows for the correct identification of priorities and action planning to address those priorities. In order to investigate the causes of stress in more detail, it is useful to look individually at the following factors. You will see that these can be related to the stress management standards contained in the Topic Focus. Organisational Factors These factors arise from the culture and individual management style of the organisation and include: Unreasonable pace of work work overload, combined with unreasonable time pressures, can create demands which are beyond the ability of the worker. Lack of control over work it is often found that workers on the shop-floor, or at junior levels, experience harmful levels of stress because they are less able to exercise control over their workload. Inadequate managerial support a lack of understanding and leadership from managers and supervisors can be stressful if staff feel that they are not being given direction and the problems that they face are not appreciated by management. Demanding work schedules any changes in work practices are likely to be perceived as stressful, but arrangements involving varying patterns of shift work, long hours and unsocial or unpredictable hours can generate high levels of psychological, and also physical, stress. Organisation of Work is Important to Avoid Work-Related Stress Personal Relationships As well as the general organisational issues listed above, there is a range of factors that affect the individual personally: Feelings of isolation issues associated with interpersonal relationships are an important source of occupational stress, and interpersonal conflict between staff can result in both social and physical isolation, and lack of social support. Bullying and harassment the conflict referred to above may be manifested in more serious forms of aggressive behaviour towards individuals, such as bullying and harassment. RRC Training Unit IB Element IB8 8-3

4 Poor Working Relationships are Often a Cause of Stress Physical Factors in the Workplace There are many aspects of the physical environment which have both psychological and physical health effects, including, for example: Lighting. Temperature. Noise. Space. Ergonomic design. These agents are covered elsewhere in this course, but it is important to bear in mind the psychological effects that may arise from conditions of exposure that would not normally be considered a physical risk. Working Hours As we noted above, the number of hours worked and the pattern of hours worked may have a significant effect on employee wellbeing. There are many useful and interesting resources available for work-related stress. Try the following: Introduction.aspx hazards/stress/stress.html Revision Questions 1. What are the short-term symptoms that might arise in staff who are suffering high levels of stress? 2. Which organisational factors could be responsible for creating avoidable workplace stress? (Suggested Answers are at the end of the book.) Unit IB Element IB8 8-4 RRC Training v2.1

5 Identification and Control of Stress Organisations can benchmark their performance against the six standards established by the UK HSE in a variety of ways, for example by carrying out staff surveys. Practical measures to control stress focus on two main areas: Changing the source of the problem (i.e. the physical environment or the management style). Changing the individual s response to the problem. Risk reduction measures have to be tailored to meet the specific needs of the organisation. Identification of Work-Related Stress There are a number of tools and techniques which can be employed in order to identify whether an organisation has an issue with work-related stress. The important thing to remember is that unless an organisation asks questions of its workers in an open manner they will only find out about problems once it is too late and people are already suffering from stress. Techniques which can be employed include: Discussions informal discussions with workers, through discussion groups or forums, can provide an opportunity for workers to voice concerns over work-related stress. Absence data reviewing absence data can provide useful information on stress-related absence. However, it should also be noted that in many instances absence may not be listed as stress or stress-related due to the perceived stigma which still exists in some environments. Often the symptoms of stress (such as stomach upset ) may be given rather than the cause. Interviews more formal interviews may be conducted in order to gauge worker feedback on the prevalence of work-related stress. These could take the form of exit interviews for those leaving the organisation, or be incorporated into worker performance reviews. Surveys and questionnaires these techniques can be used to survey the attitude and opinion of the workplace as a whole. This is a sensible approach as it takes the benchmarking exercise out of management hands (where management perceptions may bias the results) and relies on direct feedback from employees about their perception of the cultural standards. Since it is the personal opinions of employees that matter in the context of stress management, this is a very useful way of gathering data on perceived standards. An example of a survey questionnaire is the management standards indicator tool designed by the UK HSE, along with the survey analysis software that can be used to analyse its results: The questionnaire contains 35 questions and is two pages long. The intention is that it will be completed anonymously by all, or a very significant sample of, staff and used to give an indication of the level of compliance with each of the six management standards. It is not intended as a personal stress indicator tool and does not necessarily give any indication of the ability of any one individual to cope with their work pressures. The indicator tool does not have to be used. Organisations are free to adapt the survey questionnaire to suit their own purposes or use other questionnaires instead. Analysis of the indicator tool allows the organisation to identify their current level of performance against each of the six management standards and highlight areas for improvement. The organisation then has to act on these results and has to design a series of actions to address each. The HSE have indicated that larger organisations might take six months to carry out their risk assessment; involving use of the survey tool and analysis and evaluation for results, followed by a further 12 months to put action plans into effect and monitor results. Consequently, the risk assessment might be reviewed after a period of 18 months by completion of a second staff survey to find areas of improvement and areas of future concern. Productivity data productivity and performance are linked to stress, as workers under excessive pressure are prone to make more mistakes than those who are not stressed. It therefore follows that an organisation whose workers are stressed may experience higher waste and lower productivity. RRC Training Unit IB Element IB8 8-5

6 Staff turnover it is likely that an organisation experiencing a problem with work-related stress will have a higher than normal staff turnover level as workers seek alternative employment. This can also be explored during exit interviews. The UK HSE s management standards indicator tool is available at: downloads.htm Practical Control Measures The issues considered above give us a basis from which to identify the factors that can lead to stress at work, and how we might assess the level of risk. The next stage of the process involves the design and implementation of strategies for the prevention and control of the identified risks. We have already noted that stress is a more complex issue than some of the physical, chemical and biological agents we have already encountered, and involves the perceptual element associated with the individual as well as the stressor itself. As a result of this, strategies to prevent and control stress at work focus on two principal areas: Changing the Source of the Problem This strategy assumes that there are stressors arising from the workplace that are avoidable and workers should not be exposed to them. Consequently the aim is to improve aspects of two factors which are creating stressful conditions: The physical environment. The management style. Changing the Individual s Response to the Problem This strategy accepts that some sources of stress in the organisation are unavoidable, for example: Patterns of work or exposure to stressful conditions during accident/emergency response work. Individuals who are more vulnerable to stress due to factors arising from outside work. Effort should therefore be directed at helping these individuals to cope. We shall now consider in more detail the principal factors that may have an influence on the potential for stress in the workplace and the positive actions that can be taken to minimise their impact. Organisational Culture and Management The organisational culture has a considerable effect on the way individuals perceive and cope with their working environment. As health and safety professionals, we are aware of the long timescale involved in introducing an effective safety culture, so it is no surprise that changes to the organisational culture in response to an identified stress problem will not be achieved overnight. However, there are elements of good management practice that are effective in creating a positive culture which is less likely to generate avoidable stress: Clear company objectives. Good communication. Employee involvement during organisational change. Good management support, training and development. Management of Change Staff do not cope easily with the prolonged periods of high uncertainty that occur during organisational changes, and may be significantly affected by them. Again, the employment of good management practice during periods of change will help to reduce or remove unnecessary stress: Flexibility to try to accommodate the wishes of individuals. Scope for varying working conditions to increase ownership. An open attitude from managers to encourage trust. Ensuring fair treatment for staff involved in significant change. Ensuring training and resources to cope with new environments. Clarity of Roles A common source of individual stress is generated by the employee s misconception of his/her role in the organisation. This can cause overwork for staff who feel that they are obliged to respond to any demand made on them, or underwork for staff who are not clear about the precise nature or limits of their role in the organisation. It is important, therefore, that staff have: Clear personal objectives and responsibilities (documented in a written job description). An understanding of the organisational objectives and how their role fits into those objectives. Job Design and Staff Selection The issues associated with role definition are closely linked to those of job design. As well as people knowing what job they have to do, they should be confident that they can carry it out properly. It is important that the job Unit IB Element IB8 8-6 RRC Training

7 matches the abilities and skills of the person selected for it. This may mean: Involving the person in some aspects of job design. Carefully identifying the requirements of the job and the skills and experience of the person to be recruited. Offering early training and instruction. When faced with the problem of job design and the avoidance of built-in stressors, factors to consider include: Clear definition of tasks and responsibilities. Introduction of variety and avoidance of short work cycles. Proper use of skills. Proper training for those constantly dealing with the public or client groups. Proper hazard control. Work Schedules Following on from job design, a common area where potential stressors develop is that of work organisation and work schedules. Problems that we have already referred to include patterns of shift work and long, unsocial or unpredictable hours. In addition, changes in work schedules which may result from management change are a well-recognised source of stress for most workers. Some of these difficulties may be avoided by giving consideration to: Flexible work schedules. Planned and agreed work hours. Setting targets that stretch the individual but are reasonable. Relationships at Work Issues associated with interpersonal relationships are recognised as one of the main sources of occupational stress. This includes conflict between colleagues or with subordinates or superiors, or a general lack of social support which may be a result of physical, or even social, isolation. There can also be problems that arise from racial or sexual harassment, or workplace bullying. These issues can all create stress for the individuals involved and are often difficult to prevent or resolve. However, measures that can be used to try to combat these problems include: Training in interpersonal skills. Effective systems to deal with interpersonal conflict, bullying and racial or sexual harassment, including: Grievance procedures. Proper investigation of complaints. Stress Awareness and Counselling Services Many organisations provide training and services in order to help employees cope with inevitable stresses arising from their work. Training in stress management or stress awareness is a common control, as is the provision of counselling services for employees. Whilst these are useful tools, they do not combat stress at source; they only assist the worker in managing their response to stress or the situation. In civil law, judges have held that the provision of counselling services is not an adequate control and that more should be done to combat stress before workers are affected. Return to Work Policies In the event that a worker has been absent due to stress, an effective return to work policy should be in place to assist the worker as they are managed back into the workplace. Organisations who fail to acknowledge that the worker may be vulnerable may face heavy sanctions in the civil courts in the event that the worker s stress returns. Occupational health services can be invaluable resources in assisting managers as workers return to duties by agreeing what conditions need to be placed upon them to ease their return to the workplace. As always, useful information and further resources are available from the UK HSE: More information is available from the EU-OSHA website at: Revision Questions 3. Discuss examples of good management practice that can serve to reduce stress levels in an organisation that is undergoing change. 4. What measures could be taken to reduce individual stress by improving work relationships? (Suggested Answers are at the end of the book.) RRC Training Unit IB Element IB8 8-7