The longer he waited, the more David worried. For weeks he had been plagued
by aching muscles, loss of appetite, restless sleep, and a complete sense of
exhaustion. At first he tried to ignore these problems, but eventually he became
so short-tempered and irritable that his wife insisted he get a checkup. Now,
sitting in the doctor’s office and wondering what the verdict would be, he didn’t
even notice when Theresa took the seat beside him. They had been good friends
when she worked in the front office at the plant, but he hadn’t seen her since she
left three years ago to take a job as a customer service representative. Her gentle
poke in the ribs brought him around, and within minutes they were talking and
gossiping as if she had never left.
Scope of Stress in the American Workplace
David’s and Theresa’s stories are unfortunate but not unusual. Job stress has
become a common and costly problem in the American workplace, leaving few
workers untouched. For example, studies report the following:
- One-fourth of employees view their jobs as the number
one stressor in their lives.
—Northwestern National Life
- Three-fourths of employees believe the worker has more
on-the-job stress than a generation ago.
—Princeton Survey Research Associates
- 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.
—St. Paul Fire and Marine Insurance Co.
Fortunately, research on job stress has greatly expanded in recent years. But in
spite of this attention, confusion remains about the causes, effects, and prevention
of job stress. This booklet summarizes what is known about job stress and what
can be done about it.
What is Job Stress?
Job stress can be defined as the harmful physical and emotional responses that
occur when the requirements of the job do not match the capabilities, resources,
or needs of the worker. Job stress can lead to poor health and even injury.
The concept of job stress is often confused with challenge, but these concepts are
not the same. Challenge energizes us psychologically and physically, and it
motivates us to learn new skills and master our jobs. When a challenge is met, we
feel relaxed and satisfied. Thus, challenge is an important ingredient for healthy
and productive work. The importance of challenge in our work lives is probably
what people are referring to when they say “a little bit of stress is good for you.”
But for David and Theresa, the situation is different—the challenge has turned
into job demands that cannot be met, relaxation has turned to exhaustion, and a
sense of satisfaction has turned into feelings of stress. In short, the stage is set for
illness, injury, and job failure.
What are the Causes of Job Stress?
Nearly everyone agrees that job stress results from the interaction of the worker
and the conditions of work. Views differ, however, on the importance of worker
characteristics versus working conditions as the primary cause of job stress.
These differing viewpoints are important because they suggest different ways to
prevent stress at work.
According to one school of thought, differences in individual characteristics such
as personality and coping style are most important in predicting whether certain
job conditions will result in stress—in other words, what is stressful for one
person may not be a problem for someone else. This viewpoint leads to
prevention strategies that focus on workers and ways to help them cope with
demanding job conditions.
Although the importance of individual differences cannot be ignored, scientific
evidence suggests that certain working conditions are stressful to most people.
The excessive workload demands and conflicting expectations described in
David’s and Theresa’s stories are good examples. 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.
NIOSH Approach to Job Stress
On the basis of experience and research, NIOSH favors the view that working
conditions play a primary role in causing job stress. However, the role of
individual factors is not ignored. According to the NIOSH view, exposure to
stressful working conditions (called job stressors) can have a direct influence on
worker safety and health. But as shown below, individual and other situational
factors can intervene to strengthen or weaken this influence. Theresa’s need to
care for her ill mother is an increasingly common example of an individual or
situational factor that may intensify the effects of stressful working conditions.
Examples of individual and situational factors that can help to reduce the effects
of stressful working conditions include the following:
- Balance between work and family or personal life
- A support network of friends and coworkers
- A relaxed and positive outlook
Job Conditions That May Lead to Stress
The Design of Tasks. Heavy workload, infrequent rest breaks,
long work hours and shiftwork; hectic and routine tasks that have little
inherent meaning, do not utilize workers’ skills, and provide little sense
of control.
Example: David works to the point of exhaustion. Theresa is tied
to the computer, allowing little room for flexibility, self-initiative,
or rest.
Management Style. Lack of participation by workers in decisionmaking,
poor communication in the organization, lack of familyfriendly
policies.
Example: Theresa needs to get the boss’s approval for everything,
and the company is insensitive to her family needs.
Interpersonal Relationships. Poor social environment and lack
of support or help from coworkers and supervisors.
Example: Theresa’s physical isolation reduces her opportunities to
interact with other workers or receive help from them.
Work Roles. Conflicting or uncertain job expectations, too much
responsibility, too many “hats to wear.”
Example: Theresa is often caught in a difficult situation trying to
satisfy both the customer’s needs and the company’s expectations.
Career Concerns. Job insecurity and lack of opportunity for
growth, advancement, or promotion; rapid changes for which workers
are unprepared.
Example: Since the reorganization at David’s plant, everyone is
worried about their future with the company and what will happen
next.
Environmental Conditions. Unpleasant or dangerous physical
conditions such as crowding, noise, air pollution, or ergonomic
problems.
Job Stress and Health
Stress sets off an alarm in the brain, which responds by preparing the body
for defensive action. The nervous system is aroused and hormones are
released to sharpen the senses, quicken the pulse, deepen respiration, and
tense the muscles. This response (sometimes called the fight or flight
response) is important because it helps us defend against threatening
situations. The response is preprogrammed biologically. Everyone responds
in much the same way, regardless of whether the stressful situation is at
work or home.
Short-lived or infrequent episodes of stress pose little risk. But when
stressful situations go unresolved, the body is kept in a constant state of
activation, which increases the rate of wear and tear to biological systems.
Ultimately, fatigue or damage results, and the ability of the body to repair
and defend itself can become seriously compromised. As a result, the risk
of injury or disease escalates.
In the past 20 years, many studies have looked at the relationship between
job stress and a variety of ailments. Mood and sleep disturbances, upset
stomach and headache, and disturbed relationships with family and friends
are examples of stress-related problems that are quick to develop and are
commonly seen in these studies. These early signs of job stress are usually
easy to recognize. But the effects of job stress on chronic diseases are more
difficult to see because chronic diseases take a long time to develop and can
be influenced by many factors other than stress. Nonetheless, evidence is
rapidly accumulating to suggest that stress plays an important role in
several types of chronic health problems—especially cardiovascular
disease, musculoskeletal disorders, and psychological disorders.
Early Warning Signs of Job Stress
Headache
Sleep disturbances
Difficulty in concentrating
Short temper
Upset stomach
Job dissatisfaction
Low morale
Job Stress and Health:
What the Research Tells Us
Cardiovascular Disease
Many studies suggest that psychologically demanding jobs that allow employees
little control over the work process increase the risk of cardiovascular disease.
Musculoskeletal Disorders
On the basis of research by NIOSH and many other organizations, it is widely
believed that job stress increases the risk for development of back and upperextremity
musculoskeletal disorders.
Psychological Disorders
Several studies suggest that differences in rates of mental health problems (such as
depression and burnout) for various occupations are due partly to differences in job
stress levels. (Economic and lifestyle differences between occupations may also
contribute to some of these problems.)
Workplace Injury
Although more study is needed, there is a growing concern that stressful working
conditions interfere with safe work practices and set the stage for injuries at work.
Suicide, Cancer, Ulcers, and Impaired Immune Function
Some studies suggest a relationship between stressful working conditions and these
health problems. However, more research is needed before firm conclusions can be
drawn.
—Encyclopaedia of Occupational Safety and Health
Stress, Health, and Productivity
Some employers assume that stressful working conditions are a necessary evil—
that companies must turn up the pressure on workers and set aside health
concerns to remain productive and profitable in today’s economy. But research
findings challenge this belief. Studies show that stressful working conditions are
actually associated with increased absenteeism, tardiness, and intentions by
workers to quit their jobs—all of which have a negative effect on the bottom line.
Recent studies of so-called healthy organizations suggest that policies benefiting
worker health also benefit the bottom line. A healthy organization is defined as
one that has low rates of illness, injury, and disability in its workforce and is also
competitive in the marketplace. NIOSH research has identified organizational
characteristics associated with both healthy, low-stress work and high levels of
productivity. Examples of these characteristics include the following:
- Recognition of employees for good work performance
- Opportunities for career development
- An organizational culture that values the individual worker
- Management actions that are consistent with organizational values
What Can Be Done About Job Stress?
The examples of Theresa and David illustrate two different approaches for
dealing with stress at work.
Stress Management. Theresa’s company is providing stress management
training and an employee assistance program (EAP) to improve the ability of
workers to cope with difficult work situations. Nearly one-half of large companies
in the United States provide some type of stress management training for their
workforces. Stress management programs teach workers about the nature and
sources of stress, the effects of stress on health, and personal skills to reduce
stress—for example, time management or relaxation exercises. (EAPs provide
individual counseling for employees with both work and personal problems.)
Stress management training may rapidly reduce stress symptoms such as anxiety
and sleep disturbances; it also has the advantage of being inexpensive and easy to
implement. However, stress management programs have two major
disadvantages:
- The beneficial effects on stress symptoms are often short-lived.
- They often ignore important root causes of stress because they focus on the
worker and not the environment.
Organizational Change. In contrast to stress management training and
EAP programs, David’s company is trying to reduce job stress by bringing in a
consultant to recommend ways to improve working conditions. This approach is
the most direct way to reduce stress at work. It involves the identification of
stressful aspects of work (e.g., excessive workload, conflicting expectations) and
the design of strategies to reduce or eliminate the identified stressors. The
advantage of this approach is that it deals directly with the root causes of stress at
work. However, managers are sometimes uncomfortable with this approach
because it can involve changes in work routines or production schedules, or
changes in the organizational structure.
As a general rule, actions to reduce job stress should give top priority to
organizational change to improve working conditions. But even the most
conscientious efforts to improve working conditions are unlikely to eliminate
stress completely for all workers. For this reason, a combination of
organizational change and stress management is often the most useful
approach for preventing stress at work.
Preventing Job Stress – Getting Started
No standardized approaches or simple “how to”
manuals exist for developing a stress prevention
program. Program design and appropriate
solutions will be influenced by several factors—
the size and complexity of the organization,
available resources, and especially the unique
types of stress problems faced by the
organization. In David’s company, for example,
the main problem is work overload. Theresa, on
the other hand, is bothered by difficult
interactions with the public and an inflexible work schedule.
Although it is not possible to give a universal prescription for preventing stress
at work, it is possible to offer guidelines on the process of stress prevention in
organizations. In all situations, the process for stress prevention programs
involves three distinct steps: problem identification, intervention, and
evaluation. These steps are outlined beginning on page 17. For this process to
succeed, organizations need to be adequately prepared. At a minimum,
preparation for a stress prevention program should include the following:
- Building general awareness about job stress (causes, costs, and control)
- Securing top management commitment and support for the program
- Incorporating employee input and involvement in all phases of the
program
- Establishing the technical capacity to conduct the program (e.g.,
specialized training for in-house staff or use of job stress consultants)
Bringing workers or workers and managers together in a committee or
problem-solving group may be an especially useful approach for developing a
stress prevention program. Research has shown these participatory efforts to
be effective in dealing with ergonomic problems in the workplace, partly
because they capitalize on workers’ firsthand knowledge of hazards
encountered in their jobs. However, when forming such working groups, care
must be taken to be sure that they are in compliance with current labor laws.*
Steps Toward Prevention
Low morale, health and job complaints, and employee turnover often provide the
first signs of job stress. But sometimes there are no clues, especially if employees
are fearful of losing their jobs. Lack of obvious or widespread signs is not a good
reason to dismiss concerns about job stress or minimize the importance of a
prevention program.
Step 1 – Identify the Problem. The best method to explore the scope and
source of a suspected stress problem in an organization depends partly on the size
of the organization and the available resources. Group discussions among managers,
labor representatives, and employees can provide rich sources of information.
Such discussions may be all that is needed to track down and remedy stress
problems in a small company. In a larger organization, such discussions can be
used to help design formal surveys for gathering input about stressful job conditions
from large numbers of employees.
Regardless of the method used to collect data, information should be obtained
about employee perceptions of their job conditions and perceived levels of stress,
health, and satisfaction. The list of job conditions that may lead to stress (page 9)
and the warning signs and effects of stress (page 11) provide good starting points
for deciding what information to collect.
Objective measures such as absenteeism,
illness and turnover rates, or
performance problems can also be
examined to gauge the presence and
scope of job stress. However, these
measures are only rough indicators of
job stress—at best.
Data from discussions, surveys, and
other sources should be summarized
and analyzed to answer questions about
the location of a stress problem and job
conditions that may be responsible—
for example, are problems present
throughout the organization or confined
to single departments or specific jobs?
Step 2 – Design and Implement Interventions. Once the sources of
stress at work have been identified and the scope of the problem is understood,
the stage is set for design and implementation of an intervention strategy.
In small organizations, the informal discussions that helped identify stress
problems may also produce fruitful ideas for prevention. In large organizations, a
more formal process may be needed. Frequently, a team is asked to develop
recommendations based on analysis of data from Step 1 and consultation with
outside experts.
Certain problems, such as a hostile work environment, may be pervasive in the
organization and require company-wide interventions. Other problems such as
excessive workload may exist only in some departments and thus require more
narrow solutions such as redesign of the way a job is performed. Still other
problems may be specific to certain employees and resistant to any kind of
organizational change, calling instead for stress management or employee
assistance interventions. Some interventions might be implemented rapidly (e.g.,
improved communication, stress management training), but others may require
additional time to put into place (e.g., redesign of a manufacturing process).
Before any intervention occurs,
employees should be informed about
actions that will be taken and when they
will occur. A kick-off event, such as an
all-hands meeting, is often useful for
this purpose.
Step 3 – Evaluate the Interventions. Evaluation is an essential step in
the intervention process. Evaluation is necessary to determine whether the intervention
is producing desired effects and whether changes in direction are needed.
Time frames for evaluating interventions should be established. Interventions
involving organizational change should receive both short- and long-term
scrutiny. Short-term evaluations might be done quarterly to provide an early
indication of program effectiveness or possible need for redirection. Many
interventions produce initial effects that do not persist. Long-term evaluations are
often conducted annually and are necessary to determine whether interventions
produce lasting effects.
Evaluations should focus on the same
types of information collected during
the problem identification phase of the
intervention, including information
from employees about working
conditions, levels of perceived stress,
health problems, and satisfaction.
Employee perceptions are usually the
most sensitive measure of stressful
working conditions and often provide
the first indication of intervention
effectiveness. Adding objective
measures such as absenteeism and
health care costs may also be useful.
However, the effects of job stress
interventions on such measures tend to
be less clear-cut and can take a long
time to appear.
The job stress prevention process does not end with evaluation.
Rather, job stress prevention should be seen as a continuous process
that uses evaluation data to refine or redirect the intervention strategy.
From: CDC NIOSH
