Managing
Workplace Stress
Is modern life really
rubbish, or do people
complain too much?
Professor Craig A. Jackson
Head of Division of Psychology
Craig.Jackson@bcu.ac.uk
School of Social Sciences
Faculty of Education, Law & Social Sciences
Psychosocial Hazards
•Commonplace consideration in last 5 years
•Not straightforward
•All workplaces have potential to expose workers to hazards
•All social relationships have potential for stress
•Little relation between stress and occupational status
•Stress-Boom in last 3 years – VERY BIG INDUSTRY
“suffering from” & “recognising stress”
rapidly increasing issues
Workplace Hazards – current status
Shiftworking:
Long hours:
Psychosocial:
1 in 5 employed
likely to increase with growth
>48 hours per week
Fallen due to EWTD
Still > most of Europe
5 mill employees perceive effects
13 mill working days lost
Mundane occupations suffer
Chronic stress more problematic
Fatigue
Somatic symptoms
Sleep
MSDs
Depression
Cardiovascular
Accidents
Physical:
Noise
Dust
Chemical
Vibration
Technical
Changes
Monitoring
OELs
Depression
QoL
Negative Affectivity
Form of extreme pessimism
Hi. I need to see you
first thing Monday. It's
important. Try to enjoy
your weekend.
Boss
A good sign?
A bad sign?
Trouble?
Stress – The Basics
Definition problems
Not just at workplace
Individual response
Work-life Balance
Control Demand
Stress is not a useful concept:
Loose diagnostic criteria
Too many triggers
Too many responses
Too many effect modifiers
Used too casually
Fashionable
Positive perceptions
Not reliably measured
Personality
Cause of many secondary health problems
Top 5 UK Workplace Health Problems
1.
Hearing loss
NIHL, TTS, Exposure
2.
Respiratory problems
Recycling
Asbestosis, Carbon Black,
3.
Skin problemsHairdressers, Health care, Engineering
4.
Mental health Stress, Anxiety, Uncertainty
5.
Musculoskeletal disorders
Drivers
Desk workers, Cleaners,
France Telecom Case
Privatised in 1998
40,000 jobs lost since 1998
186,000 employees
45% of those outside France
4.3% fall in profits in 1Q of 2009
182 million customers in 5 continents
France Telecom Internationale'
45% of customers outside France
182 million customers in 5 continents
France Telecom Suicides
30 staff committed suicide 2008-2009
23 staff committed suicide 2010
French suicide rate:
26.4 per 100,000 male pop
9.2 per 100,000 female pop
17.8 per 100,000 all pop
France Telecom Cases
9th Sept: 49 yr old male employee stabbed
himself in meeting – told he would be
undergoing internal job transfer
11th Sep: 32 yr old female employee leapt to
death from office window
14th Sep: 53 yr old senior manager overdosed
1st Oct: 51yr old male employee jumped from
road bridge – note blamed work “atmosphere”
France Telecom Staff Situation
Uncertainty
New working conditions
Modernisation
Internal job transfers - Japanese problem
cultural & organisational changes needed
France Telecom's 2 Point Defence
“There were 28 suicides in the company in 2000, so 23
suicides over 17 months is actually an improvement and
not evidence of an epidemic”
“Most suicides caused by personal problems not
professional ones”
High Profile Case 1
2008
Isaac Blake VS Ragdoll Productions
“Cold-blooded murder of English Justice”
Tombliboo
Homophobia , Bullying, Harassment
Faulty animatronics - Painful work – hip joints
Lost 4 / 5 claims
Awarded £2000 for being called a “faggot” twice
High Profile Case 2
Armed response officer, aged 37
One of first female snipers in UK
90-strong team (88 males)
Hanged at home 2004
2003 Dismissed from firearms duties
Complained:
•Colleagues viewing porn video on a residential course
•Felt victimised in macho culture of firearms unit
•Fell out with a number of influential male colleagues
Sefton Coroner Christopher Sumner: “Paula Tomlinson
killed herself at a time that she was suffering from stress,
a contributory factor of which was work related.”
Stress Statistics
1995: Labour Force Survey
515,000 reported work-related stress
250,000 attributions of physical symptoms
30% increase in reports since 1990
1996: Institute of Management
270,000 daily absences for stress
£10.2 Billion cumulative annual cost
(sick pay, lost production, treatment)
2002: UK Health and Safety Executive
265,000 new “cases” in 2001
2000: Evans et al. Scottish heart attack deaths higher on Mondays
2004: UK Health and Safety Executive
13,000,000 working days lost / year -- £12 Billion cost
Stress Definitions
A.
Stress occurs when demands exist which are outside a person’s
capacity for meeting those demands
B.
Stress is a response to the presence of psychosocial hazards in
the workplace
C.
Stress is the reaction people have when they feel they cannot
cope with the pressures or demands placed upon them
Over-simplistic definitions !
Acute Stress and Chronic Stress
Common
After-effects
Leave behind
Life threatening
One-off
Ever-present
By proxy
Acute Hazards
Work characteristics
1. Potential for violence
Accident & Emergency Services
2. Peril or Danger
Expected Dangerous Conditions
3. Potential for aggression
Hazardous conditions
1. Verbal abuse
Ordinary Conditions
2. Physical abuse
Unpredictable Behaviour / Incident
3. PTSD inducement
Chronic Hazards
Job content
Work overload / underload
Hazardous conditions
Under utilisation of skills
Time pressures
Lack of control
Work organisation
Shift work
Working hours
unsociable
long
unpredictable
Work Culture
Communication too little (home-working) / too much (email)
Change / technology
Poor resources
No feedback
No decision process
Chronic Hazards (cont)
Work role
Ambiguity
Conflict
Advancement structure
Insecurity
Promotion
under / over
Low status
Poor pay
Environment
Hazards
physical / chemical
Home – work interface
Conflicting demands
Support
Domestic problems
Commuting
Interpersonal Conflict
Colleagues
Superiors
Subordinates
Personal Issues
Isolation
Lack of support
Harassment
Bullying
Violence
. . . Attitudes have changed
st
21
Century Satanic Mills
When did this happen?
NOTICE
OUR STAFF HAVE
THE RIGHT TO
WORK IN AN
ENVIRONMENT FREE
FROM VIOLENCE
We will prosecute
anyone found abusing
or threatening
employees
*
* This will not affect your treatment
Misperceptions of workplaces
UK Climate of:
over-perception of danger
stress being unavoidable
wanting too much in return
Common Popular Headlines
Legal Aspects
“Personal Injury”
Any impairment or any disease of a person’s physical or mental
condition
1974 Health and Safety at Work Act
“Assessments of risks of activities associated with potential hazards”
1992 Management of Health & Safety at Work Regulations
1. Johnstone
2. Walker
3. Jones
4. Hurley
5. Fearon
6. Armstrong
vs
vs
vs
vs
vs
vs
Bloomsbury H.A
Northumberland C.C.
Birmingham C.C
Gwent Constabulary
Martin
Home Office
Doctor
Social Worker
Teacher
Police officer
Burglar
Prison warder
High Profile Case 3
Andrew Hurley vs Gwent Constabulary
Armed Response Unit
First on scene of armed robbery – 3 offenders
Hurley shot 1. all 3 in custody
Won a commendation for the job
Resultant stress & depression
Left job 5 months later
Wanted £250,000 for loss of earnings and pension rights
Claimed offered no post-intervention counselling
Kept isolated for an hour after event – blood on hands
Evidence from Gwent Co. counselling offered 2 months post incident
Court of Appeal Guidelines (16 points)
Individuals who do not notify their employer of any
problems are less likely to succeed in claiming
compensation
Employers entitled to assume employee can withstand normal jobpressure unless any vulnerability or problem is known
No occupations should be regarded as intrinsically dangerous to
mental health
Employers offering counselling and access to treatment unlikely to
be found in breach of duty
Employers not in breach of duty if only option is to demote or fire
employee, if a willing worker continues in same job
Necessary to identify all steps employers (could) have taken before
finding them in breach
Traditional model of Disease
Pathogen
Modifiers
Lifestyle
Individual susceptibility
Disease (pathology)
Biopsychosocial model of Disease
Hazard
Psychoscial Factors
Attitudes
Behaviour
QoL
Illness (wellbeing)
Rise of the worker
as a “psychological
entity”
Psychosocial factors: core of ill-health
MSDs
Individual vulnerability
Personality type
Stress
Distress
Somatics
Experience
Mental Health
Learned behaviours
Will workers take responsibility
for their ill-health?
Historical Errors of Psychosocial View
Historically, distress was “blamed” for many ills
Now we know better…
CHD
Cholera
Pellagra
Beri Beri
Asthma
Down’s syndrome
Scurvy
Yellow fever
Typhoid
Peptic ulcer
All believed to be
caused by “stress”
or “distress” at one
time or another
Puts
“blame”
for
illness
on the
person
Commuting
“Cattle Truck Syndrome”
Chronic health problems exacerbated
by train travel?
Cumulative impact theory
Increased B.P, Anxiety,
Chronic Heart Conditions
Over-crowded trains / buses
Straining public transport system
Lack of control
Commuting
"People develop a
constant internal anger
on crowded trains that
they cannot easily
displace . . . an
individual‘s immune
system could also be
suppressed by stress,
making passengers more
susceptible to illnesses”
Long Working Hours
“Workaholism”
“Presenteeism”
“Unpaid Overtime”
uninterrupted heavy workload
heavy physical work
excessive demands from irregular
overtime and shift work
excessive workloads from emotional
stress, such as responsibility, transfers,
and conflicts
• irregular sleep habits
• decreases in rest
• decrease social time
• alcohol abuse
• increased smoking
• unhealthy diet
• neglecting medical checks
• breakdown in family life
High Profile Case 5
Psychological interventions can work
Cromwell Street Murders
John Bennett SIO
Team of 40 detectives
Sought “Stress Counselling”
Proactive
Some accepted – others did not
Before retirement . . . He did a little digging
Who has the “bad” jobs?
EXTREMELY STRESSFUL
Police
Fire
Ambulance
Prison
VERY STRESSFUL
Civil pilots
Media
Performers
Health care (non-emergency) Social work
Teaching
Mining
Nursing
Construction
ABOVE AVERAGE STRESS
Marketing
Publishing
Printing
Retail
Catering
Transport
HOW MUCH FAITH CAN BE PUT INTO BROAD
CATEGORIES?
Cooper 1988
Some Stress is good
Keeps one alert
Keeps one alive
Evolutionary perspective:
Too little stress = extinction
Too much stress = extinction
Balance stress = evolution
Pressure is good - - Stress is bad
Admissions and World Cup 1998
Examine hospital admissions for range of diagnoses on days
surrounding England's 1998 World Cup football matches
Hospital admissions obtained from English hospital episode statistics
Pop. Aged 15 – 64 years
Admissions for
• Acute MI
On match day
• Stroke
and 5 days after
• Deliberate self harmmatch day
• Road traffic injuries
Compared with admissions at the same time in 1997 and 1998
Carroll, D et al. 2002
Admissions and World Cup 1998
Major environmental events, whether physical catastrophes or
cultural disappointments, are capable of triggering myocardial
infarction.
If the triggering hypothesis is true, preventive efforts should consider
strategies for dealing with the effects of acute physical and
psychosocial upheavals.
“Perhaps the national lottery or even
the penalty shoot-out should be
abandoned on public health grounds.”
Limitations:
Harvesting effect?
Reporting tendency? Sudden deaths?
Iatrogenesis
Induced inadvertently by the
medical treatment or procedures
or activity, examination, manner
or discussion of a physician.
The term is now applied to any
adverse condition in a patient
occurring as the result of
treatment by a physician or
surgeon, (e.g. acquired infections)
A disease produced as a
consequence of medical or
surgical treatment.
Common Coping Styles
Adaptive coping
Seek those with similar experiences
Confront issue
Stick to a plan of action
Support seeking
Day to day basis
Change situation
Seek information
•LONG
•TERM
•STRATEGY
Maladaptive coping
Withdraw from people in general
Avoidance
Deny what has happened
Consumption
Drink, eat, smoke to relieve tension
Denial
•SHORT
•TERM
•STRATEGY
Individual Variability / Vulnerability
Differing Attitudes
&
Differing perceptions
Natural differences
Complex reasons
Experience
Personality
Learned behaviours
Stress is associated directly with workplaces
BUT
is also mediated by individual differences
No universal profile of what will certainly constitute
stressful situations
Vulnerable People
Important to be aware of vulnerable individuals and groups
Associated with socio-economic, cultural or demographic status
Females
Immigrant workers
Disabled
Excluded groups
Ethnic minorities
Any group by definition which is un-empowered
Personality although some of this is spurious!
“Type A” (uptight, goal oriented) likelihood of stress-illness and CHD
“Type C” (high anxiety) likelihood of Cancer
“Type D” (negative affectivity, emotional inhibition) likelihood of CHD
“External” locus of control à poorer at handling stress
“Hardiness” à greater resistance and operability
Karasek’s demand-control model
high
Productive,
Motivated
active
passive
high strain
low
job control
low strain
low
high
job demands
1979
Risk of psychological
strain and increased
illness
Summary of Occupational Stress
Any workplace / person / social interaction
Stress is a natural / healthy response
Some responses to stress are pathological
Worker intolerance
Impossible to predict stress reliably – easier to predict intolerance
Individual modifiers – personality, behaviour, coping style, perception
Legal obligation clearer than ever
Psychosocial hazards unavoidable & intrinsic in some cases
Most psychometric stress testing unethical
Recommended Reading
Carroll D, Davey Smith G, Sheffield D, Shipley MJ, and Marmot MG. Pressor reactions to
psychological stress and prediction of future blood pressure: data from the Whitehall II study.
BMJ 1995;310:771-775.
Chen C, David AS, Nunnerley H, Michell M, Dawson JL, Berry H, Dobbs J, and Fahy T.
Adverse life events and breast cancer: case-control study. BMJ 1995; 311: 1527-1530.
Jackson CA and Cox T. Health and well-being of working age people. ESRC Seminar Series.
ESRC. London. 2006
Jackson CA. Psychosocial Aspects of the Workplace. In Aw, T.C et al. (eds) Occupational
Health Pocket Consultant (fifth edition). Oxford: Blackwell Scientific Publishing; 2006. 191201
Jackson CA. Psychosocial Hazards. In Smedley, J et al. (eds) Oxford Handbook of
Occupational Health. Oxford. Oxford University Press; 2007. 167-179
Karasek R. Jobs demands, job decision latitude and mental strain : implication for job
redesign, Administrative Science Quarterly 1979, 285-308.
Recommended Reading
Kivimäki M, Leino-Arjas P, Luukkonen R, Riihimäki H, Vahtera J, and Kirjonen J. Work stress
and risk of cardiovascular mortality: prospective cohort study of industrial employees. BMJ
2002; 325: 857.
Lees, R., and Laundry, B.R. Comparison of reported workplace morbidity in 8-hour and 12hour shifts in one plant. Journal of the Society of Occupational Medicine (1989) 39.
Levenstein S. Stress and peptic ulcer: life beyond helicobacter. BMJ 1998; 316: 538-541.
Lodden, T., The Effect on the Health and Safety of Older Offshore Personnel - Long Shifts
and Working Night Shift. Society of Petroleum Engineers. SPE 60996.
Parkes, K.R.: Sleep patterns, Shift work, and Individual Differences: A Comparison of
Onshore and Offshore Control-Room Operators. Ergonomics (1994) 37(5).
Shain M and Kramer DM. Health Promotion in the Workplace: Framing the Concept;
Reviewing the Evidence. Occupational and Environmental Medicine 2004;61:643-648.
Recommended Reading
Rosa, R.R: Performance, alertness, and sleep after 3.5 years of 12 hour shifts: a follow-up
study. Work and Stress (1991) 5(2).
Spurgeon A, Harrington JM, Cooper CL. (1997) Health and safety problems associated with
long working hours: a review of the current position. Occup Environ Med; 54:367-375.
Work Stress: The Making of a Modern Epidemic. Michael Fitzpatrick. Open University Press,
2002.