THE NATION’S NEWSPAPER Collegiate Case Study www.usatodaycollege.com U.S. workers feel burn of long hours, less lesisure By Stephanie Armour 2-3 In the war on colds, personality counts By Marilyn Elias Summary Statement 4-5 Rising job stress could affect bottom line By Stephanie Armour 5-6 Catnap is best way to stretch your day By Al Neuharth, USA TODAY Founder Stress: The Workforce Epidemic 6 Discussion Questions and Future Implications Additional Resources 7 2004 Phi Theta Kappa Case Study Challenge Winners Stress: The Workforce Epidemic Nu Chi Chapter, Chipola College, Marianna, Florida Biotechnology and Human Welfare Beta Theta Omicron Chapter, Skyline College, San Bruno, California Individual Insurance Wanda Hamblen, Beta Zeta Mu Chapter, Western Iowa Technical Community College, Sioux City, Iowa Americans, the FDA, and Canada: Prescription Drugs and the New Drug Trafficking Eric Erkenbrack, Alpha Kappa Alpha Chapter, Normandale Community College, Bloomington, Minnesota Americans are becoming increasingly stressed from overworking themselves to the limit on their jobs-and researchers say it is having damaging effects on their health. In an effort to boost the sluggish economy, Americans are working longer hours in the workplace. In 1977, combined weekly hours for dual-earning couples with children stood at 81 hours. Now, that number has soared to 91 hours per week. This new trend has had its upsideUnited States productivity has finally surpassed that of Europe and Japan-but its adverse effects far outweigh its advantages. According to the Chicago-based company ComPysch, there has been a 23% increase in stress therapy requests from clients in the first three months of 2003 compared with the same time frame in 2002. Additional surveys report a 35% increase in anxiety and stress related ailments in the workplace in the last year. Escalating research suggests that there are extreme mental and physiological problems associated with overwork, including more susceptibility to chronic illnesses. In addition to costing Americans hundreds of hours of invaluable sleep, intense personal or work-related stress over a period of time significantly increases the chances of getting ill. Relaxed people have shown to be less susceptible to sickness than their more tense counterparts. In fact, adults who scored poorly on calmness tests are three times more likely to acquire colds than the more relaxed sect of people. Arthur Stone, a psychologist at the State University of New YorkStony Brook, conducted a three month study of daily stress levels and conse- quent illnesses. The consensus was the body contained more antibodies to infection during “stress-free” days; however, during more taxing times, fewer antibodies were present. Thus, adults catch cold three to five days after their most stressful days. Americans’ insistence to work “to the max” has undeniably led to financial success in the business world, but its consequential effects on health are costing businesses, as well. Mandatory overtime costs industries up to $300 billion per year in fatigue and stress related problems. If Americans continue at this pace, these costs will continue to rise, and in time, rival the profit the country is amassing from its constant productivity. If Americans cannot afford to cut back their hours, stress and its negative effects can be subsided by something as simple as a catnap. A 2002 Harvard University study discovered that a midday nap can sharply increase performance. Before the recent economic recession, many employers embraced this concept; they went as far as to offer “powernap” rooms for midday breaks. Unfortunately, those napping rooms have now been transformed into coffee rooms to keep employees awake. There are many relevant health-related issues plaguing our society today, but stress in the workplace and its harmful effects on employees is a potentially disastrous issue that is only getting worse. This case study was created to inform others of the negative effects of stress in the workplace while offering suggestions on future implications of this potentially detrimental epidemic to the American workforce. Reprinted with permission. All rights reserved. AS SEEN IN USA TODAY MONEY SECTION, WEDNESDAY, DECEMBER 17, 2003, PAGE 1B U.S. workers feel burn of long hours, less leisure Employees pay cost of rising productivity By Stephanie Armour USA TODAY A backlash is building against America’s work epidemic. More employees are resisting companies’ demands for longer hours on the job, the 24/7 pace of business that means operations never cease, and the surrender of leisure time to work because of new technology such as cellphones and e-mail. “People are putting in 40 and 50 hours a week, and there’s not enough time for anything,” says Gretchen Burger, in Seattle, an organizer with Take Back Your Time, a grass-roots movement aimed at focusing attention on the issue of overwork. “There is an alternative.” Some workers, unwilling to clock extra hours without extra pay, are suing their companies over alleged overtime violations. In fiscal 2003, the Labor Department collected $212 million in back wages, which include overtime violations. That’s a 21% increase over the record-setting amount collected in 2002. Some economists also believe that many productivity gains of the ’90s can be attributed to longer work hours rather than the efficiency of new technology.For the first time, industries that have been notorious for their taxing schedules are scaling back. New guidelines now limit the number of hours that medical residents can work. And starting Jan. 4, federal regulations will require many truck drivers to set aside more time for breaks. Some beleaguered workers are also taking action, changing to less-demanding occupations or leaving corporations to start their own businesses, where they can feel more in control of their work lives. Others are scaling back to spend more time with families. week, to about 50 a week, and he downsized his business by reducing products and shedding staff. ing to the International Labor Organization (ILO). Hours were about the same in the USA as in Japan. Faith, 40, who worked in information services at a bank, opted to stay home with children. Combined weekly work hours for dualearning couples with children rose 10 hours per week, from 81 hours in 1977 to 91 hours in 2002, according to a new study by the New York-based Families and Work Institute. “My wife and I decided that we needed to cut back on our work hours and simplify our lives,” says Rothberg, 37, who runs Minneapolis-based online career site CollegeRecruiter.com. He has two sons, ages 9 and 7, and a daughter, 4. “The result? We started to love our lives again and two years later decided to have another child. Our daughter owes her life to our decision to try to bring balance to our lives.” Employees feel the strain. Mounting research shows there’s a tangible downside to overwork, from mental-health problems to physical ailments and job injuries caused by fatigue and stress. It’s also a bottom-line issue: A study by the Economic Policy Institute found that mandatory overtime costs industry as much as $300 billion a year in stress- and fatigue-related problems. Working to the max About six years ago, Steven Rothberg and his wife, Faith, decided to make a change. They sat down, crunched the numbers and took the plunge: Steve cut back his work hours, sometimes as much as 80 hours a But they’re the exception. U.S. workers put in an average of 1,815 hours in 2002. In major European economies, hours worked ranged from about 1,300 to 1,800, accord- Cody Mooneyhan, 31, can relate. He works as much as 14 hours a day, getting up at 4:30 a.m. and arriving home at 9:30 p.m. to work two jobs: senior writer for Vanguard Communications and assistant at the Reprinted with permission. All rights reserved. Page 2 American Journal of Pathology. His wife, Renée, 31, works several nights a week as a social worker. His employers don’t require long hours, but Mooneyhan feels he must work two jobs to support his three children: Sarah, 1, Zoe, 3, and Zack, 7. He says he works to maintain a middleclass lifestyle, not to have luxuries. He lives in a three-bedroom town house, has a 7year-old computer and owns a Toyota Tercel and a minivan. Says Mooneyhan, of Germantown, Md.: “Being tired makes everything that much more stressful, but it’s like having a baby. You get used to it. It’s kind of sad. The kids sometimes ask, ‘What’s the deal with Dad? Does he still live here?’ I’ve thought, ‘This is going to kill me.’ ” Output gains due to longer hours Some doubt the effort to curb hours will cause the USA to adopt the more leisurely approach of Europe, where women in Sweden get 96 weeks of maternity leave and workers in France enjoy about five weeks of vacation a year. Some efforts to curtail hours Under pressure The number of hours worked by couples has increased by more than 10% in 25 years. Combined work hours of all couples (dual and single earner): 1977 70 82 2002 Combined work hours of dualearner couples with children: 1977 81 2002 91 Source: Families and Work Institute 2002 National Study of the Changing Workforce Increased hours could be contributing to unhappiness on the job. Not satisfied with their job 83% Not happy with their work/ life balance 80% Consider themselves overworked “Good luck,” says Stephen Roach, chief economist for Morgan Stanley in New York. He believes much of the accelerated productivity in the USA since the mid-1990s is due to longer work hours. An ILO report in September found that U.S. productivity grew in 2002, surpassing Europe and Japan in annual output per worker for the first substantial period since World War II. The report found that the difference was due to the longer hours worked by Americans. But much of that growth isn’t picked up in government data measuring work hours, Roach says. “This is work that happens outside the workplace,” he says. “People work in planes, cars and at home.” Government data on hours worked don’t capture time put in off the job, such as during weekends, or after-hours work that many salaried employees do on laptops, cellphones and e-mail. They also don’t capture the overall rise in hours put in by families. But the data do show a recent uptick in the average workweek for production and non-supervisory workers as the economic recovery picks up steam. 57% Source: Monster’s 2003 Work/Life Balance Survey of between 36,128 and 61,346 users. By Alejandro Gonzalez, USA TODAY Hours are rising in part because of new technology, which makes it easier to work outside the office, and a sluggish economy, which has led companies to lay off workers, leaving fewer workers shouldering the same (or more) work. Even vacations are going by the wayside: Employees are handing companies more than $21 billion in unused vacation days each year, according to a study by Expedia.com. Andy Lefkowitz, 47, took at least a month of vacation when he worked as a securities lawyer. Now, he’s president of Ganeden Biotech in Cleveland. As the boss, he says, he’s lucky if he takes two weeks off a year. “The hours are also more intense,” says Lefkowitz, a father of three who works about 10 hours a day and some evenings after the children go to sleep. “Information is coming at you from so many different directions. ... I don’t take vacations. Maybe just a day here or there.” A backlash to the overwork trend is building in Philadelphia, Boston, Seattle and other cities where dozens of events were held in the fall to mark the first Take Back Your Time Day. Organizers of the grass-roots movement want to establish the Oct. 24 event as an annual affair to draw attention to the issue of overwork. Several jurisdictions, including Seattle, officially proclaimed Oct. 24 as Take Back Your Time Day. Efforts to ease the leisure-time shortage are also catching the attention of politicians. The U.S. Senate this year passed a resolution designating October as National Work and Family Month — a move that organizers of the Take Back Your Time movement say has put the work and home conflict onto the national stage. It has also become an issue that presidential contenders might have to tackle: This month, Sen. Joseph Lieberman of Connecticut, who is seeking the Democratic nomination, proposed a paid family leave program for employees. Some proponents trying to curb overwork believe change is already afoot: uStarting this year, all 7,800 medical residency programs must comply with new limits on work hours. Guidelines issued by the Accreditation Council for Graduate Medical Education include limiting resident hours to a maximum of 80 hours a week. Programs that don’t comply can lose their accreditation. uA report in November from the Institute of Medicine of the National Academies found that “long work hours pose one of the most serious threats to patient safety.” The report calls on regulators to bar nurses from working more than 12 hours a day and 60 hours a week. There are more than 4 million registered nurses and nursing assistants in the country. uNew federal rules for truck drivers — the first major change since 1939 — will require truckers to increase their rest time to 10 hours from eight in a 24-hour period. In most cases, the total time a driver can be on duty will drop to 14 hours from 15. Some companies are responding by allowing workers to customize schedules. Jennifer Maler, 29, is a tax compliance specialist at Ernst & Young. Working full time, she wanted more time for other passions, such as modeling and dancing. “I love what I Reprinted with permission. All rights reserved. Page 3 do, but I felt like I was living at the office,” Maler says. So she asked — and got permission — to adopt a flexible work schedule. In 1999, she took a pay cut and began working a 30-hour week spread over three days. made me a more complete person.” Although the growing push to reclaim time sounds appealing to some employees, others say long hours and after-hour work have become so ingrained that change might be hard. “It’s the best thing I ever did,” says Maler, who works in New York. “It’s given me the ability to stay with my career, and it’s As chairman and CEO of HealthExpo, which organizes health fairs around the USA, Cynthia Ekberg Tsai, 47, of New York, often arrives at work before her team. After working through lunch, she may leave at 8 p.m. for dinner and return to the office until 1 a.m. “I do not go to lunch, because it gives me the chance to keep on working. Do I have the sense that people are working harder? Yes,” says Ekberg Tsai. “Most people overcommit. We haven’t learned the magical word of ‘no.’ ” AS SEEN IN USA TODAY LIFE SECTION, TUESDAY, DECEMBER 2, 2003, PAGE 5D In the war on colds, personality counts Evidence links stress, social life to resistance By Marilyn Elias USA TODAY The common cold is not an equal-opportunity attacker. Everyone knows it’s contagious, yet some stay healthy or suffer only mild symptoms even when they’re exposed to armies of sniffling kids and co-workers. Others seem to be knocked out by every passing bug. Scientists are far from understanding everything about colds. But a growing pool of evidence suggests that personality, stress and social life all can influence healthy adults’ vulnerability to cold symptoms. Just like in kindergarten, those who “play well with others” are better off, says psychologist Sheldon Cohen of CarnegieMellon University in Pittsburgh. For 16 years he has been exposing volunteers to colds by dropping rhinoviruses into their noses. Then he quarantines them for five days to see who gets sick. Medical tests and questionnaires show: uHappy, relaxed people are more resistant to illness than those who tend to be unhappy or tense. Adults with the worst scores for calmness and positive mood are about three times more likely to get colds than the most relaxed and contented adults. When happy people do get sick, their symptoms are milder. uThe more extroverted a person is, the less likely he is to catch cold. Use common sense against the common cold More than 200 viruses cause the common cold, and they’re all on the prowl for victims. “The only way to be sure you’ll get no more colds is to become a hermit,” says Jack Gwaltney of the University of Virginia School of Medicine, an expert on infectious diseases. Still, health and lifestyle practices matter. Among the important ones: uGetting enough sleep helps protect against infections. uFrequent hand washing after uSerious work-related or personal stress for at least a month increases the chances of catching cold. The longer people had lived with bad stress, the more likely they were to catch cold in the lab. uPlaying diverse social roles — spouse, parent, worker, friend, club member — improves resistance to infection. Those with three or fewer roles were four times more likely to get colds than those with six or more. The stress factor Pam Jacobson, 39, knows about stress and demands: She has three children ages 3 to 9, a husband who works long hours and a “chauffeur” schedule that traps her in Los Angeles traffic about two hours a day. exposure to someone with a cold helps to lower your chances of getting it, Gwaltney says. “And keep your fingers out of your nose and eyes, because that’s where it’s easy for the virus to invade.” uRegular exercisers also catch fewer colds. It may be the stress relief or some other, unknown factor, researchers say. uModerate alcohol use — about two drinks a day — correlates with less risk for colds. It’s not known whether this is because alcohol promotes relaxation or has other infection-fighting effects. uSmokers don’t get more colds but do have worse symptoms, Gwaltney says; smoke worsens their airway irritation, nasal congestion and coughs. For more information on colds, and evading them, visit Gwaltney’s Web site, www.commoncold.org. “I feel like I’m always juggling,” she says. “They all have different activities. I’m always on the way somewhere. I can barely remember things, I have to write everything down.” Still, Jacobson is, by nature, an “up” and calm person, says her mother, Gloria Welles. “Chaos can be going on all around her, but she’s very steady.” Although her kids bring home colds, and she gets them sometimes, symptoms tend to be mild, “and I don’t stop my life,” Jacobson says. She attends yoga class twice a week to relieve stress and plays tennis. She also keeps up with pals. “I have a lot of friends, and I make time to see them.” The tie between human behavior and vul- Reprinted with permission. All rights reserved. Page 4 nerability to illness is not magical. Scientists are finding some explanations. For example, in a three-month study of daily moods and illness, adults had more antibodies to infection on days with positive events. The worse the day, the fewer antibodies, says psychologist Arthur Stone of State University of New York-Stony Brook. Cohen believes a diverse social network can buffer against losses in any one area. And stress clearly affects the immune system, he says. Stress triggers the release of inflammatory particles, called cytokines and histamines, that fight off infection but also cause miserable cold symptoms. About one-fourth of adults who are infected with a cold virus don’t develop symptoms, and they have low levels of these inflammatory molecules, says Jack Gwaltney, an infectious-disease expert at the University of Virginia School of Medicine. Cohen is studying whether positive emotions affect release of these cytokines, per- haps easing symptoms. In Stone’s studies, adults got sick three to five days after their roughest days. Animal research may explain why people often get through acute stress but fall ill afterward, says Esther Sternberg, who directs the Integrative Neural-Immune Program at the National Institute of Mental Health. Stress unleashes adrenaline-like hormones first, which stimulates the immune system. Then cortisol is released; this hormone battles inflammation but weakens immunity. “For a while both hormones are going full-steam ahead,” Sternberg says. When the stress ends, the adrenaline hormones shut down first, leaving hormones that suppress immunity to hang around alone, “and in these few days illness may take hold.” Conflict as a culprit Miserable marriages can weaken the immune system and promote colds, adds psychologist Janice Kiecolt-Glaser of Ohio State University. In her study, newlyweds who used putdowns and sarcasm in their exchanges had more respiratory infections and poorer immune function in the first three years of marriage; wives were hit particularly hard. “It’s not always easy to get out of stressful situations,” Cohen says. “But it’s clear that jobs and marriages with constant conflict are not good for your health. Not everyone is a positive person, but we all should try to be this way more.” In the face of stress, “try to pace yourself,” Sternberg says. “If you’ve been through an unusual challenge, take it easy for a while.” That’s especially important as people age because the immune system isn’t as strong. “We need to respect the limits of our bodies.” AS SEEN IN USA TODAY MONEY SECTION, TUESDAY, JULY 29, 2003, PAGE 1B Rising job stress could affect bottom line By Stephanie Armour USA TODAY Impact of stress Mounting stress in the workplace is reaching burnout levels for some as more workers report feeling unable to keep up with the demands of their jobs. The rise in stress — driven by mounting unemployment, leaner workplaces and a jobless recovery — could pose a bottomline threat to companies as workers suffer more mental and physical health problems related to job pressure, experts say. Chicago-based employee assistance provider ComPsych experienced a 23% increase in crisis- and stress-counseling requests from client companies in the first quarter of 2003 compared with the first quarter of 2002. Nearly 30% were because of worker anxiety and terminations. Nearly 35% of workers say they’ve seen an increase in anxiety and stress-related physical ailments in their workplace in the last year, according to a May survey by The Marlin Co., a North Haven, Conn.based workplace communications firm. Work one to four days per year when too stressed to be effective 44% No impact on effectiveness 37% Work more than six days per year when too stressed to be effective 19% Coping strategies for stress Take frequent Work harder 23% breaks Take a day off 9% 68% Source: ComPsych StressPulse survey of 500 clients between March 27 and April 16 tional problems such as insomnia and depression. The impact: uStress-busting corporate programs. Companies are trying to help workers cope with job-related tension. At AstraZeneca, a Wilmington, Del.-based pharmaceutical company, a form of meditation called Qi Gong has been introduced. Classes take place at regular department meetings, including a pre-meeting meditation and — instead of a coffee break — there is an afternoon energy break with Qi Gong and tea. One reason for the attention: Humanresources experts say employees exposed to stresses such as layoffs are more likely to engage in violent behavior. uMounting health care costs.Employees who worry about losing their jobs were less safety motivated and had more injuries, according to a study of 237 food-processing plant employees by psychologists at Washington State University-Vancouver. By Robert W. Ahrens, USA TODAY Twenty-seven percent report a rise in emo- A survey through the University of Northern Iowa in Cedar Falls of more than 2,000 workers found ongoing work stress Reprinted with permission. All rights reserved. Page 5 and long hours had a negative effect on physical and mental health. After Steve Braman put his company, Sunshine Farms Poultry, into Chapter 11 bankruptcy protection in 2001, he suffered a blood clot and heart trouble. “It was all stress related. I went from being content financially to selling my home,” says Braman, who now works as a food broker in Stuart, Fla. “It was more stressful than when I was on Wall Street trading.” which has a tremendous impact on how hard (employees) work,” says Carol Kauffman, a psychologist and instructor at Harvard Medical School. “They work more but less effectively.” uLowered morale. “It surfaces in morale, AS SEEN IN USA TODAY NEWS SECTION, FRIDAY, NOVEMBER 14, 2003, PAGE 15A Catnap is best way to stretch your day By Al Neuharth USA TODAY Founder If you ever sleep on the job, or even during a work break, chances are the boss is out to get you. A study due to be released on Dec. 1 will show that more than half of employers now suspend or reprimand employees who catch a wink at work, even if they're on a break. The survey among 532 companies by Circadian Technologies of Massachusetts reveals this sharply increasing number getting tough on nappers: u2003 — 52% u2002 — 38% u2000 — 32% The strict new company policies fly in the face of a Harvard University study in 2002 that concluded that a midday nap can sharply increase performance. Before the economic downturn caused a lot of bosses to go bananas on cost-cutting, many companies actually provided so-called “POWERNAP” rooms for midday breaks. Now, some of those have been turned into coffee rooms to keep employees awake. If you think naps are just for babies or kids, you're wrong. I've stretched my days with a catnap or two for nearly 50 years. They work. In my 30s and 40s, when I was climbing the career ladder, the nap often was just five or 10 minutes during lunchtime. Sometimes on a chair or bench. Sometimes in my car. In my 50s and 60s, when I headed Gannett and USA TODAY, the pressure was greater but the catnapping easier. Frequently, I double-dipped, with a 15- or 20-minute nap on a sofa in my office after lunch and another after an early dinner. Result: My workdays at the office often ran 15 hours or longer. Some thought I never slept, but most co-workers knew I did it with catnaps. I urged others to do the same. Bosses who don't understand that a little catnap can make employees feel better and work better aren't smart enough to be the boss. Reprinted with permission. All rights reserved. Page 6 For Discussion 1. Have the media and public figures “glamorized” immense amounts of work, and consequently, living with large amounts of stress? 2. With new research on the benefits of short rest periods at the workplace, should companies initiate “catnap” times and other ways to “de-stress” on the job? 3. Should the United States start to move toward a more European work style and formally place a “cap” on the amount of hours Americans work each week? Future Implications While many concerns remain with the growing issue of stress in the workforce and its adverse health effects, positive changes are being implemented. In 2003, the Senate passed a resolution designating the month of October as National Work and Family Month, progress that likely will force this conflict onto a national stage and will become an issue that presidential candidates may have to undertake. Senator Joseph Lieberman, seeking the Democratic nomination, recently suggested a paid vacation family leave plan. Additionally, new regulations require medical residency programs to limit their residents to 80 hours per week. Although these new laws and regulations show improvement toward a less stressed, healthier world, true progress will not be achieved until stress in the workplace is dramatically reduced. Whether it be a “cap” placed on the amount of hours employees can work or simply more ways to “de-stress” in the workplace (such as more breaks and “catnap” times), something must be done to combat this issue. Americans are getting increasingly stressed and continually sicker, and until the government and medical professionals formally recognize this serious concern facing our society, Americans’ daily cup of coffee will be replaced by their daily dosage of cough syrup. Additional Resources Burmark, Lynell & Fournier, Lou. Enlighten Up! An Educational Guide to Stress-Free Living. (2003) Rouse, James. Health Solutions for Stress. (2003) O'Donnell, Michael P. Health Promotion in the Workplace. (2002) Berman, Carol. Overcoming Stress in the Workplace. (2000) Kompier, Michiel. Preventing Stress, Improving Productivity: European Case Studies in the Workplace. (1999) Manning, George. Stress: Living and Working in the Changing World. (1999) For more information, log on to www.usatodaycollege.com Page 7