Job Conditions That May Lead to Stress

by US Department of Veterans Affairs

(Page 2 of 3)

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 decision- making, poor communication in the organization, lack of family-friendly 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.

Example: David is exposed to constant noise at work.

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.

Health care expenditures are nearly 50% greater for workers who report high levels of stress.

— Journal of Occupational and Environmental Medicine

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 upper- extremity 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

Stress Prevention and Job Performance

St. Paul Fire and Marine Insurance Company conducted several studies on the effects of stress prevention programs in hospital settings. Program activities included (1) employee and management education on job stress, (2) changes in hospital policies and procedures to reduce organizational sources of stress, and (3) establishment of employee assistance programs.

In one study, the frequency of medication errors declined by 50% after prevention activities were implemented in a 700-bed hospital. In a second study, there was a 70% reduction in malpractice claims in 22 hospitals that implemented stress prevention activities. In contrast, there was no reduction in claims in a matched group of 22 hospitals that did not implement stress prevention activities.

— Journal of Applied Psychology

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.

How to Change the Organization to Prevent Job Stress

• Ensure that the workload is in line with workers' capabilities and resources.

• Design jobs to provide meaning, stimulation, and opportunities for workers to use their skills.

• Clearly define workers' roles and responsibilities.

• Give workers opportunities to participate in decisions and actions affecting their jobs.

• Improve communications-reduce uncertainty about career development and future employment prospects.

• Provide opportunities for social interaction among workers.

• Establish work schedules that are compatible with demands and responsibilities outside the job.

— American Psychologist

About the Author

www.va.gov
The United States Department of Veterans Affairs is a Cabinet department of the United States government responsible for administering programs of veterans benefits for veterans, their families, and survivors. It was formerly called the Veterans Administration or VA (created in 1930).