Workplace stress

Workplace stress is the harmful physical and emotional response that occurs when there is a poor match between job demands and the capabilities, resources, or needs of the worker. Stress-related disorders encompass a broad array of conditions, including psychological disorders (e.g., depression, anxiety, post-traumatic stress disorder) and other types of emotional strain (e.g., dissatisfaction, fatigue, tension, etc.), maladaptive behaviors (e.g., aggression, substance abuse), and cognitive impairment (e.g., concentration and memory problems). In turn, these conditions may lead to poor work performance or even injury. Job stress is also associated with various biological reactions that may lead ultimately to compromised health, such as cardiovascular disease.

Prevalence
Stress is a prevalent and costly problem in today's workplace. About one-third of workers report high levels of stress. One-fourth of employees view their jobs as the number one stressor in their lives. Three-fourths of employees believe the worker has more on-the-job stress than a generation ago. Evidence also suggests that stress is the major cause of turnover in organizations.

Health and Healthcare Utilization
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. Many studies suggest that psychologically demanding jobs that allow employees little control over the work process increase the risk of cardiovascular disease. On the basis of research by the National Institute for Occupational Safety and Health and many other organizations, it is widely believed that job stress increases the risk for development of back and upper-extremity musculoskeletal disorders. High levels of stress are associated with substantial increases in health service utilization. Workers who report experiencing stress at work also show excessive health care utilization. In a 1998 study of 46,000 workers, health care costs were nearly 50% greater for workers reporting high levels of stress in comparison to “low risk” workers. The increment rose to nearly 150%, an increase of more than $1,700 per person annually, for workers reporting high levels of both stress and depression. Additionally, periods of disability due to job stress tend to be much longer than disability periods for other occupational injuries and illnesses.

Causes of Workplace Stress
Job stress results from the interaction of the worker and the conditions of work. Views differ on the importance of worker characteristics versus working conditions as the primary cause of job stress. The differing viewpoints 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. 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. Personal interview surveys of working conditions, including conditions recognized as risk factors for job stress, were conducted in Member States of the European Union in 1990, 1995, and 2000. Results showed a trend across these periods suggestive of increasing work intensity. In 1990, the percentage of workers reporting that they worked at high speeds at least one-fourth of their working time was 48%, increasing to 54% in 1995 and to 56% in 2000. Similarly, 50% of workers reported they work against tight deadlines at least one-fourth of their working time in 1990, increasing to 56% in 1995 and 60 % in 2000. However, no change was noted in the period 1995–2000 (data not collected in 1990) in the percentage of workers reporting sufficient time to complete tasks. A substantial percentage of Americans work very long hours. By one estimate, more than 26% of men and more than 11% of women worked 50 hours per week or more in 2000. These figures represent a considerable increase over the previous three decades, especially for women. According to the Department of Labor, there has been an upward trend in hours worked among employed women, an increase in extended work weeks (>40 hours) by men, and a considerable increase in combined working hours among working couples, particularly couples with young children.

Signs of Workplace Stress
Mood and sleep disturbances, upset stomach and headache, and disturbed relationships with family and friends are examples of stress-related problems. 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.

Prevention
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.

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.

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