health and the workplace

Health and the Workplace

Job Stress and Your Health

|What is job stress?|
|What are the causes of job stress?|
|Job stress and health|
|Job stress, health, and productivity|
|What can be done about job stress?|
|How to change the organization to prevent job stress|
|Preventing job stress: Getting started|
|Steps toward prevention|

Office Conflict Resolution: 11 Communication Tips for a Healthy Workplace

Medical Author: |Melissa Conrad Stöppler, MD|
Medical Editor: |William C. Shiel, Jr, MD, FACP, FACR|

Misunderstandings and communication problems remain one of the most common sources of workplace strife, and interpersonal difficulties are magnified when conflicting work styles coexist in one setting. Generational differences (baby boomers vs. GenX-ers), personal management styles, educational background, and cultural diversity are all potential sources of office misunderstandings.

While conflict is inevitable, it need not ruin your workday or cause unbearable |stress|. Try these conflict resolution tips to make your work environment a less stressful, more productive place:

Be specific in formulating your complaints. "I'm never invited to meetings" is not as effective as "I believe I would have been able to contribute some ideas at last Thursday's marketing meeting."

Resist the temptation to involve yourself in conflicts that do not directly involve you or your responsibilities. Even if someone has clearly been wronged, allow him or her to resolve the situation as he/she chooses.

Try to depersonalize conflicts. Instead of a "me versus you" mentality, visualize an "us versus the problem" scenario. This is not only a more professional attitude, but it will also improve productivity and is in the best interests of the company.

Be open and listen to another's point of view and reflect back to the person as to what you think you heard. This important clarification skill leads to less misunderstanding, with the other person feeling heard and understood. Before explaining your own position, try to paraphrase and condense what the other is saying into one or two sentences. Start with, "So you're saying that..." and see how much you really understand about your rival's position. You may find that you're on the same wavelength but having problems communicating your ideas.

What is job stress?

Job stress can be defined as the harmful physical and emotional responsesthat 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 eveninjury.

The concept of job stress is often confused with challenge, butthese concepts are not the same. Challenge energizes us psychologically andphysically, and it motivates us to learn new skills and master our jobs. When achallenge is met, we feel relaxed and satisfied. Thus, challenge is an importantingredient for healthy and productive work. The importance of challenge in ourwork lives is probably what people are referring to when they say "a littlebit of stress is good for you."

When the challenge has turned into jobdemands that cannot be met, relaxation has turned to exhaustion, and a sense of satisfactionhas turned into feelings of stress, the sate is set for illness, injury and jobfailure.

What are the causes of job stress?

Nearly everyone agreesthat job stress results from the interaction of the worker and the conditions ofwork. Views differ, however, on the importance of worker characteristicsversus working conditions as the primary cause of job stress. Thesediffering viewpoints are important because they suggest different ways toprevent stress at work.

According to one school of thought, differences in individual characteristicssuch as personality and coping style are most important in predicting whethercertain job conditions will result in stress -- in other words, what isstressful for one person may not be a problem for someone else. This viewpointleads to prevention strategies that focus on workers in ways to help them copewith demanding job conditions.

Although the importance of individual differences cannot be ignored,scientific evidence suggests that certain working conditions are stressful tomost people (for example, excessive workload demands and/or conflictingexpectations). Such evidence argues for a greater emphasis on working conditionsas the key source of job stress, and for job redesign as a primary preventionstrategy.

According to the NIOSH (National Institute for Occupational Safety andHealth), these are 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.
Management style. Lack of participation by workers in decision-making, poor communication in the organization and lack of family-friendly policies.
Interpersonal relationships. Poor social environment and lack of support or help from coworkers or supervisors.
Work roles. Conflicting or uncertain job expectations, too much responsibility, too many "hats" to wear.
Career concerns. Job insecurity and lack of opportunity for growth, advancement, or promotion; rapid changes for which workers are unprepared.
Environmental conditions. Unpleasant or dangerous physical conditions such as crowding, noise, air pollution, or ergonomic problems.

|Health and the Workplace Index|
|Glossary|

Next: |Job stress and health »|

Health and the Workplace (cont.)

|What is job stress?|
|What are the causes of job stress?|
Job stress and health
|Job stress, health, and productivity|
|What can be done about job stress?|
|How to change the organization to prevent job stress|
|Preventing job stress: Getting started|
|Steps toward prevention|
|Health and the Workplace Glossary|
|Health and the Workplace Index|

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

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.

Health and the Workplace (cont.)

|What is job stress?|
|What are the causes of job stress?|
|Job stress and health|
Job stress, health, and productivity
What can be done about job stress?
How to change the organization to prevent job stress
|Preventing job stress: Getting started|
|Steps toward prevention|
|Health and the Workplace Glossary|
|Health and the Workplace Index|

Job 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?

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.

Health and the Workplace (cont.)

|What is job stress?|
|What are the causes of job stress?|
|Job stress and health|
|Job stress, health, and productivity|
|What can be done about job stress?|
|How to change the organization to prevent job stress|
Preventing job stress: Getting started
|Steps toward prevention|
|Health and the Workplace Glossary|
|Health and the Workplace Index|

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.*

*The National Labor Relations Act may limit the form and structure of employee involvement in worker-management teams or groups. Employers should seek legal assistance if they are unsure of their responsibilities or obligations under the National Labor Relations Act.

|What is job stress?|
|What are the causes of job stress?|
|Job stress and health|
|Job stress, health, and productivity|
|What can be done about job stress?|
|How to change the organization to prevent job stress|
|Preventing job stress: Getting started|
Steps toward prevention
|Health and the Workplace Glossary|
|Health and the Workplace Index|

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 and the warning signs and effects of stress 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?

Hold group discussions with employees.
Design an employee survey.
Measure employee perceptions of job conditions, stress, health, and satisfaction.
Collect objective data.
Analyze data to identify problem locations and stressful job conditions.

Survey design, data analysis, and other aspects of a stress prevention program may require the help of experts from a local university or consulting firm. However, overall authority for the prevention program should remain in the organization.

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).

Target source of stress for change.
Propose and prioritize intervention strategies.
Communicate planned interventions to employees.
Implement Interventions.

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.

Conduct both short- and long-term evaluations.
Measure employee perceptions of job conditions, stress, health, and satisfaction.
Measure employee perceptions of job conditions, stress, health, and satisfaction.
Include objective measures.
Refine the intervention strategy and return to Step 1.

For more information about occupational safety and health problems, call1-800-35-NIOSH (1-800-356-4674), or visit |www.cdc.gov/niosh| (http://www.cdc.gov/niosh).

Portions of the above information has been provided with the kind permissionof the Centers for Disease Control.

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