Taking the Stress Out of Work

There is both good and bad stress in the workplace. But with the staggering cost of harmful stress, the effort to remove it from the workplace appears to be gathering momentum. And it's not just a health issue: Companies are finding that such initiatives also maximize human capital and build a work culture that is vital, creative and productive.

Thursday, September 16, 2010
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What costs American businesses an estimated $150 - $300 billion a year, affects four of five American workers, has provoked an "explosion" of scientific research -- yet has been largely ignored by U.S. companies, the news media and politicians?

Workplace stress.

In identifying the various sources of this staggering estimated price tag, the American Institute of Stress illustrates how pervasive a problem it is for the economy and the people who work in it. According to AIS, the $300 billion estimated cost is due to a number of factors:

* Accidents on the job;

* Absenteeism;

* Employee turnover;

* Diminished productivity;

* Direct medical, legal and insurance costs; and

* Workers' compensation awards and tort judgments.

In November 2007, the United Kingdom's Health and Safety Executive estimated that workplace stress costs Great Britain's smaller economy more than £530 million. Estimates vary greatly, in part because of the difficulty of determining the indirect costs, such as absenteeism and diminished productivity. (See more on The High Cost of Stress here.)

"The topic of workplace stress is exploding in the scientific literature," says Steven Sauter, coordinator for the research program on work organization and stress-related disorders at the National Institute for Occupational Safety and Health (NIOSH), based in Washington and Atlanta.

He says the "big awakening" was due to the massive downsizing and outsourcing of the 1990s, along with "more flexible employment practices, the use of temporary or contract workers, and the growth of new operating systems, such as lean production."

Other experts point to the added stress faced by two-income families, an aging workforce, growing job insecurity, a faster pace of work, poor work/life balance and longer work hours confronting many people.

Nonetheless, workplace stress rarely enters public or political discourse on either side of the Atlantic, according to Eusebio Real Gonzalez, head of the European Risk Observatory in Bilbao, Spain. "It's a source of permanent frustration," he says.

Until recently, U.S. industry hasn't been paying much attention, either.

But the issue is serious and has long been on the occupational-safety-and-health agenda, according to Sydney Robertson, who co-authored a National Occupational Research Agenda document on the organization of work.

"We've tried to engage our client base in it," he says, "but we've been relatively unsuccessful," says Robertson, the former executive vice president at ORC Worldwide (now part of New York-based Mercer where full disclosure: I work as communications director in the Washington office).

That may be changing. The evident connections between workplace stress and soaring health costs, not to mention the rigors of competing in a global marketplace, have led a number of U.S. and foreign organizations to develop innovative programs that cut long-term costs while boosting morale, productivity and profits.

And aware of the connection between stress and illness, government agencies on both sides of the Atlantic devoted to occupational safety and health are encouraging this process.

The Subjectivity of Defining Stress

Researchers concede that "stress" can be difficult to define because it is inherently a subjective experience; we all react differently.

In Stress Work, NIOSH defines job stress as: "the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources or needs of the worker."

The European Agency for Safety and Health at Work has a similar definition: "People experience stress when they perceive an imbalance between the demands made of them and the resources they have available to cope with those demands."

Researchers also talk about "good stress," sometimes called "eustress" to distinguish it from harmful stress. For example, running a race might be stressful, but this may be considered eustress, as it can lead to improved performance.

"Pressure might be good for performance," says Gonzalez, "but stress is not."

Allowing for "good stress," however, can lead to a slippery slope that fails to identify harmful stress, he says. Duration is a key way to distinguish one from the other: Stress that is not temporary, but is chronic, will likely be harmful.

When confronted with workers complaining of job stress, employers have two basic choices: They can treat it as an individual difficulty or they can treat it as a symptom of the workplace.

Given the inherently subjective dimension of stress, placing the entire burden of dealing with it on the individual might at first appear to be reasonable. In this case, if employers choose to respond at all to the workers' stress, the effort will go no further than encouraging employees to exercise, consulting a psycho-therapist or sending them to an employee-assistance program.

A growing body of evidence appears to demonstrate, however, that the workplace itself can be a cause of stress.

"We can show differences in the prevalence of stress from workplace to workplace," says Sauter. "So it stands to reason that the workplace can be a source of stress."

The Organization of Work

The term of art given to the conditions in the workplace is the organization of work. There is no agreed-upon definition but there is fairly common terminology, says Gonzalez, who has worked with NIOSH's Sauter.

In a narrow sense, the term refers to, "how you distribute, design and manage the tasks for jobs." In a broader sense, the organization of work can also include how people are hired, fired, trained, managed and evaluated.

NIOSH's widely cited definition is found in its publication, The Changing Organization of Work and the Safety and Health of Working People: "Organization of work refers to the work process -- the way jobs are designed and performed, and the organizational practices (management and production methods and accompanying human resource policies) that influence job design."

When Robertson was the head of human resources at BP, he saw first-hand how the pressure to cut costs led to high stress levels.

"I knew it [couldn't] be good for people ... and later, I saw the research linking design of work systems and stress levels to health-and-safety outcomes," he says.

Ignoring this issue can lead not only to health-and-safety risks for the workers, he notes, but also to regulatory intervention, legal risk or business risk, noting that if workers aren't productive, the company is at a competitive disadvantage.

Many employers are addressing the organization of work not just to avoid costs, but to compete, thrive and survive in a global marketplace. In order to attract and keep high-quality workers, companies are finding that the issues surrounding the organization of work are inescapable in order to maximize human capital and build a work culture that is vital, creative and productive.

Gonzalez says he has seen increasing interest in this over the past 10 to 15 years, in part because of the switch to a more service-oriented economy, where stress is more important and can hurt customer service.

"Just admitting there may be a problem is a big first step," says Robertson. He adds that a lot of good information about the organization of work and workplace stress can be found on the NIOSH website.

What Are Companies Doing?

It was in 1999, that the American Psychological Association in Washington first began its "Psychologically Healthy Workplace" award, which has evolved into a national award that has recognized more than 400 organizations, says David Ballard, assistant executive director for corporate relations and business strategy at APA.

Ballard says the first step is for employers "to assess the needs of your workforce." A "one-size-fits all" approach is not the way to address the organization of work, and he recommends asking employees throughout the organization what they need.

A health-risk-and-productivity-assessment survey is exactly how the Toronto Police Service began its process of reducing workplace stress. The largest municipal police force in Canada, the TPS effort won the APA's 2009 Best Practices Award for a Psychologically Healthy Workplace.

"The assessment revealed a number of health risks, including cardiovascular risks, and there were indications that employees were reporting high levels of job stress," says Carol Vipari, corporate psychologist at TPS.

Efforts were already underway to reduce stress through a wellness program; the survey led TPS to address work stress more systematically, according to Vipari.

For those unfamiliar with workplace stress, Gonzalez recommends the Management Standards developed by the Health and Safety Executive of the United Kingdom as a useful place to begin. Launched in early 2009, these standards identify six areas of psycho-social risks and provide practical guidance for the average manager who is not a psychologist. (See here for more information and links to resources.)

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Gonzales notes that doing the risk assessment is "the easy part." The hard part is determining what to do once you understand what your people are saying about work-related stress.

"There's no matrix on what to do," he says.

Barriers to Success

The "silos" separating human resource leaders, risk managers and health-and-safety managers can also be a huge challenge for companies trying to come to grips with workplace stress, according to Gonzalez and Robertson.

"The HR function is not just about pay, but policies, job design and job performance," says Gonzalez. "Yet now we know these have a direct impact on health and safety. So you can see in some companies there's a little bit of 'ping-pong' going on."

If the HR, risk-management and health-and-safety functions are not integrated, it is difficult to make much progress, Gonzalez says. "If only one department does it, it won't work. You need the support and vision of top management to integrate these departments."

Addressing workplace stress through the organization of work need not be a huge undertaking at first, Ballard says. You can build the program piece by piece, engaging employees to determine what their top priorities are. The organization of work can also be seen in the broader context of health and wellness.

"What we emphasize," says Gonzalez, "is to focus attention on work-related factors that are commonalities across your staff, not just individual judgments. If I have 12 people in my unit and nine say I don't communicate well, I'd have to recognize I have a problem."

It is important to stay focused on working conditions because that usually tackles the root cause, rather than symptoms. Sometimes working conditions will include individuals, especially middle managers, "as they can be pretty toxic to people's health," Gonzalez says.

Communication with employees is the key to addressing workplace stress, Ballard says. The APA has five categories it looks at when picking the winners of its Psychologically Healthy Workplace Award program:

* Employee involvement;

* Work/life balance;

* Employee growth and development;

* Health and safety; and

* Employee recognition.

"But these five categories aren't the key to success -- employee communication and involvement is," says Ballard. "Communication is the hub of everything."

In order to engage employees, it is essential to have effective two-way communication between workers and management, not the traditional top-down "we-know-best" approach.

"What we're seeing," adds Ballard, "is that you simply can't be successful without employee involvement. Many companies think they are doing this well -- and they aren't." 

For example, most organizations do surveys of their employees, but people never hear the results or nothing is ever done with the data. This can actually destroy trust -- and trust can make the difference between success and failure in a program.

"Don't ask them questions and then implement a plan without their full participation," Ballard advises. "Employees must be involved in the design, implementation and evaluation of the program."

Letting employees have this much power over how work is done makes some managers nervous, Robertson notes. Most private-sector managers tend to believe that the reason they are managers is they know how to make decisions about how work is organized.

"If you believe in the right to manage, then you don't accept the notion of a two-way dialog between management and employees," he says. "But if you believe in developing a more effective organization, then you'll want workers and managers to have a dialog."

"The question of whether to have a real dialog with employees about the organization of work is one of the crucial points in the whole debate," he adds. "The participants in the debate about how to address workplace stress typically cannot reach agreement on whether to have a dialog with employees."

The EU is clear that worker participation is an obligatory element in the employer's effort to address workplace stress. "For some, this is anathema," says Gonzalez. "In fact, that's part of the reason it's enshrined in EU legislation -- we've found worker participation in both identifying and resolving problems is essential for success."

While there is a consensus that effective employee involvement is critical, the experts also agree there is no single "right" solution to the complex issue of workplace stress. Companies are, in fact, responding in a variety of ways to this emerging challenge.

Some organizations remain wedded to the traditional view that stress is a purely individual problem and that management always knows best -- but the risks of continuing down this familiar road appear to growing.

James Nash, Ph.D., joined Mercer (formerly ORC Worldwide) in 2006 and is now the communications director in the Washington office. Through its consulting expertise, networking opportunities and a range of other specialized services, Mercer's Occupational Safety, Health and Environmental Networks today help more than 120 leading corporations achieve safety, health and environmental excellence.

Prior to working for Mercer, Nash was senior editor in the Washington office of Occupational Hazards Magazine, since renamed EHS Today ( He received a doctorate in moral theology at the Catholic University of America, where he taught in the School of Religious Studies from 1990 until 1994.

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