Epidemic may be considered too strong a word in referring to job stress, but, when surveys reveal that a quarter to a half of workers cite job stress as a problem, it needs to be recognized and alleviated.

A new report by the U.S. National Institute for Occupational Safety and Health (NIOSH), "Stress at Work," addresses job stress as a growing occupational safety and health problem.

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."

"Job stress can lead to poor health and even injury," the federal safety and health research agency concluded.

The NIOSH report acknowledged that there are many other life factors, in addition to work, that can lead to chronic stress, such as financial worries and family problems.

But more often the stress factors become interrelated. An example cited by NIOSH is a worker whose job and employer are so demanding that he or she can't get time off to care for a sick parent or child without fear of losing his or her job or getting further behind at work.

'Fight or flight'

According to research, the reason that stress affects health is the basic human biological response to danger. "Stress sets off an alarm in the brain, which responds by preparing the body for defensive action," the NIOSH report said. "The nervous system is aroused and hormones are released to sharpen the senses, quicken the pulse, deepen respiration, and tense the muscles."

This "fight or flight" response, as it is often called, has helped the human species survive acute danger for tens of thousands of years. The problem today occurs when the "fight or flight" response becomes chronic with unresolved stressful situations. As a chronic or constant situation, it can wear down body systems, including the nervous and immune systems. "As a result," NIOSH said, "the risk of injury or disease escalates."

Why is stress perceived as worse today than in past eras? Researchers suggest that job insecurity and increased workloads resulting from corporate mergers and downsizing, competitive pressures, new technology, and the struggle to maintain living standards against decades of a downward push on workers' wages and benefits are factors that contribute to the increase in job stress.

Workplace stress factors

Brian J. Bobal, GCIU Safety and Health director, cited the example in the printing industry of the trend toward 12-hour shifts and rotating shifts. He said about 20 percent of workers are unable to adapt to changing shifts. For these workers, forcing them into shift situations that they cannot handle increases stress and may increase their risk of on-the-job injury.

NIOSH listed many factors that can lead to job stress:

• Task design – Heavy workloads, infrequent rest breaks, long work hours, and shift work. Also 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, lack of family-friendly policies.

• Interpersonal relationships – Poor social environment and lack of support or help from co-workers 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.

Bobal said another area of concern for GCIU members involves environmental conditions. Noise, chemical exposures, ergonomic hazards, and working under production pressure with dangerous equipment, such as presses and cutters, are important stress factors.

Noise, for example, is a chronic stressor because loud noise is a biological trigger for the "fight or flight" response.

Bobal pointed out that some chemicals used in the printing industry, such as many solvents, are known to affect the nervous system. Symptoms caused by these neurotoxins include sleep disturbances, chronic fatigue, headaches, irritability, social withdrawal, depression, restlessness, nervousness, memory loss, confusion, and mental slowness.

Symptoms of stress

For non-chemical-related stress, too, early symptoms can include mood and sleep disturbances, upset stomach, headache, poor concentration, short temper, job dissatisfaction, low morale, and disturbed relationships with family and friends.

There is growing evidence that long-term stress contributes to many other health risks. Among those cited by NIOSH are:

• increased risk of workplace injury;
• cardiovascular disease;
• musculoskeletal disorders, especially back and upper-extremity disorders;
• psychological disorders, including depression, burnout; and suicide;
• ulcers;
• cancer;
• impaired immune functions.

Bobal said that another long-term risk of job stress is workplace violence. "Workers who are overly stressed generally have two outcomes – they become depressed or they lash out."

Bobal noted that GCIU officers and members in several plants have suffered violence – including murder – at the hands of stressed-out members. "We have to wonder if the workers who committed these violent acts could have been helped before they got to the point of committing violence," he said.

Strategies for prevention

Employers who think job stress means busy, productive workers should think again. Job stress and its related illnesses can seriously cut into productivity through absenteeism, disability, sick days, and the reduced efficiency caused by work overload and poor organization. As NIOSH observed: "Recent studies of so-called healthy organizations suggest that policies benefitting worker health also benefit the bottom line."

Many companies have developed positive strategies to prevent and alleviate job stress among its workers, NIOSH said. The two primary avenues that can be pursued to reduce job stress are organizational change and individual-oriented programs. NIOSH suggested that a combination of the two is often the most useful.

Organizational change is the most direct way to reduce stress at work, NIOSH said. To implement change, employers and managers should:

• 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.

Employee-oriented programs include stress management training and employee assistance programs (EAPs). Stress management training can include identifying the sources of stress for the individual and learning positive ways to deal with stress, such as time management and relaxation exercises. EAPs provide individual counseling for work and personal problems, such as financial management.

Like NIOSH, Bobal noted that the most effective programs to reduce job stress, and the possibility of related workplace violence, are joint labor-management programs that provide employees with the opportunity to participate.

NIOSH said that, although stress problems and solutions vary from company to company, the stress prevention process always involves three distinct steps: problem identification, intervention, and evaluation. NIOSH stressed the importance of employee involvement in all three steps.

While group discussions have proved to be the most valuable approach for developing a stress management program, NIOSH said, employers must comply with labor laws in forming any worker-management teams or groups.

Once stress problems have been identified through group discussions, surveys and/or expert evaluation, management must design and implement interventions. NIOSH emphasized that the commitment to solve problems must begin at the top, but employees should be informed about any actions before they are taken.

The last step also is important, NIOSH said, because "job stress prevention should be seen as a continuous process that uses evaluation data to refine or redirect the intervention strategy."

Evaluation of stress management programs should include measurements of employee perceptions of job conditions, stress, health, and satisfaction as well as objective measures, such as absenteeism and health care costs.

Because the evidence demonstrates that stress is a growing problem among workers in the printing industry, Bobal said, the International is developing a model for a joint stress management program.

"The GCIU is hoping to get management with us on this," Bobal said. "We can't just put our heads in the sand and ignore it because we've already seen how terrible the consequences can be."