Combat job stress: does work make you sick?

Health News,  August, 1994  

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In our society, work underlies self-esteem and identity. Unemployment typically lowers the sense of self-worth, produces anxiety, depression and increased illness risks. On the other hand, monotonous, souless jobs can erode self-identity, stifle initiative and impair mental health, leading to injuries, absenteeism and unwanted staff turnover. Job satisfaction depends not only upon the task in had but also on the work culture or atmosphere. "In essence," notes one expert from Toronto's Addiction Research Foundation, "an organization that imposes superfluous stress, ignores employee needs and rides roughshod over their autonomy is likely to damage health andincrease alcohol and substance abuse." The organization of work is a health issue in which employees "do better when they feel more in command."

Stress-related worker complaints on the rise

In the past, workplace health concerns centred mainly on safety and physical working conditions -- such as hazardous toxins, cleanliness, noise, cigarette smoke and work overload. But in recent years, complaints of job distress have skyrocketed. One U.S. survey found tht almost a quarter of the workforce aged 25-44 suffered from stress-induced nervous strain severe enough to "diminish performance." The U.S. National Institute for Occupational Safety and Health reports that stress-related disorders are fast becoming the most prevalent reason for worker disability claims.

In Canada, as in the rest of the industrial world, absenteeism has tripled during the past 15 years, almost one third of it attributed to stress-linked disorders. Over 60 per cent of Canadians claim to have experienced "negative job stress" during the past year. Stressed employees are more likely to be involved in accidents, make mistakes and miss work.

Although hard to evaluate, stress-related disorders can arise from monotonous tasks, authoritarian supervision, time pressure, tight schedules, lack of stimulation, coercion, harassment and poor employee-to-employee interaction. The more stressful the work atmosphere, the greater the likelihood of stresslinked symptoms such as fatigue, anxiety, insomnia, headaches, dizziness, panic attacks, depression, cardiac disorders, backache and other muscular syndromes, and substance abuse -- with a resultant rise in injuries and absenteeism.

"In addition," notes one psychologist at the Toronto Hospital, "poor psychosocial work conditins can make employees with minor workplace injuries become incapacitated and take prolonged disability leave." Even if there is no evidence of organic impairment, and employees are deemed physically fit enough to resume work, the injury may "take over their lives" so that they "can't face going to work."

Understanding the stress pathway

Evolution marvellously prepared human beings for danger through the "fight or flight" response. In the immediate, alarm stage of this reaction the adrenal glands release stimulatory hormones, the heartbeat accelerates, extra glucose is supplied for energy and blood is diverted to working muscles. But while very apt for fighting or fleeing tigers, the fight-or-flight response hardly equips us for the stresses of modern life. A little stress is a stimulus, making us more alert and "on the ball," but although some stress can improve performance, too much is counterproductive.

Stress is a "state of arousal" provoked by specific stressors that call on the body's physical and mental reserves, triggering physiological, psychological and biochemical changes -- for instance, raising blood pressure and increasing secretion of catecholamine (stimulant) hormones such as adrenaline and noradrenaline. A stressor is any force, change or event that calls upon a person's inner resources.

Stressors can be environmental (excess noise, bad fumes), job-related (a bullying boss) or personal (an abusive spouse). They can be acute (such as nuclear accidents, bereavement), developmental (such as marriage, job promotion) or ongoing (such as poverty, an alcoholic parent). Some stressors -- for instance, a job switch or marriage -- are welcome changes, but still produce stress. The more stressors people are exposed to, the greater the stress or distress.

Continued or frequent exposure to stressors can produce profound physical, emotional and psychological reactions. Skyrocketing levels of corticoid (steroid) hormones and other biochemical changes may lead to typical stress reactions: exhaustion, headaches, muscular aches, insomnia, anxiety disorders, depression, elevated blood pressure, increased risks of heart disease and weakened immune (white blood cell) defences. But stress reactions vary widely, depending on the way individuals perceive events or stressors -- as a threat or a challenge -- and their personal problem-solving skills. The long-term outcome of prolonged stess also varies from person to person: for example, some develop changes in blood lipids (fats) -- with increased cardiovascular risks -- or reduced immune defences with increased susceptibility to infection. Some overuse alcohol, tobacco and other substances. Substance abuse generally worsens rather than relieves the mental strain. (About 10 per cent of the workforce currently misuses alcohol and/or other drugs.)