Definition of Stress Stress may be defined as "a state of psychological and / or physiological imbalance resulting from the disparity

between situational demand and the individual's ability and / or motivation to meet those demands." Dr. Hans Selye, one of the leading authorities on the concept of stress, described stress as "the rate of all wear and tear caused by life." Stress can be positive or negative. Stress can be positive when the situation offers an opportunity for a person to gain something. It acts as a motivator for peak performance. Stress can be negative when a person faces social, physical, organisational and emotional problems.

Causes of Stress Factors that cause stress are called "Stressors." The following are the sources or causes of an organisational and non-organisational stress. 1. Causes of an Organisational Stress The main sources or causes of an organisational stress are :1. Career Concern : If an employee feels that he is very much behind in corporate ladder, then he may experience stress and if he feels that there are no opportunities for self-growth he may experience stress. Hence unfulfilled career expectations are a major source of stress. 2. Role Ambiguity : It occurs when the person does not known what he is supposed to do on the job. His tasks and responsibilities are not clear. The employee is not sure what he is expected to do. This creates confusion in the minds of the worker and results in stress. 3. Rotating Shifts : Stress may occur to those individuals who work in different shifts. Employees may be expected to work in day shift for some days and then in the night shift. This may create problems in adjusting to the shift timings, and it can affect not only personal life but also family life of the employee. 4. Role Conflict : It takes place when different people have different expectations from a person performing a particular role. It can also occur if the job is not as per the expectation or when a job demands a certain type of behaviour that is against the person's moral values. 5. Occupational Demands : Some jobs are more stressful than others. Jobs that involve risk and danger are more stressful. Research findings indicate that jobs that are more stressful usually requires constant monitoring of equipments and devices, unpleasant physical conditions, making decisions, etc.

6. Lack of Participation in Decision Making : Many experienced employees feel that management should consult them on matters affecting their jobs. In reality, the superiors hardly consult the concerned employees before taking a decision. This develops a feeling of being neglected, which may lead to stress. 7. Work Overload : Excessive work load leads to stress as it puts a person under tremendous pressure. Work overload may take two different forms :i. Qualitative work overload implies performing a job that is complicated or beyond the employee's capacity. Quantitative work overload arises when number of activities to be performed in the prescribed time are many.

ii.

8. Work Underload : In this case, very little work or too simple work is expected on the part of the employee. Doing less work or jobs of routine and simple nature would lead to monotony and boredom, which can lead to stress. 9. Working Conditions : Employees may be subject to poor working conditions. It would include poor lighting and ventilations, unhygienic sanitation facilities, excessive noise and dust, presence of toxic gases and fumes, inadequate safety measures, etc. All these unpleasant conditions create physiological and psychological imbalance in humans thereby causing stress. 10. Lack of Group Cohesiveness : Every group is characterised by its cohesiveness although they differ widely in degree of cohesiveness. Individuals experience stress when there is no unity among the members of work group. There is mistrust, jealously, frequent quarrels, etc., in groups and this lead to stress to employees. 11. Interpersonal and Intergroup Conflict : Interpersonal and intergroup conflict takes place due to differences in perceptions, attitudes, values and beliefs between two or more individuals and groups. Such conflicts can be a source of stress to group members. 12. Organisational Changes : When changes occur, people have to adapt to those changes and this may cause stress. Stress is higher when changes are major or unusual like transfer or adaption of new technology. 13. Lack of Social Support : When individuals believe that they have the friendship and support of others at work, their ability to cope with the effects of stress increases. If this kind of social support is not available then an employee experiences more stress. 2. Causes of Non-Organisational Stress Certain factors outside the scope of an organisation also cause stress. These main sources or causes of non-organisational stress are :-

1. Civic Amenities : Poor civic amenities in the area in which one lives can be a cause of stress. Inadequate or lack of civic facilities like improper water supply, excessive noise or air pollution, lack of proper transport facility can be quite stressful. 2. Life Changes : Life changes can bring stress to a person. Life changes can be slow or sudden. Slow life changes include getting older and sudden life changes include death or accident of a loved one. Sudden life changes are highly stressful and very difficult to cope. 3. Frustration : Frustration is another cause of stress. Frustration arises when goal directed behaviour is blocked. Management should attempt to remove barriers and help the employees to reach their goals. 4. Caste and Religion Conflicts : Employees living in areas which are subject to caste and religious conflicts do suffer from stress. In case of religion, the minorities and lower-caste people (seen especially in India) are subject to more stress. 5. Personality : People are broadly classified as 'Type A' and 'Type B'. i. ii. iii. iv. Feels guilty while relaxing. Gets irritated by minor mistakes of self and others. Feels impatient and dislikes waiting. Does several things at one time.

While the 'Type B' people are exactly opposite and hence are less affected by stress due to above mentioned factors. 6. Technological Changes : When there are any changes in technological field, employees are under the constant stress of fear of losing jobs, or need to adjust to new technologies. This can be a source of stress. 7. Career Changes : When a person suddenly switches over a new job, he is under stress to shoulder new responsibilities properly. Under promotion, over promotion, demotion and transfers can also cause stress.

Occupational stress is stress involving work. According to the current World Health Organization's (WHO) definition, occupational or work-related stress "is the response people may have when presented with work demands and pressures that are not matched to their knowledge and abilities and which challenge their ability to cope." [1]

Contents [hide]

1 Models 2 Categories 3 Prevalence 4 Related disorders 5 Gender

o

5.1 Factors

6 Health and healthcare utilization 7 Causes

o

7.1 Sexual harassment

8 Effects 9 Prevention 10 See also 11 References 12 Further reading

Models[edit]
Stress can be factored in by a number of different variables, but results from the complex interactions between a large system of interrelated variables. [2][3](1998). The diathesis-stress model is a psychological theory that aims to make clear of behaviors as a susceptibility burden together with stress from life experiences.[4] Theories of organizational stress. New York: Oxford.[5] It is useful to distinguish stressful job conditions or stressors from an individual's reactions or strains.[6]Strains can be mental, physical or emotional. Occupational stress can occur when there is a discrepancy between the demands of the environment/workplace and an individuals ability to carry out and complete these demands.[7][8] Often a stressor can lead the body to have a physiological reaction that can strain a person physically as well as mentally. A variety of factors contribute to workplace stress such as excessive workload, isolation, extensive hours worked, toxic work environments, lack of autonomy, difficult relationships among coworkers and management, management bullying, harassment and lack of opportunities or motivation to advancement in ones skill level.[9] A concern with stress research is that studies often neglect to consider the broader organizational context.[10]

Categories[edit]
Categories associated with occupational stress are[9]

factors unique to the job, role in the organization, career development, interpersonal work relationships, organizational Structure/climate.

These individual categories demonstrate that stress can occur specifically when a conflict arises from the job demands of the employee and the employee itself. If not handled properly, the stress can become Distress (medicine).[11] The first category concerns with the ability of the employee coping with the specific hours worked, the level of productive rate expected, the physical environment, as well as the expectancy of the work desired by management. For instance, research shows that night shifts in particular has a high possibility of negative impact towards the health of the employee. In relation to this, approximately 20 percent of night shift workers have experienced psycho-physiological dysfunctions, including heart diseases. Extreme factors can affect the competence levels of employees. The second category, role in the organization, is associated with the hierarchical ranking of that particular employee within the organization. Upper management is entitled to oversee the overall functioning of the organization. This causes potential distress as the employee must be able to perform simultaneous tasks. With the third category, career development, other factors come into play. Security of their occupation, promotion levels, etc. are all sources of stress, as this business market in terms of technology of economic dominance is ever-changing. The fourth category of workplace stress pertains to the interpersonal relationships within the workplace. The workplace is a communication and interaction based industry. These relationships (either developed or developing) can be problematic or positive. Common stressors include harassment, discrimination, biased opinions, hearsay, and other derogatory remarks. Finally, the last category of workplace stress is the organizational climate or structure. The overall communication, management style, and participation among groups of employees are variables to be considered. In essence, the resultant influence of the

high participation rate, collaborative planning, and equally dispersed responsibilities provides a positive effect on stress reduction, improved work performance, job satisfaction, and decreased psychosomatic disorders.

Prevalence[edit]
Distress is a prevalent and costly problem in today's workplace. About one-third of workers report high levels of stress.[7]One-quarter of employees view their jobs as the number one stressor in their lives.[12] Three-quarters of employees believe the worker has more on-the-job stress than a generation ago.[13] Evidence also suggests that distress is the major cause ofturnover in organizations.[7] With continued distress at the workplace, workers will develop psychological and physiological dysfunctions and decreased motivation in excelling in their position.[9] Increased levels of job stress are determined by the awareness of having little control but lots of demands in the work area.[14] The Kenexa Research Institute released a global survey of almost 30,000 workers which showed that females suffered more workplace distress than their male counterparts. According to the survey, women's stress level were 10% higher for those in supervisory positions, 8% higher stress in service and production jobs than men, and 6% higher in middle and upper management than men in the same position.[15]

Related disorders[edit]
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, higher absenteeism, less work productivity or eveninjury.[9] Job stress is also associated with various biological reactions that may lead ultimately to compromised health, such as cardiovascular disease,[16] or in extreme cases death. Due to the high pressure and demands in the work place the demands have been shown to be correlated with increased rates of heart attack, hypertension and other disorders. In New York, Los Angels and other municipalities, the relationship between job stress and heart attacks is so well acknowledged.[17]

Gender[edit]

Frustrated man at a desk (cropped)

Men and women are exposed to many of the same stressors.[18] However, women may be more sensitive to interpersonal conflict whereas men might be more sensitive to things that waste time and effort. Furthermore, although men and women might not differ in overall strains, women are more likely to experience psychological distress, whereas men experience more physical strain. Desmarais and Alksnis suggest two explanations for the greater psychological distress of women. First, the genders differ in their awareness of negative feelings, leading women to express and report strains, whereas men deny and inhibit such feelings. Second, the demands to balance work and family result in more overall stressors for women that leads to increased strain. [18]

Factors[edit]
Combining housework, childcare, shopping and cooking with an outside job and trying to do everything on time is one of the biggest factors of women being more stressed at work, characterized mainly by feelings of guilt and hostility. 60% of women who have children under age six have an outside job and cope with family problems; single or married most of duties at home fall on shoulders of a woman.[19]

Health and healthcare utilization[edit]

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.[20] Many studies suggest that psychologically demanding jobs that allow employees little control over the work process increase the risk of cardiovascular disease.[21] Research indicates that job stress increases the risk for development of back and upperextremity musculoskeletal disorders.[21] High levels of stress are associated with

substantial increases in health service utilization.[7] 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.[22] Additionally, periods of disability due to job stress tend to be much longer than disability periods for other occupational injuries and illnesses. [23] Physiological reactions to stress can have consequences for health over time. Researchers have been studying how stress affects the cardiovascular system, as well as how work stress can lead to hypertension and coronary artery disease. These diseases, along with other stress-induced illnesses tend to be quite common in American work-places.[24] There are four main physiological reactions to stress:[25]

Blood is shunted to the brain and large muscle groups, and away from extremities, skin, and organs that are not currently serving the body. An area near the brain stem, known as the reticular activating system, goes to work, causing a state of keen alertness as well as sharpening of hearing and vision. Energy-providing compounds of glucose and fatty acids are released into the bloodstream. The immune and digestive systems are temporarily shut down.

Causes[edit]
This article has an unclear citation style. The references used may be made clearer with a different or consistent style of citation, footnoting, or external linking.(September 2011)

Job stress results from various interactions of the worker and the environment of the work they perform their duties. Location, gender, environment, and many other factors contribute to the build up of 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. Differences in individual characteristics such as personality and coping skills can be very 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 underlies prevention strategies that focus on workers and ways to help them cope with demanding job conditions.[7] 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.[7] Large 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 time trend suggesting an increase in work intensity. In 1990, the percentage of workers reporting that they worked at high speeds at least one-quarter 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 19952000 (data not collected in 1990) in the percentage of workers reporting sufficient time to complete tasks.[26] 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 have been a rise in increasing amount of hours in the work place by 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. [27][28]

Evidence of occupational stress due to an individual's status in the workplace

A person's status in the workplace can also affect levels of stress. While workplace stress has the potential to affect employees of all categories; those who have very little influence to those who make major decisions for the company. However, less powerful employees (that is, those who have less control over their jobs) are more likely to suffer stress than powerful workers. Managers as well as other kinds of workers are vulnerable to work overload.[29] Economic factors that employees are facing in the 21st century have been linked to increased stress levels. Researchers and social commentators have pointed out that the computer and communications revolutions have made companies more efficient and productive than ever before. This boon in productivity however, has caused higher expectations and greater competition, putting more stress on the employee(Primm, 2005). The following economic factors may lead to workplace stress:

Pressure from investors, who can quickly withdraw their money from company stocks. The lack of trade and professional unions in the workplace. Inter-company rivalries caused by the efforts of companies to compete globally

The willingness of companies to swiftly lay off workers to cope with changing business environments.

Bullying in the workplace can also contribute to stress. This can be broken down into five different categories:[9]

Threat to profession status Threat to personal status Isolation Excess Work Destabilization i.e. lack of credit for work, meaningless tasks etc.[9]

This in effect can create a hostile work environment for the employees that, which in turn, can affect their work ethic and contribution to the organization.[30]

Sexual harassment[edit]
Women are more likely than men to experience sexual harassment, especially for those working in traditionally masculine occupations. In addition, a study indicated that sexual harassment negatively affects workers' psychological well-being.[17][31] Another study found that level of harassment at workplaces lead to differences in performance of work related tasks. High levels of harassment were related to the worst outcomes, and no harassment was related to least negative outcomes. In other words, women who had experienced a higher level of harassment were more likely to perform poorly at workplaces.[31]

Effects[edit]
Stressful working conditions can lead to three types of strains: Behavioral (e.g., absenteeism or poor performance), physical (e.g., headaches or coronary heart disease), and psychological (e.g., anxiety or depressed mood).[32] Physical symptoms that may occur because of occupational stress include fatigue, headache, upset stomach, muscular aches and pains, chronic mild illness, sleep disturbances, and eating disorders. Psychological and behavioral problems that may develop include anxiety, irritability, alcohol and drug use, feeling powerless and low morale.[33] The spectrum of effects caused by occupational stress includes

absenteeism, poor decision making, lack of creativity, accidents, organizational breakdown or even sabotage.[34] If exposure to stressors in the workplace is prolonged, then chronic health problems can occur includingstroke. An examination was of physical and psychological effects of workplace stress was conducted with a sample of 552 female blue collar employees of a microelectronics facility. It was found that job-related conflicts were associated with depressive symptoms, severe headaches, fatigue, rashes, and other multiple symptoms.[35] Studies among the Japanesepopulation specifically showed a more than 2-fold increase in the risk of total stroke among men with job strain (combination of high job demand and low job control). [36] Along with the risk of stroke comes high blood pressure and immune systemdysfunction. Prolonged occupational stress can lead to occupational burnout. The effects of job stress on chronic diseases are more difficult to ascertain because chronic diseases develop over relatively long periods of time and are influenced by many factors other than stress. Nonetheless, there is some evidence that stress plays a role in the development of several types of chronic health problems including cardiovascular disease,musculoskeletal disorders, and psychological disorders.[7]

Prevention[edit]
A combination of organizational change and stress management is often the most useful approach for preventing stress at work.[7] Both organizations and employees can employ strategies at organizational and individual levels. Generally, organizational level strategies include job procedure modification and employee assistance programs (EPA). Individual level strategies include taking vacation. Getting a realistic job preview to understand the normal workload and schedules of the job will also help people to identify whether or not the job fit them. How to Change the Organization to Prevent Job Stress[37]

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.

To reduce workplace stress, managers may monitor the workload given out to the employees. Also while they are being trained they should let employees understand and be notified of stress awareness.[38]

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. Combat workplace discrimination (based on race, gender, national origin, religion or language). Bringing in an objective outsider such as a consultant to suggest a fresh approach to persistent problems.[39] Introducing a participative leadership style to involve as many subordinates as possible to resolve stress-producing problems.[39] Encourage work-life balance through family-friendly benefits and policies

An 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) the 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.[40] Telecommuting is another way organizations can help reduce stress for their workers. Employees defined telecommuting as "an alternative work arrangement in which employees perform tasks elsewhere that are normally done in a primary or central workplace, for at least some portion of their work schedule, using electronic media to interact with others inside and outside the organization." One reason that telecommuting gets such high marks is that it allows employees more control over how they do their work. Telecommuters reported more job satisfaction and less desire to find a new job. Employees that worked from home also had less stress, improved work/life balance and higher performance rating by their managers.[41]

What is a healthy job? A healthy job is likely to be one where the pressures on employees are appropriate in relation to their abilities and resources, to the amount of control they have over their work, and to the support they receive from people who matter to them. As health is not merely the absence of disease or infirmity but a positive state of complete physical, mental and social well-being (WHO, 1986), a healthy working environment is one in which there is not only an absence of harmful conditions but an abundance of health-promoting ones. These may include continuous assessment of risks to health, the provision of appropriate information and training on health issues and the availability of health promoting organisational support practices and structures. A healthy work environment is one in which staff have made health and health promotion a priority and part of their working lives. What is work-related stress?

Work-related stress is the response people may have when presented with work demands and pressures that are not matched to their knowledge and abilities and which challenge their ability to cope. Stress occurs in a wide range of work circumstances but is often made worse when employees feel they have little support from supervisors and colleagues, as well as little control over work processes. There is often confusion between pressure or challenge and stress and sometimes it is used to excuse bad management practice. Pressure at the workplace is unavoidable due to the demands of the contemporary work environment. Pressure perceived as acceptable by an individual, may even keep workers alert, motivated, able to work and learn, depending on the available resources and personal characteristics. However, when that pressure becomes excessive or otherwise unmanageable it leads to stress. Stress can damage an employees' health and the business performance. Work-related stress can be caused by poor work organisation (the way we design jobs and work systems, and the way we manage them), by poor work design (for example, lack of control over work processes), poor management, unsatisfactory working conditions, and lack of support from colleagues and supervisors. Research findings show that the most stressful type of work is that which values excessive demands and pressures that are not matched to workers knowledge and abilities, where there is little opportunity to exercise any choice or control, and where there is little support from others. Employees are less likely to experience work-related stress when - demands and pressures of work are matched to their knowledge and abilities - control can be exercised over their work and the way they do it - support is received from supervisors and colleagues - participation in decisions that concern their jobs is provided. What are stress-related hazards at work? Stress related hazards at work can be divided into work content and work context. Work contents includes - job content (monotony, under-stimulation, meaningless of tasks, lack of variety, etc) - work load and work pace (too much or too little to do, work under time pressure, etc.) - working hours (strict or inflexible, long and unsocial, unpredictable, badly designed shift

systems) - Participation and control (lack of participation in decision-making, lack of control over work processes, pace, hours, methods, and the work environment) Work context includes - career development, status and pay (job insecurity, lack of promotion opportunities, under- or over-promotion, work of 'low social value', piece rate payment schemes, unclear or unfair performance evaluation systems, being over- or under-skilled for a job) - role in the organization (unclear role, conflicting roles) - interpersonal relationships (inadequate, inconsiderate or unsupportive supervision, poor relationships with colleagues, bullying/harassment and violence, isolated or solitary work, etc) -organizational culture (poor communication, poor leadership, lack of behavioural rule, lack of clarity about organizational objectives, structures and strategies) - work-life balance (conflicting demands of work and home, lack of support for domestic problems at work, lack of support for work problems at home, lack of organizational rules and policies to support work-life balance)

Workplace Stress

Numerous studies show that job stress is far and away the major source of stress for American adults and that it has escalated progressively over the past few decades. Increased levels of job stress as assessed by the perception of having little control but lots of demands have been demonstrated to be associated with increased rates of heart attack, hypertension and other disorders. In New York, Los Angels and other municipalities, the relationship between job stress and heart attacks is so well acknowledged, that any police officer who suffers a coronary event on or off the job is assumed to have a work related injury and is compensated accordingly (including heart attack sustained while fishing on vacation or gambling in Las Vegas).

Although the Institute is often asked to construct lists of the most and least stressful occupations, such rankings have little importance for several reasons. It is not the job but the person-environment fit that matters. Some individuals thrive in the time urgent pressure cooker of life in the fast lane, having to perform several duties at the same time and a list of things to do that would overwhelm most of us provided they perceive that they are in control. They would be severely stressed by dull, dead end assembly line work enjoyed by others who shun responsibility and simply want to perform a task that is well within their capabilities. The stresses that a policeman or high school teacher working in an inner city ghetto are subjected to are quite different than those experienced by their counterparts in rural Iowa. It is necessary to keep this in mind when sweeping statements are made about the degree of stress in teachers, police personnel, physicians and other occupations. Stress levels can vary widely even in identical situations for different reasons. Stress is a highly personalized phenomenon and can vary widely even in identical situations for different reasons. One survey showed that having to complete paper work was more stressful for many police officers than the dangers associated with pursuing criminals. The severity of job stress depends on the magnitude of the demands that are being made and the individuals sense of control or decision-making latitude he or she has in dealing with them. Scientific studies based on this model confirm that workers who perceive they are subjected to high demands but have little control are at increased risk for cardiovascular disease.

What Is Job Stress?

Job stress can be defined 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 concept of job stress is often confused with challenge, but these concepts are not the same. Challenge energizes us psychologically and physically, and it motivates us to learn new skills and master our jobs. When a challenge is met, we feel relaxed and satisfied. Thus, challenge is an important ingredient for healthy and productive work. The importance of challenge in our work lives is probably what people are referring to when they say "a little bit of stress is good for you. But for David and Theresa, the situation is different-the challenge has turned into job demands that cannot be met, relaxation has turned to exhaustion, and a sense of satisfaction has turned into feelings of stress. In short, the stage is set for illness, injury, and job failure.

What are the Causes of Job Stress?

Nearly everyone agrees that job stress results from the interaction of the worker and the conditions of work. Views differ, however, on the importance of worker characteristics versusworking conditions as the primary cause of job stress. These differing viewpoints are important because they 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. The excessive workload demands and conflicting expectations described in David's and Theresa's stories are good examples. 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. In 1960, a Michigan court upheld a compensation claim by an automotive assemblyline worker who had difficulty keeping up with the pressures of the production line. To avoid falling behind, he tried to work on several assemblies at the same time and often got parts mixed up. As a result, he was subjected to repeated criticism from the foreman. Eventually he suffered a psychological breakdown.

By 1995, nearly one-half of the States allowed worker compensation claims for emotional disorders and disability due to stress on the job [note, however, that courts are reluctant to uphold claims for what can be considered ordinary working conditions or just hard work]. -1995 Workers Compensation Yearbook

NIOSH Approach to Job Stress

On the basis of experience and research, NIOSH favors the view that working conditions play a primary role in causing job stress. However, the role of individual factors is not ignored. According to the NIOSH view, exposure to stressful working conditions (called job stressors) can have a direct influence on worker safety and health. But as shown below, individual and other situational factors can intervene to strengthen or weaken this influence. Theresa's need to care for her ill mother is an increasingly common example of an individual or situational factor that may intensify the effects of stressful working conditions. Examples of individual and situational factors that can help to reduce the effects of stressful working conditions include the following:

Balance between work and family or personal life A support network of friends and coworkers A relaxed and positive outlook

NIOSH Model of Job Stress

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. Example: David works to the point of exhaustion. Theresa is tied to the computer, allowing little room for flexibility, self-initiative, or rest. Management Style. Lack of participation by workers in decision- making, poor communication in the organization, lack of family-friendly policies. Example: Theresa needs to get the boss's approval for everything, and the company is insensitive to her family needs. Interpersonal Relationships. Poor social environment and lack of support or help from coworkers and supervisors. Example: Theresa's physical isolation reduces her opportunities to interact with other workers or receive help from them. Work Roles. Conflicting or uncertain job expectations, too much responsibility, too many "hats to wear." Example: Theresa is often caught in a difficult situation trying to satisfy both the customer's needs and the company's expectations. Career Concerns. Job insecurity and lack of opportunity for growth, advancement, or promotion; rapid changes for which workers are unprepared. Example: Since the reorganization at David's plant, everyone is worried about their future with the company and what will happen next. Environmental Conditions. Unpleasant or dangerous physical conditions such as crowding, noise, air pollution, or ergonomic problems. Example: David is exposed to constant noise at work.

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. Health care expenditures are nearly 50% greater for workers who report high levels of stress. -Journal of Occupational and Environmental Medicine

Early Warning Signs of Job Stress

Job Stress and Health: 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 upperextremity 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. -Encyclopaedia of Occupational Safety and Health

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

Stress Prevention and Job Performance 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. -Journal of Applied Psychology According to data from the Bureau of Labor Statistics, workers who must take time off work because of stress, anxiety, or a related disorder will be off the job for about

20 days. -Bureau of Labor Statistics

What Can Be Done About Job Stress?

The examples of Theresa and David illustrate two different approaches for dealing with stress at work. Stress Management. Theresa's company is providing stress management training and an employee assistance program (EAP) to improve the ability of workers to cope with difficult work situations. Nearly one-half of large companies in the United States provide some type of stress management training for their workforces. Stress management programs teach workers about the nature and sources of stress, the effects of stress on health, and personal skills to reduce stress-for example, time management or relaxation exercises. (EAPs provide individual counseling for employees with both work and personal problems.) Stress management training may rapidly reduce stress symptoms such as anxiety and sleep disturbances; it also has the advantage of being inexpensive and easy to implement. However, stress management programs have two major disadvantages:

The beneficial effects on stress symptoms are often short-lived. They often ignore important root causes of stress because they focus on the worker and not the environment.

Organizational Change. In contrast to stress management training and EAP programs, David's company is trying to reduce job stress by bringing in a consultant

to recommend ways to improve working conditions. This approach is the most direct way to reduce stress at work. It involves the identification of stressful aspects of work (e.g., excessive workload, conflicting expectations) and the design of strategies to reduce or eliminate the identified stressors. The advantage of this approach is that it deals directly with the root causes of stress at work. However, managers are sometimes uncomfortable with this approach because it can involve changes in work routines or production schedules, or changes in the organizational structure. 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.

Preventing Stress at Work: A Comprehensive Approach

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.