Stress and psychosocial risks: some practical solutions

1. Stress and psychosocial risks: some practical solutions Dr Eusebio Rial-Gonzalez Project Manager

2. Overview • Introduction to the Agency • Psychosocial risks: current situation • Agency activities and publications • Research review • Identifying ‘good practice’ • Some practical solutions • Tools and methods • Success factors

3. European Agency for Safety and Health at Work

4. Agency Network Structure

5. EU Focal Points CC Focal Points EEA EFTA Focal Points

6. The Agency’s aims and role • Aims to make Europe’s workplaces safer, healthier and more productive • Acts as a catalyst for developing, collecting, analysing and disseminating information that improves the state of occupational safety and health in Europe • http://agency.osha.eu.int

7. Psychosocial work environment: stress • Second biggest OSH problem in the EU • Plus: interaction with second-biggest problem: back ache and MSDs in general • Approximately 28% of workers affected (40M) • Can be related to up to 50% of all absence • Number of people affected has doubled in the last decade (HSC, GB). High in the public sector • Estimated cost per year: • EU: €20,000 million (EC, 2000) • UK: £3.7 billion (HSE 1995/96)

8. Current situation Workers reporting stress(by country)

9. Stress in Spain • IV Encuesta Nacional de Condiciones de Trabajo (data from late 1999) • Short-term ‘symptoms of stress’

10. Spain: conditions by sector Accident at work in previous 2 years > 3 ‘stress symptoms’

11. Current situation: intimidation [1] Workers reporting intimidation(by sector)

12. Current situation: intimidation [2] Workers reporting intimidation(by country)

13. Current situation: EU15 / CC12 Health outcomes (CC12 vs EU15)

14. Current situation: trends

15. Current situation: trends by country

16. Needs identified by Member States • Stress as top priority for action • Psychosocial risks: issues of definition and reporting, but clearly a problem • Need to identify and disseminate ‘practical solutions’

17. Stress research review (2000) – key findings • Limitations in contemporary research but enough scientific evidence to support: • Stress can be dealt with in the same way as other OSH issues: • Adapting the ‘control cycle’ (already well-established for the assessment and management of physical risks) to the management of psychosocial risks. • Practical examples of this approach applied already exist in the EU. • Future research should concentrate on stress management interventions at the organisational level.

18. Actions to prevent or reduce stress at work • Treat like other workplace hazards • Risk assessment and management: • Identify hazards • Decide who might be harmed and how • Evaluate the risk by: • Identifying what action is already being taken • Deciding whether it is enough • If it is not, deciding what more should be done • Record the findings • Review the assessment and check the impact of measures taken

19. Stress prevention: instruments and tools • Psychosocial risks: different in nature from physical risks (not tangible, interactions, etc.) • More difficult to develop standardised, ‘off the shelf’ solutions • EU legislation: focus should be on risk assessment and primary prevention • Long research tradition, but few practical tools • Need to develop user-friendly tools, especially for SMEs

20. Identifying solutions • Need to use tools that: • are valid and reliable • fit the organisational climate/culture • are sensitive to the context of the specific workplace – risk assessment • Some examples:

21. Work Positive: prioritising organisational stress • Health Education Board for Scotland & Heath and Safety Authority (Ireland) • ‘Commended entry’ at the Agency’s Good Practice Awards 2002 • Developed a user-friendly pack to guide organisations through a 5-step process • Raising awareness, gaining and demonstrating commitment • Benchmarking: assessing the current situation • Identifying the causes and assessing the risks • Avoiding and reducing any risks identified • Reviewing the situation www.hebs.com/workpositive

22. Work Positive: benchmarking tool Completed by coordinator before questionnaire sent out

23. Work Positive: risk assessment questionnaire 3 pages: 54 questions + ‘open response’

24. CoPsoQ (2000) • Copenhagen Psychosocial Questionnaire • Developed by AMI (DK), after studying 16 other questionnaires • 3 versions: • Long [141 questions]: for research purposes • Medium [95]: to be used by workenvironment professionals (incl. software) • Short [44]: to be used ‘by the workplace’

25. CoPsoQ

26. CoPsoQ • Questions about working conditions, mental and general health, and coping • Thorough psychometric development • Already used in many studies: allows for comparisons to be made with national average (MS), and with age groups, job types, pay systems, etc. • Spanish and other versions

27. ISTAS-21: adapted from CoPsoQ • Measuring only ‘dimensions’ for which there is good scientific evidence of impact on health • Adapted by: • Arbejdsmiljpinstitittet • ISTAS • Instituto Nacional de Seguridad e Higiene en el Trabajo • Centre de Seguretat i Condicions de Salut en el Treball de Barcelona • Universitat Pompeu Fabra • Universitat Autònoma de Barcelona • Mutua Fraternidad Muprespa • Gabinet Higia Salut i Treball • Departament de Salut Laboral de Comissions Obreres de Catalunya (CONC). www.istas.net/istas21

28. Other examples: WOCCQ • WOrking Conditions and Control Questionnaire (Package) • Developed at the University of Liège • Validated in French and Dutch, also available in English • Basic tool + optional questionnaires to ‘refine the diagnosis’ www.woccq.be

29. Other examples: QPSNordic • GeneralNordic Questionnaire, Lindstrom et al. • Analysis at 3 levels: • Task • Individual • Social and organisational • Two versions: • QPSNordic: research, in-depth, 123 questions • QPSNordic 34+: practical tool, 34 questions • Available in English, Swedish, Danish, Norwegian and Finnish

30. QPSNordic 34+

31. QPSNordic

32. SUVA checklists • Simple, attractive ‘checklists’ (4pp.) • Self-assessment and space for ‘control measures’ • Also published support/reference documents • Available in Italian, German and French

33. SUVA checklists

34. SUVA checklists

35. SUVA checklists

36. More than just tools: process issues [1] • Example: ‘soft guidelines’ developed at AMI for the COPSOQ: • Never start a survey unless there is a clear intention to take action • All results are anonymous and participation is completely voluntary • Workers should have the right to see and discuss all results

37. More than just tools: process issues [2] • The results should be considered as a common tool for dialogue and future development – not as a judgment or a school report! • All parties – workers, middle management and management – should participate in, and be committed to, the whole process

38. Identifying practical solutions • Agency’s European Week 2002: Stress, bullying, violence • Raising awareness and disseminating practical solutions • Factsheets • Case studies report • Good Practice awards

39. Agencypublications – factsheets • Factsheets available on: • Work-related stress • Bullying at work • Violence at work • Information from the Agency on stress at work • Practical advice for workers on tackling stress at work • Strategies to tackle psychosocial issues • Research on work-related stress

40. Agency publications - magazine

41. Agency publications - reports

42. Case studies report: examples include: • Regulatory approaches • Non-regulatory interventions • Campaigns • Guidance • Sector approaches • National and regional authority initiatives • Workplace examples • Collective agreements

43. Good Practice Awards: European Week 2002 psychosocial risks Examples: • 11 stress prevention • 4 violence • 5 bullying Criteria: • Tackling risks at source • Real improvements • Sustainability • Consultation • > just legal compliance • Transferability

44. Stress prevention in an old people’s home – Spain – (1) how: • Cooperation: management, trade unions & local insurance company • Risk assessment of the work and a staff questionnaire • Problems found included: • High work load • Lack of information • Lack of decision-making responsibility • Little possibility of promotion • Unforeseen events/changes of plan • Physical work conditions and physical effort

45. Stress prevention in an old people’s home – Spain – (2) solutions: • Providing lifting aids, hoists • Staff training to deal with emotional stress • Clear definitions of content of tasks and responsibilities, in an agreement • Specifying functions and competencies of nursing assistants –e.g drug dispensing • Increase staffing levels during peak hours • Communication protocol for risks • Increasing worker autonomy, discretion • Promoting worker participation Often low or zero cost solutions!

46. Good practice award winners I Call centre in Germany: including stress prevention measures at the design stage Preventive measures • Staff participation, job rotation, task completion, scope, short breaks, training, improvements in work environment

47. Good practice award winners II • Petrochemicals company in Scotland • During a plant commissioning project • Effective employee involvement: multi-disciplinary project team formed, including an external expert • ‘top five’ stressors identified and controls identified

48. Success factors [1] What we can learn from experience: • Risk assessment is the key & the first step • Context-specific solutions • Thorough planning and a stepwise approach • Staff involved in identifying problems and developing solutions • Combination of measures covering anticipation, prevention, intervention, support and evaluation, with main focus on collective prevention measures

49. Success factors [2] • Involvement & commitment from staff, their representatives and management: essential for long-term sustainability • Solutions do not have to be expensive (sometimes low or zero cost), but there must be management commitment to take action • Any outside expertise must be competent: experienced practitioners and evidence-based solutions • May require liaison with external bodies – police, judiciary, local community (violence)

50. Summary • Psychosocial risks: less tangible, not so straight-forward • Tools for risk assessment already available and tested • Variety of tools: from complex, research-led instruments to simple checklists • No ‘easy fix’ or recipe for interventions: Context-specific solutions • Collaborative process for identifying and tackling risks