Risk assessment and work related stress

1. Risk assessment and work related stress psih. Mihaela SERACIN, psih. Raluca IORDACHE National Research & Development Institute for Labour Protection “Alexandru Darabont”

2. Risk Observatory Report (2007) of the European Agency for Safety and Healthat Work „Expert forecast on Emerging Psychosocial Risks related to Occupational Safety and Health” significant changesin the world of worknew challengesfor safety and health at work.These changeslead – besidesphysical, biological and chemical risks – new emerging psyhosocial risks, dependingon the task designand work organization, and also the general work economic and social context. Psychosocialrisks - Prognoses - Concepts

3. „An emerging OSH risk has been defined as any occupational risk that is both new and increasing”. • New risk means that: • the risk was previously unknown and is caused by new processes, new technologies, new types of workplace, or social or organizational change; or • a long-standing issue is newly considered as a risk due to a change in social or public perceptions; or • new scientific knowledge allows a long-standing issue to be identified as a risk. • Therisk is increasing if: • the number of hazards leading to the risk is growing; or • the likelihood of exposure to the hazard leading to the risk is increasing (exposure level and/or the number of people exposed); or • the effect of the hazard on workers’ health is getting worse (seriousness of health effects and/or the number of people affected). • Psychosocial risksare considered to bethose aspects of work design, organization and management, of work social and environmental context, which can determine psychological, social or physical injuries.

4. Study results lead to the identification of a top of emerging psychosocial risksas follows: • New forms of employment contracts and job insecurity • new forms of employment and contracting practices(e.g., temporary contracts), and the trend in companies towards new forms of production (e.g., „lean production” and „outsourcing”) are important factors affecting the occupational health and safety of many workers. • Workers in these types of contracts are more vulnerable than, for instance, permanent workers, and • successive short-term contracts and of the resulting discontinuity in work careers the risk of social marginalisation. Workers’ isolation caused by new forms of working patterns such as telework or temporary work is also put forward. These implications, in the context of unstable labour markets, increase workers’ feeling of job insecurity, which augments the level of work-related stress and may have a negative impact on workers’ health.

5. Work intensification: • high workload and work pressure as a consequence of the reduction of workplaces, and also of the growing amount of information to handle at work as a result of the introduction of new Information and Communication Technologies (ICT) into the workplace; • a higher workload and demand shared between fewer workers, hence an increase in work-related stress; Within this context, workers may also fear to be more assessed upon their efficiency and the outcomes of their work, and hence tend to work longer working hours in order to finish their task, sometimes without receiving adequate compensations (in the form of free-time or financial compensation) and social support. • European statistics indicate that almost half of all European employees work at very high speed three quarters or more of the time.

6. The ageing workforce: • It is a consequence of both the ageing population and the higher retirement age. • Ageing workers are more vulnerable to poor working conditions than young workers. • The failure in providing ageing workers with life-long learning opportunities increased mental and emotional demands upon them, which may: • affect their health, and • increase the probability of work-related accidents.

7. High emotional demands at work: • Workers may try to hide their difficulties in coping with these demands as a reaction to the fear of losing job, which can be the source of additional stress. • The issue is not new, it is a growing concern, especially in the health care and the service sector, which is growing and where competition is increasing. • Workplace violence (and also „bullying”, „mobbing”) was identified as a contributing factor to this increased emotional demands.The consequences of workplace violence may appear in psychological pathology (deterioration of self-esteem, anxiety, depression, apathy, irritability, memory disordersetc.), and somatic pathology as well (organic, functional and sleep disorders, alterations in the cortisol cycle, loss of appetite, hypertension, vomiting, chronic fatigue, back, muscular and joint pain as well as headaches etc.).

8. Poor work-life balance • the relevant literature stipulates that irregular working time, especially combined with the lack of possibility for the employee to arrange thier work to a certain extent to their personal needs, often causes problems affecting the work life balance and the employees’ health. Non-standard hours such as shift, weekend, and night work can be especially disruptive for work-life balance when the employee is in a precarious employment situation. Casual work combining high work intensity, variable and unpredictable working hours lead to work-life conflict and has detrimental effects on wellbeing.

9. Statistics • Stressis on the second placein the top of the most frequent complaints regarding work related health problems. • Stress affectsalmost one of four workers in EU. • The studies showed that between 50% and 60% of all not-performed workdays are stress related. • The economic costs of work related stress in EU-15was about 20 000 milions EUR in 2002. • The number of persons affected by work related stress could grow.

10. Approaches • One of the main characteristics of the new approaches in both scientific and OSH risks practical prevention fields is referring to the necessity of a multifactorial, multidimensional and, as a consequence, a multidisciplinary approach of risks, taking into account that: • Under the circumstances of new techniques and technologies, there is the danger for personnel to be exposed to acumulus of occupational noxes; • One and the same risk factor, especially the neuropsychic overload and psychological stress, is a result of a cumulative action of different occupational (therefore, multidimensional), extra-occupational and individual factors; • Human being is a bio-psycho-social entity, which reacts as a whole at external / occupational factors; the reactions could be somatic, psychological, behavioral plans, depending on the nature of risk and individual vulnerabilities.

11. Occupationalpsychological and psychosocial factors – as risk / stress factors

12. Factors of physical environment: noise, vibrations, microclimate, lightning, workplace design, chemical noxes, radiations etc. – objective or perceived noxious factors; accident risk. Activity related factors: indicatorsof complexitaty / speed number of routine choices number of aware choices cycle duration and number of operations / cycle memory effort speed in execution attention level (concentrate, distributive…) attention continuity etc. degree of precision Occupationalpsychological and psychosocial factors – as risk / stress factors Temporal demands: • duration (day, week…) • break regime • free or imposed rhythm • repetitive / no repetitive activities • shift work • wage system • Work at imposed or free rhythm

13. Organizational and leadership factors: role (task) ambiguity conflict between work demands responsibilities on people and their safety or, on the contrary, lack of responsibility lack of consultation and participation in the decision process unreasonable restrictions regarding the work behaviour lack of control and auto-control Interpersonal relationships: difficult relations with the superiors, colleagues and / or subordinates inadequate psychosocial climate absence of feeling of group membership no safety feeling lack of self – confidence lack of appreciation, recognition and support

18. Workers groups most at risk Although the majority of EU workers have typical work schedules, gender, age and socio professional differences are observed in terms of the prevalence of atypical work schedules. Some employees seem to be especially at risk because of flexible or irregular working time.

19. Age Older workers (between 55 and 64) are less affected by, but not excluded from, atypical work such as night work, shift work, weekend work and irregular schedules, than the younger age groups. For instance, in 2005, about 20% of the EU25 employees in the age range 24-39 reported shift work, whereas there were 16% of such employees in the age range 40-54, and 11% among those the aged 55 and more. Nevertheless, workers aged 65 and over are well involved in atypical time schedules like weekend work, irregular schedules and other atypical schedules specific to the service sector.

20. Stress indicators at organizational level •  Absenteeism • High fluctuation of the work force • Disciplinary problems • Violenceand bullying • Low productivity • Errors and accidents • High costs coming from compensations and medical care

21. Psychological, physiological and behavioral responses to occupational stress / overload factors

22. Psychological responses • Cognitive disorders • perception restriction • low concentration • memory disorders • hesitations in decision making • modifications in thinking content • lowering of creativity • Emotional reactions • feelings of deprivation, weariness, guilt, emotional tension, anxiety, irritation, worry, sadness, pessimism, lack of hope regarding the future, depression • apathy • low professional satisfaction • discomfort and threatening state • Self image • lowering of self confidence, high discrepancy between ideal (reference) image and the perceived one

23. Physiological responses • Biochemical modification in: • neuroendocrine function (hormones secretion) • imunological mechanisms • blood lipidesand carbohydrates • alimentary acids secretions • Alteration in some organs or systems activity • brain, and its electrical activity (EEG ) • muscles (EMG) • skin, electrodermal functions (GSR) • gastrointestinal tract (electrogastrogram) • cardiovascular system(CF and other indicators in ECG, vasomotory activity, AT) • sexual functions • pupil (pupilometry) • posture • sight

24. Behavioral responses • Generals • high consumption of coffee, tobacco, alcohol and drugs (especially tranquillizantsand stimulants) • modifications in feed habits • sleep disorders • neglecting physical exercise • low activism and social participation • assuming of sickness, excessive appeal or, on the contrary, avoidance of medical care • changes in lifestyle • antisocial actions and behaviours • breaking interpersonal relationships and sexual relations • suicide • Work related • absenceand postponing job responsibilities • low work performance, both quantitative and qualitative • increasing of accidents number • Interpersonal conflicts • risky behaviour

25. Legislation • EU Framework Directive (89/391/EEC), according to whichthe employers „must assure employees safety and health,in every work related aspects”, and also „adjusting work to people, especially regarding workplaces design, choices of technique equipment and work and production methods, with an accent on reduction of monotonous and imposed rhythm work and, as a consequence, reduction of their effect on health”. • Framework Agreement on fighting against stress at work(four European organizations of social partners) - social dialogue program 2003 – 2005. • Law no. 202 (19 April 2002)regarding equality of chances between women andmenandLaw no. 501 (17 November 2004)regarding approval ofGovernmentOrdinance no. 84/2004 to modification and completion of Law no. 202/2002 • Government Resolution no. 319/08.03.2006 regarding approval of National Strategy for equality of chancesbetween women and men for 2006 - 2009 and of General Plan of Actions for implementingof National Strategy.

26. The national unique collective work contract 2007-2010: Regarding work content, the employer and the contract signatories must act together to transpose the stress management standards at enterprise level: • taking into accountthe number of work hours established by law, and work contracts, which should be applied when underpinning the workload for the employees; • pursuing thatthe employees’ level of competence, aptitudes and skills should fit workplace demands; • the workplace conditions should be ergonomically adjusted to workers; • the employees should be informed and consulted and have all the needed information to understand their work responsibilities, according to workplace record.

27. Regarding work control: • the employer should encourage the employee to use his capacities and skills at work; • in close cooperation with the unions or employees’ representatives, the employer should establish a stimulative system to motivate the employees in effective achievement of the work tasks. Regarding activity managementat the workplace, there should be stipulatedin the work contracts time intervals and practical information modalities for the employees regarding the changes related to work conditions. Regarding work relations,under the care of Safety and Health Committee and the Parity Commission, the information related to bad practices at workplaces will be analyzed and corrective measures will be prescribed.

28. NATIONAL STRATEGY ON SAFETY AND HEALTH AT WORK FOR 2008 – 2013 based on COMMUNITY STRATEGY ON SAFETY AND HEALTH AT WORK FOR 2007-2012 (adoptedthroughCounsel Resolution from 25 June 2007)