Job Stress and Health
Excerpt from a publication of the Center for the Promotion of Health in the New England Workplace:
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
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How does job stress contribute to cardiovascular disease, and what can be done to intervene?
Cardiovascular diseases (CVD) are the leading cause of death in the United States.
Considerable evidence has demonstrated that occupational stress contributes to CVD morbidity and mortality. It is estimated that up to 23 percent of heart disease related deaths per year could be prevented if the levels of job strain in the most stressful occupations were reduced to average levels seen in other occupations …
Job stress results from the interaction of the worker and the working conditions. Specific workplace features of concern include highly repetitive, monotonous tasks, excessive job demands and time pressure, racial or sexual discrimination; management style, interpersonal relationships, work roles, job insecurity, and environmental exposures such as constant background noise, or heat. One very widely used definition of stressful work is the combination of high demands with little or no leeway for decision-making about the job (also referred to as “high demand/low control” or “job strain”). A high demand with insufficient rewards (known as
“effort/reward imbalance”) has also been highlighted as problematic.
Evidence supporting the multiple mechanisms by which job stress contributes to cardiovascular diseases (and other chronic health conditions) comes from a vast body of international scientific literature that includes epidemiologic studies, patho-physiological studies of animals and humans, and behavioral studies. Stressful conditions on the job can result in at least three main mechanisms or pathways:
1. Changes in physiological processes that increase the risk for CVD—high cholesterol, high blood pressure, high blood sugar, weakened immune response, high cortisol, and changes in appetite and digestive patterns.
2. Changes in behavior that increase the risk for CVD—low physical activity levels, excessive coffee consumption, smoking, poor dietary habits.
3. Development of mental health conditions (anxiety and depression) that independently increases the risk for a range of chronic health conditions, including CVD (obesity, stroke, atherosclerosis, arrhythmias, myocardial infarction, etc.).
… evidence from intervention research shows clear benefits for a “systems” approach that emphasizes primary prevention, and that combines approaches for improving working conditions with approaches for managing occupational stress-related illnesses. Examples of primary prevention approaches include clarifying worker roles, increasing worker decision making opportunities, improving worker management communication, ensuring a respectful work environment, and increasing social interaction between workers. Examples of managing occupational stress-related illness include training on stress management techniques, providing space for exercise and medication, and providing access to employee assistance programs …
Authors: Suzanne Nobrega, M.S., and Manuel Cifuentes, M.D, Sc.D., University of MA Lowell
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STUDY: BAD MANAGERS POTENTIALLY LETHAL
In a groundbreaking 2008 study, Swedish researchers, led by Anna Nyberg at the Stress Institute in Stockholm, studied more than 3,100 men over a 10 year period in typical work settings. The researchers reported in the Journal of Occupational and Environmental Medicine that employees who had managers who were incompetent, inconsiderate, secretive and uncommunicative were 60 percent more likely to suffered a heart attack or other life-threatening cardiac condition. Employees who worked with “good” leaders were 40 percent less likely to suffer heart problems.