How Stress Leads to Injuries on the Job - Literature review Example

How stress leads to injuries on the job. Despite increased recognition by the legal, medical and insurance communities, for many workers (even those in scientific community) stress remains a complex and nebulous construct implying numerous events and processes. Speaking about occupational stress, Henry Freudenberger wrote that, “there is always a potential for stress when an environmental situation is perceived as presenting a demand which threatens to exceed the person’s capabilities and resources for meeting it, under conditions where he/she expects a substantial differential in rewards and costs from meeting the demand versus not meeting it.” (cited in Stellman 1998, p. 516) For example, conflict may arise between the individual and the world of work because a transition is called for. To illustrate: for the beginning worker we have the self-centredness of adolescence to the disciplined subordination of personal needs to the demands of the workplace. (p. 516) This is the reason why many workers need to learn and adapt to the reality those personal feelings and values are often of little importance or relevance to the workplace. The dilemma is underscored by the fact that the work environment is becoming more complex, ever changing and technologically sophisticated. The impact of stress in the field of occupational safety engineering is tied to the fact that exposure to stressful working conditions can have a direct influence on a worker’s safety or the risk of illness and injury. Literature Review Occupational stress, as a field of inquiry examining job conditions and their health and performance consequences, is a relatively new research domain that crystallized in 1970s. The study of occupational stress was given impetus in the early 1970s by the establishment in the US of the National Institute for Occupational Safety and Health (NIOSH), whose goal is to conduct research to reduce work-related illnesses and injuries. From then on, research and studies conducted by the agency would help shape the course of job-stress research in the United States. One of the most important findings of NIOSH is that job stress is viewed as a situation in which job stressors – alone or in combination with other stressors – interact with individual worker characteristics and result in acute disruption of psychological or physiological homeostasis. Levy, Baron and Sokas (2006) elaborated on this study further, citing that: This disruption (often called job strain) can be psychological (disruption in effect or cognition); physiological; or behavioral. Job strain, if prolonged, is thought to lead to a variety disorders, including cardiovascular disease, psychological disorders and musculoskeletal disorders. (p. 383) Cary Cooper conducted an early review of occupational research and was able to develop a facet model outlining the relationship among stress-and-non-stress-related variables found or assumed in the literature in 1979. (p. 7) In his stress model, occupational stressors are located in the environmental facet, and that the individual’s strains are part of the human consequences facet. Here, strains and stressors are the two types of variables whose presence is necessary and sufficient to define an occupational stress situation. In regard to the job stressors, a more detailed definition is presented by B.S. Dhillon (2003), who identified four classifications of job stressors: occupation-related, workload-related, occupational-frustration and miscellaneous stressors. (p. 111) Dhillon would also attribute much of the common causes of accidents to stress as he cited its common causes: overexertion, impact accidents, compression, motor vehicle accidents, bodily reaction to chemicals and falls. (p. 44) He particularly referred to the human factor theory explaining occupational accident causation, assumes the occurrence of accidents to a chain of events caused by human error which, in turn is caused by three broad factors – all relating to stress - inappropriate response, overload and inappropriate activities. (p. 44) In the tradition of Hans Selye’s experiments, William Rom and Steven Markowitz (2006) elaborated on how stress could bring injury to a worker in the workplace: In the wide variety of stressors, such as exposure to temperature extremes, information overload, noise, executive stress, high expectations, low motivation, among others, evoke identical patterns of physiologic changes wherein the cortex of the adrenal glands became enlarged, the thymus and other lymphatic structures became involuted, and deep-bleeding ulcers develop in the stomach. (p. 860) This example established the role of emotions in affecting physiologic functions and disease – eliciting a response that could be potentially dangerous to the worker in situations in the workplace. Such response could be an elevated heart rate and blood pressure, redistribution of blood flow to the brain and major muscle groups. This particular detail becomes significant in terms of worker’s safety when machineries are involved. The impact of this dimension – stress as a cause of work injury - to occupational stress and safety in engineering is underscored by statistics: In the year 2000 a total of 97, 300 deaths occurred due to unintentional injuries or accidents and that the overall cost of accidents in the United States was around $512 billion – costs including medical expenses, insurance expenses, lost wages fire-related losses, and indirect costs. (Dhillon, p. 43) Rom and Markkowitz explored this issue further as they cite how costs associated with work-related chronic diseases drain a nation’s economy and tax business organizations too much. An example was given: “while the average (median) time lost attributable to nonfatal illness is about 6 days per incident, stress-related claims are associated with a median of 25 lost days, and over 40% of stress-related claims entail more than 30 days of missed time.” (p. 860) Applying occupational stress to the engineering field, Cary Cooper (1998) looked for stressors in the physical environment at work by examining changes in performance as an outcome as much more often than employee strains, and recommended a change in the organizational environment in order to form a treatment or intervention. (p. 7) Such approach sought to understand the potentially harmful effects of the social, physical and psychological characteristics of the workplace on the worker. This is probably the major reason why organizational psychologists, physicians, clinical psychologists, engineering psychologists, labor economists as well as nurses contributed greatly to the pile of occupational stress literature. The study of occupational stress has, henceforth, become a multidisciplinary field. In this regard, Steve Jex (2002) suggested that occupational stress can be approached from four different perspectives: 1) medical; 2) clinical/counseling; 3) engineering psychology; and, 4) organizational psychology. (p. 181) I would like to highlight the recognition of the engineering sector in addressing occupational stress issues. Cannon provided us an invaluable insight by advancing the concept of physiologic homeostasis and by developing an engineering concept of stress and strain (i.e. stress as the inputs, strain the response). (cited in Rom & Markowitz, p. 861) Interventions Stellman suggested measures for the improvement of professional and managerial workers’ working conditions and these include the following: All managerial, supervisory and professional workers should be included in health and safety training on the worksite. Worksite smoking cessation programmes are appropriate as they are convenient, allow practice of cessation behaviours during office hours (when workers are often most needed to cope with stressful events) and provide incentive to quit smoking. Drafting and implementation of time management proggrammes which could lead to improved worker satisfaction and productivity. Diversity training improves cross-cultural understanding. Female professional and managerial staff must have workplace support for their demanding roles at home and in the workplace. Development of employee assistance programmes that are non-judgmental and confidential. Computer, machinery work hazards require organizational, environmental, equipment and training emphasis. Workers must be given engineering equipments, work practice, protective gears. (p. 99) Gaps Despite the plethora of literature on the nature, causes, and physical and psychological consequences of occupational stress, surprisingly, there are few explorations and studies in regard to occupational stress intervention. Of course, this does not mean that no intervention system, models or solutions are being implemented in the workplace as some researchers suggest intervention guides just like what is outlined above. Indeed, as the human and financial costs of occupational stress have become known, many organizations have introduced initiatives that reduce stress and improve employee health in the workplace. (Stellman, p. 99) However, that there are just few current studies that document, compare and analyse these occupational stress interventions including their successes and failures. According to William Rom and Steven Markowitz views differ regarding the importance of worker characteristics versus working conditions as the major cause of occupational stress and this, in effect, led to the development and use of distinctly different interventions approaches. (p. 860) A case in point is the Swedish study or professional telecommunications engineers which suggested that most studies of stress, which have usually been based on low- and medium-skill jobs, are not applicable to skilled professionals. Also, a particular limitation of existing work is that nearly all investigations were conducted with American or British samples, leaving open the question of whether stress plays a similar role in work as an occupational hazard in non-Anglosaxon cultures. James Quick (1990) reminded us that the extent of to which interpersonal support acts as a buffer against the adverse effects of stressors may be culturally different. (p. 114) Now this is a serious because the trend today for companies is to become global in operations and that stress research with a comparative focus across cultural or national boundaries becomes imperative. These gaps in literature have important implications on future studies in the area of occupational stress. First, it is important to undertake studies that would analyse, compare and collate intervention solutions to occupational stress in terms of successes and failures as well as by industries. Second, personal and cultural orientations in terms of idiosyncrasies of styles of coping, individual characteristics in relation to stress and work environment should be studied in greater depth. Third, it is important to develop a more precise theoretical argument as to what interventions and stress coping styles would cover the broad sectors of workers and workplaces. Finally, the importance of work and non-work and personality factors in the prediction of work- and health-related outcomes must be explored since the body of literature cited in this paper indicates that these factors are important in predicting employee reactions to stressful events. References Cooper, Cary. (1998). Theories of Organizational Stress. New York: Oxford University Press. Dhillon, B.S. (2003). Engineering Safety: Fundamentals, Techniques and Applications. World Scientific. Jex, Steve. (2002). Organizational Psychology. John Wiley and Sons. Levy, Barry, Baron, Sherry, and Sokas, Rosemary. (2006). Occupational and Environmental Health. Lippincott Williams and Wilkins. Rom, William, and Markowitz, Steven. (2006). Environmental and Occupational Medicine. Lippincott William & Witkins. Stellman, J. (1998). Encyclopedia of Occupational Health and Safety. International Labor Organization. Quick, J. (1990). Career Stress in Changing Times. Haworth Press. Read More