PART II

1. PART II Management and Stress: Making Workers Sick

2. The lack of protection for workers’ health and well-being in the form of work-related accidents, illness and stress, lack of workers’ compensation and paid sick leave, lack of maternity protection, excessive hours of work, etc. – remains one of the worst aspects of economic insecurity around the world. An estimated 2,000,000 workers die each year from work-related accidents and disease.

3. Socio-Economic Insecurity, Stress & Disease • Workers’ health information limited, unreliable, systematically understated • Economic liberalization  shift away from statutory regulationworse working conditions, increased stress, declining health • Flexible labour relations  worse working conditions hazard exposures, work-related stress, disease, injury rates • Work intensification management practices are the norm today: increased commuting time, growing insecurities - “time insecurity” is a growing problem.

4. Socio-Economic Insecurity, Stress & Disease • Globally heart attacks, suicide, strokes expected as top occupational diseases of the 21st century (physical stress & psychological distress) • Globally depression important cause premature death/disability(WHO, 2001)including death from overwork (karoshi), much of which is stress-related ILO Enterprise and Household surveys show: • Transition countries’ industrial enterprises lack safety depts./committees  workers more vulnerable to occupational accidents & diseases • Over half of workers in Indonesia have no workplace OSH department/committee

5. Workplace Safety

6. Socio-Economic Insecurity, Stress & Disease ILO Household and Enterprise surveys show: • The poor report extremely poor working conditions • Majority in developing countries bear costs work-related accidents/illnesses, no benefits for incidents (least able to afford it) • Sick/injured workers work without taking leave (fear income or job loss) • Workers in African countries, rural women workers, & casual workers least likely to have insurance against work accidents or injury

7. Socio-Economic Insecurity, Stress & Disease Agricultural workers suffer work-related health insecurity disproportionately: • Agricultural workers suffer much higher rates of accidents and fatal injuries than workers in most other sectors; • Agricultural workers figure disproportionately among over 160 million workers estimated to become ill as a result of workplace hazards/exposures. Ill health/disease prevalent in agricultural communities; • Overcrowded/unhygienic housing perpetuates spread of infectious diseases among agricultural workers (including TB, cholera, diphtheria, STDs, HIV/AIDS).

8. Socio-Economic Insecurity, Stress & Disease ILO Enterprise and Household surveys show: • Social support based on informal networks are protections during economic shocks • Informal networks/social support are the glue holding people together during increasing insecurity But: • Informal systems declining in developing countries • Many workers have no access to such networks • Informal networks depend on culture • Who can give when more have less?

9. (Lack of) Social Support

10. Relyingon Whom During Crisis

11. Causes of Absence from Work Note: The above findings on stress refer to time off due to stressat work or stress outside work

12. Workers’ Health and Well Being Only small fraction of stress-related lost work time ever recorded as such. Yet: in 2002, over 500,000 people said were affected by stress at work (13.4 million working days lost due to stress). Stress affects workers in industrialized economies who have been subject to work intensification management practices

13. Workers’ Health and Well Being • Anational work securityindex measures how well countries protect workers’ health and well-being • Overtwo-thirdsof countries have unsatisfactory levels of worker protection • Mostcritical casesinclude most deprived countries of Africa, Asia, eastern Europe • Laws & mechanisms aloneinsufficientto protect workers’ health

14. Workers’ Health and Well Being • Self-regulation & weak forms of collective voice erode workers’ health and safety • Strong voice representation is associated with strong protection of workers’ health and well being. • Strengthening collective voice is key means of improving working conditions & protecting workers’ health.

15. Workers’ Health and Safety • The trend away from statutory regulation toward « self regulation » causes: • increased stress • worse working conditions • worse health among workers • Opportunism, inertia, self-exploitation • Lack of safety committees/departments globally: • still very weak in developing countries (no workplace safety committee for most Indonesian workers) • weakening in industrialized countries

16. Work-related Stress:a 21st Century Disease • Causes include: • labour intensification • competitive pressures • time-squeeze • rapid technological change • lack of workers’ control in jobs • flexible labour relations (downsizing, contracting out) higher injury rates, hazard exposure, disease and work-related stress

17. The Breakdown of Costs for Work-related Injuries and Diseases “Other” diseases include cancer, skin diseases and mental disorders Source: ILO, 1999

18. Musculoskeletal Disorders MSDs are associated with physical stress and psychological distress • Stress higher in jobs with high demands but where workers have little control over their jobs • Stress and illness outcomes higher where social support low • Stress higher in low skill level jobs with repetitive, boring, mundane tasks.

19. Tight reign of control to make workers productive?

20. …the appearance of non use of control? (the ultimate manipulation?)

21. Such practices have risks…Ouch!

22. Management practices contribute to stress • Some management practice are risk factors for stress and ill health: • total quality management • team working • job enrichment • lean production • process re-engineering • just-in-time policies(Japanese management) • benchmarking or continuous improvement

23. Management practicescontribute to stress • Some management methods cause more mental & physical ill health than others: • Taylorism • neo-Taylorism • Fordism • techno-bureaucratic management style • management based on competitiveness • management by stress

24. Management practicescontribute to stress • Taylorism, neo-Taylorism, Fordism: • repetitive and monotonous task work • intense time pressure • high work demand/low worker control • absence of autonomy

25. Management practices contribute to stress from: • high speed work • de-humanized work tasks • low-skill work • lack of recognition for work performed • lack of management support • unrealistic deadlines • long work hours • poor communication • responsibility without authority

26. Management practicescontribute to stress from: • downsizing • dead end jobs • lack of input in decision-making • hierarchical management • conflicting demands • repetitive tasks • insufficient breaks • low pay and benefits • shift work (especially rotating shifts) • poor supervision

27. Management practices contribute to stress from: • workers doing meaningless jobs with low decision-making die younger than other workers. (B. Amick et al, Psychosomatic Medicine, 2002) • overwork affects all income groups • heart attack & death from overwork is a global problem (USA, UK, India, New Zealand, Australia, China, Philippines, Italy, Indonesia, Rep. Korea) • major health problem: suicide from overwork (Japan 1997-2000 100 suicides everyday!)

28. Management practices contribute to stress • Known outcomes of stress • workers with stressful jobs more likely to die of heart disease than those with non-stressful (M. Kimimaki et al, British Medical Journal, Oct. 2002; A. Spurgeon, ILO 2003) • increase in workload with low control leads to mental health deterioration (Whitehall II Study, London HSE, 2002) • long-term job strain is worse for your heart than gaining 20 kg. or ageing 30 years (Landsbergis et al, Amer. J. of Epidemiology, 2003)

29. End Part II