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Stress Is modern life really rubbish or are we just complaining too much? Dr. Craig A. Jackson Occupational Psychologist Research Director Health Research Consultants Research Consultants .co.uk. Misperceptions of workplaces UK Climate of: over-perception of danger
Is modern life really rubbish or
are we just complaining too much?
Dr. Craig A. Jackson
Research DirectorHealth Research Consultants
UK Climate of:
over-perception of danger
stress being unavoidable
wanting too much in return
Attention Deficit Trait
Shiftworking: 1 in 5 employed
likely to increase with growth
Long hours: >48 hours per week
Fallen due to EWTD
Still > most of Europe
Psychosocial: 5 mill employees perceive effects
13 mill working days lost
Mundane occupations suffer
Chronic stress more problematic
Physical: Noise technical
Mainstream in last 15 years
Quality of Life
Rise of the worker as a “psychological entity”
1. Hearing loss NIHL, TTS, Exposure
2. Respiratory problems Asbestosis, Carbon Black, Recycling
3. Skin problems Hairdressers, Health care, Engineering
4. Mental health Stress, Anxiety, Uncertainty
5. Musculoskeletal disorders Desk workers, Cleaners, Drivers
Potential Health Risks
2x Substance abuse
3x Back pain
5x Certain cancers
Mental health problems
Shain & Kramer 2004
“One evening we had an almost inaudible talk from…..the BBC staff doctor who told us how to recognise stress in our staff: the body sits slumped, with the head shrunk between the shoulders. At least I think that is what he said. He was difficult to hear as we were all sitting slumped with our heads shrunk between our shoulders”
Frank Muir in A Kentish Lad
Anxiety Depression Tension Tired Worry
Apathy Apprehension Alienation Resentment
Confidence Aggression Withdrawal Restlessness
Indecision Sleeping problems Concentration
Any impairment or any disease of a person’s physical or mental condition
1974 Health and Safety at Work Act
“Assessments of risks of activities associated with potential hazards”
1992 Management of Health & Safety at Work Regulations
Big stress cases
1. Johnstone vs Bloomsbury H.A Doctor
2. Walker vs Northumberland C.C. Social Worker
3. Jones vs Birmingham C.C Teacher
4. Hurley vs Gwent Constabulary Police officer
5. Fearon vs Martin Burglar
6. Armstrong vs Home Office Prison warder
Education / Training
Unmotivated staff ?
“Cattle Truck Syndrome”
Chronic health problems exacerbated
by train travel?
Cumulative impact theory
Increased B.P, Anxiety, Chronic Heart Conditions
Over-crowded trains / buses
Straining public transport system
Lack of control
“People develop a constant internal anger on crowded trains that they cannot easily displace…an individual's immune system could also be suppressed by stress, making passengers more susceptible to illnesses”
Japan, South Korea, Indonesia, UK
uninterrupted heavy workload
heavy physical work
excessive demands from irregular overtime and shift work
excessive workloads from emotional stress, such as responsibility, transfers, and conflicts
“Veal – Fattening Crate” *
“Small, cramped office workstations built of fabric covered disassemblable wall partitions and inhabited by junior staff members. Named after the small pre-slaughter cubicles used by the cattle industry”
Douglas Coupland in Life After God
*Do farm animals get better conditions than some workers?
“Golden Age of Stress”
Everyone is Stressed
BBCi - “Stress” = 16,000 finds
More people experiencing more stress
Greater demands from employers
People working longer hours
24 / 7 / 365 society
Will workers take responsibilityfor their ill-health?
A.Stress occurs when demands exist which are outside a person’s capacity for meeting those demands
B.Stress is a response to the presence of psychosocial hazards in the workplace
C.Stress is the reaction people have when they feel they cannot cope with the pressures or demands placed upon them
Over-simplistic definitions !
Stress Definitions #2
Stress is the disparity between what needs to be done (required) and what can be done (actual)
demands are not static
abilities are not static
how to quantify disparity
meaningfulness of any quantification
Police Fire Ambulance Prison
Civil pilots Media Performers Teaching Nursing
Health care (non-emergency) Social work Mining Construction
ABOVE AVERAGE STRESS
Marketing Publishing Printing
Retail Catering Transport
HOW MUCH FAITH CAN BE PUT INTO BROAD CATEGORIES?
Stress Looks like a flaming deamon Sounds like an eagle squaking Tastes like a burnt sausage Smells like sour milk Feels like stroking a hedgchog Stress is when mum says NO!!!!!
by Andrew (aged 10) Year 5 Potley Hill Primary School
The curse of the Corpus Linguistic
World Wars I and II
Where was stress?
Dud shell manufacture
Some Stress is good
Keeps one alert
Keeps one alive
Too little stress = extinction
Too much stress = extinction
Balance stress = evolution
Pressure is good - - Stress is bad
1995: Labour Force Survey
515,000 reported work-related stress
250,000 attributions of physical symptoms
30% increase in reports since 1990
1996: Institute of Management 270,000 daily absences for stress
£10.2 Billion cumulative annual cost
(sick pay, lost production, treatment)
2002: UK Health and Safety Executive 265,000 new “cases” in 2001
2000: Evans et al.Scottish heart attack deaths higher on Mondays
2004: UK Health and Safety Executive 13,000,000 working days lost / year
£12 Billion cost
Carroll, D et al. 2002
England's matches in the 1998 World Cup
15 June (England 2, Tunisia 0) win
22 June (Romania 2, England 1) lost
26 June(Colombia 0, England 2) win
30 June (Argentina 2, England 2) lost: penalties 4-2
Extracted hospital admissions data for acute myocardial infarction, stroke, deliberateself harm, and road traffic injuries among men and womenaged 15 to 64
Games all took place in late evening
Examined the same associations using only the two days afterthe match omitting the day of the match as the exposedcondition
During the period of England's World Cup matches (15 June to 1 July)
81,433 emergency admissions occurred:
1348 (2%) formyocardial infarction
662 (1%) for stroke
856 (1%) for roadtraffic injury
3308 (4%) for deliberate self harm
observed / expected actual – expected ARR
Day of match 91 / 72 19 1.25 (0.99 to 1.57)
1 day after 88 / 72 16 1.21 (0.96 to 1.57)
2 days after 91 / 71 20 1.27 (1.01 to 1.61)
3 days after 76 / 74 2 0.99 (0.77 to 1.27)
4 days after 71 / 74 3 0.92 (0.71 to 1.19)
5 days after 83 / 72 11 1.13 (0.89 to 1.43)
Major environmental events, whether physical catastrophes or cultural disappointments,are capable of triggering myocardial infarction.
If the triggeringhypothesis is true, preventive efforts should consider strategiesfor dealing with the effects of acute physical and psychosocialupheavals.
“Perhaps the national lottery or even the penalty shoot-out should be abandoned on publichealthgrounds.”
Harvesting effect? Reporting tendency? Sudden deaths?
This has all gone too far
The Anti-Stress Backlash
Seek those with similar experiences
Stick to a plan of action LONG
Support seeking TERM
Day to day basis SOLUTION
Withdraw from people in general Avoidance
Deny what has happened Consumption TERM
Drink, eat, smoke to relieve tension Denial
Differing Attitudes & Differing perceptions
Complex reasons Experience Personality
Stress is associated directly with workplaces
is also mediated by individual differences
No universal profile of what will certainly constitute stressful situations
Important to be aware of vulnerable individuals and groups
Associated with socio-economic, cultural or demographic status
Disabled Any group by definition which is un-empowered
Personality – although some of this is spurious!
“Type A” (uptight, goal oriented) likelihood of stress-illness and CHD (?)
“Type C” (high anxiety) likelihood of Cancer (?)
“Type D”(negative affectivity, emotional inhibition) likelihood of CHD (?)
“External” locus of control poorer at handling stress
“Hardiness” greater resistance and operability
Is this a good sign or a bad sign?
Optimism vs Pessimism
Hi Claire. Are you around and do you fancy a brew?
Hey. On way home. Left lecture early cos feel like crap. Next time!
Historical Errors of Distress-Related-Ill Health
Historically, distress was “blamed” for many ills
Now we know better…
Beri Beri All believed to be
Asthma caused by stress
Down’s syndrome at one time or another
Puts “blame” for illness on the person
1. Potential for violence Accident & Emergency Services
2. Peril or Danger Expected Dangerous Conditions
3. Potential for aggression
1. Verbal abuse
2. Physical abuse
Unpredictable Behaviour / Incident
3. PTSD inducement
Work overload / underload
Under utilisation of skills
Time pressures Lack of control
Working hours unsociable long unpredictable
Communication too little (home-working) / too much (email)
Change / technology
No decision process
Promotion under and over
Hazards physical / chemical
Home – work interface
Lack of support
Chemical pollutants Equipment
Air con Telephones
Control, communication, feedback
Is STRESS the common link with SBS?
Risk of psychological strain and increased illness
Risk of psychological strain and increased illness
There is too much pressure to get
everything done on time
If I have a personal problem, I talk
to people about it
I often feel drained and tired
I get headaches at the end of the day
I feel much better at weekends
My partner asks me how my day has
Occupational & clinical
perceived sources of stress
Any workplace / person / social interaction
Stress is a natural / healthy response
Some responses to stress are pathological
Impossible to predict stress reliably – easier to predict intolerance
Individual modifiers – personality, behaviour, coping style, perceptual processes
Legal obligation clearer than ever
Psychosocial hazards unavoidable & intrinsic in some cases
Most psychometric stress testing unethical
HUMAN CONDITION, NOT A “VARIABLE”
Why become stress intolerant?
Who benefits from this?
Too much personal freedom?
Celebrity culture - nobody wants the bad jobs?
What happens to stress-prone workers?
Who is to blame for being stressed?
Who is to blame for being ill?
Carroll D, Davey Smith G, Sheffield D, Shipley MJ, and Marmot MG. Pressor reactions to psychological stress and prediction of future blood pressure: data from the Whitehall II study. BMJ 1995;310:771-775.
Chen C, David AS, Nunnerley H, Michell M, Dawson JL, Berry H, Dobbs J, and Fahy T. Adverse life events and breast cancer: case-control study. BMJ 1995; 311: 1527-1530.
Jackson CA. Psychosocial Aspects of the Workplace. In Aw, T.C et al. (eds) Occupational Health Pocket Consultant (fifth edition). Oxford: Blackwell Scientific Publishing; 2006. 191-201
Jackson CA and Cox T. Health and well-being of working age people. ESRC Seminar Series. ESRC. London. 2006
Jackson CA. Psychosocial Hazards. In Smedley, J et al. (eds) Oxford Handbook of Occupational Health. Oxford. Oxford University Press 2006 (in press).
Kivimäki M, Leino-Arjas P, Luukkonen R, Riihimäki H, Vahtera J, and Kirjonen J. Work stress and risk of cardiovascular mortality: prospective cohort study of industrial employees. BMJ 2002; 325: 857.
Levenstein S. Stress and peptic ulcer: life beyond helicobacter. BMJ 1998; 316: 538-541.
Shain M and Kramer DM. Health Promotion in the Workplace: Framing the Concept; Reviewing the Evidence. Occupational and Environmental Medicine 2004;61:643-648.
Work Stress: The Making of a Modern Epidemic. Michael Fitzpatrick. Open University Press, 2002.