WORK ORGANIZATION AND STRESS-RELATED DISORDERS
Inputs: Occupational Safety and Health Risks
Although information is limited, indicators of occupational safety and health risks associated with the organization of work and workplace stress come from two sources: (1) data on the prevalence of stress and stress-related disorders in the workplace, and on how experiences of job stress have changed in recent years coincident with changing organizational practices, and (2) data on the scope of workplace exposures to workplace conditions that are known risk factors for stress and stress-related disorders, and on how these exposures have changed.
Data on the Prevalence of Stress and Stress-Related Disorders
Claims about escalating and exorbitant levels of job stress in the United States are common in the popular media. Although information on this topic is still sketchy, reliable evidence has begun to emerge on both the extent of job stress and stress-related disability in the U.S. workforce, and on recent changes in these measures. The following information represents a sampling of this evidence.
Stress and Mental health Data
Stress/Stressful Working Conditions
The General Social Survey (GSS), a biannual personal interview survey of U.S. households conducted by the National Opinion Research Center, contains a question asking how frequently work is stressful. In the period 1989-2002, between 30% and 40% of respondents reported their work was "often" or "frequently" stressful, but no clear trend exists in these data during this period. These figures are in reasonable agreement with other sources suggesting a high prevalence of stressful working conditions during the 1990s. For example, in a study by Northwestern National Life, 40% of workers reported their jobs to be "very" or "extremely" stressful. Similarly, the Families and Work Institute's 1997 National Study of the Changing Workforce reported that 26% of workers said they were "often" or "very often" burned out or stressed by their jobs, and 36% felt "often" or "very often" used up at the end of the day [Bond, Galinsky, and Swanberg 1998].
Employee Burnout: Causes and Cures, 1992.
Reference: Northwestern National Life Insurance Company . Employee burnout: Causes and cures. Minneapolis, MN: Northwestern National Life Insurance Company.
The 1997 National Study of the Changing Workforce, 1998.
Reference: Bond JT, Galinsky E, Swanberg JE . The 1997 national study of the changing workforce. New York: Families and Work Institute.
Poor Mental Health
In the 2002 GSS, the NIOSH Quality of Work Life (QWL) module (http://www.cdc.gov/niosh/qwlquest.html) was added to provide national estimates on the conditions of work with special attention to work organization factors and stress-related disorders. Four questions in the QWL were taken from the CDC Health-Related Quality of Life measures. One of these questions asked about the number of days in the past month that workers felt their mental health was not good. Figure 1 shows the percent of workers in various industries who reported poor mental health for 14 or more days per month (case definition for poor mental health). As seen, retail trade workers are at greatest risk for poor mental health (17% with 14 or more days of poor mental health per month), followed by workers in transportation and public utilities. Workers in wholesale trade were at least risk.
Figure 1. Employee Reports of Poor Mental Health (by Industry Sector)
General Social Survey, 2002
Lost Workday Data
The annual Survey of Occupational Injuries and Illnesses (SOII) is a surveillance system in which the BLS collects information from private industry establishments on the number of different types of injuries and illnesses involving time away from work, the amount of time lost, and the circumstances of the injuries and illnesses (http://www.bls.gov/iif/). Illnesses reported in the SOII are those most easily and directly related to workplace activity. Diseases that develop over a long period or that have workplace associations that are not immediately obvious are under-recorded in SOII. Since data are reported only for the private sector and does not include the self-employed and farms with fewer than 11 employees, a large segment of the U.S.workforce is not represented.
Among the types of illness and injury information provided, the survey collects data on anxiety, stress, and neurotic disorder cases that involved days away from work. The NIOSH Worker Health Chartbook, 2004 contains a wealth of information on these types of disorders, such as their yearly prevalence and distribution by demographic factors, industry, and occupation. As shown in Figure 2, in comparison to all other types of injuries and illnesses, anxiety, stress and neurotic disorders are associated with longer periods of lost work days. In 2001, the number of lost work days for workers with these types of disorders was, on average, more than four times greater (average=25 days) than the number of workdays lost for all nonfatal injuries or illnesses together (average=6 days). However, the prevalence of these disorders was quite low in comparison to other types of illnesses and injuries.
Figure 2. Days Away from Work Due to Anxiety, Stress, and Neurotic Disorders Compared to Days Lost for All Injuries and Illness
Anxiety, stress, and neurotic disorders differ according to industry sector. Figure 3 shows incidence rate of anxiety, stress, and neurotic disorder cases by private industry sector in 2001. As seen in this figure, higher rates of these disorders were reported for transportation and public utilities, finance, insurance, real estate, and services. Of interest, the increased rate for transportation and public utilities parallels the increased risk of poor mental health in this sector described above, although the same is not true for the finance, real estate, and insurance sectors. Also, wholesale trade workers are at the lowest risk in both data sets. (Note: A dash in parentheses indicates that no data were reported or that data do not meet BLS publication criteria.)
Figure 3.Incidence Rates of Anxiety, Stress, and Neurotic Disorders (by Industry Sector)
It is worth noting that the SOII shows a decline in the number of anxiety, stress, and neurotic disorders during the 1990s, with an upswing in 2001. This decline, as shown in Figure 4, would be unexpected if changing work organization practices were causing jobs to become more stressful during this period. However, it should also be noted that this decline corresponds to a general decline in lost time injuries and illness during this period.
Figure 4.Cases of Lost Time Illness Due to Anxiety, Stress, and Neurotic Disorders (by Year)
Stress and Healthcare Utilization Data
Workers who report experiencing stress at work also show excessive health care utilization. In a 1998 study of 46,000 workers, health care costs were nearly 50% greater for workers reporting high levels of stress in comparison to "low risk" workers. The increment rose to nearly 150%, an increase of more than $1,700 per person annually, for workers reporting high levels of both stress and depression.
The Relationship Between Modifiable Health Risks and Health Care Expenditure: An Analysis of the Multi-Employer HERO Health Risk and Cost Database, 1998.
Reference: Goetzel, RZ, Anderson, DR, Whitmer, RW, Ozminkowski, RJ, Dunn, RL, Wasserman J . The relationship between modifiable health risks and health care expenditure: An analysis of the multi-employer HERO health risk and cost database. J Occup Environ Med, 40:843-854.
Alcohol Use and Abuse Data
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that drinking among U.S. workers threatens public safety, impairs job performance, and results in costly medical and social problems affecting workers and employers alike. Productivity losses attributed to alcohol were estimated at $119 billion for 1995, and NIAAA cites a number of organization factors that contribute to problem drinking in the workplace.
Data on Exposure to Workplace Risk Factors for Job Stress
As noted in the preceding discussion of Economic Inputs, organizational practices have changed dramatically in recent years. However, we have limited capacity to judge how these changes may have cascaded downward to influence aspects of job design that are suspected risk factors for stress. A primary obstacle is the paucity of information about how exposures to stressful job conditions have changed during this period, prohibiting analyses to correlate changing organizational practices with job conditions. Following below is a sampling of the limited data on how job conditions that are recognized risk factors for stress have changed in recent years. These data are gleaned from an assortment of surveys in the United States and other industrialized countries where organizational practices have followed a similar course as in the United States. While the trends noted in these examples suggest increased risk of stress in the workplace, much has yet to be learned about the influence of changing organizational practices on the broad spectrum of working conditions that contribute to stress.
Working Hours Data
A substantial percentage of Americans work very long hours. By one estimate, more than 26% of men and more than 11% of women worked 50 hours per week or more in 2000. These figures represent a considerable increase over the previous three decades, especially for women. According to the Department of Labor, there has been an upward trend in hours worked among employed women, an increase in extended work weeks (>40 hours) by men, and a considerable increase in combined working hours among working couples, particularly couples with young children.
Report on the American Workforce.
The Time Divide: Work, Family, and Gender Inequality, 2004
Reference: Jacobs JA, Gerson K . The time divide: Work, family, and gender inequality. Cambridge: Harvard University Press.
Data on Job Security
Analyses of data from the 1989 and 1998 GSS revealed a pronounced decline in job security in the United States during this period. The percentage of workers strongly agreeing that their job was secure declined from 27% in 1989 to 22% in 1998. This fall in job security is particularly striking in the presence of a decline in the unemployment rate during this same period, which would be expected to cause workers to feel more secure about their jobs.
Trends in Perceived Job Quality, 1989 to 1998, 2005.
Reference: Handel, MJ . Trends in perceived job quality, 1989 to 1998. Work and Occup 32 (1):66-94.
Data on Work Intensification
Personal interview surveys of working conditions, including conditions recognized as risk factors for job stress, were conducted in Member States of the European Union in 1990, 1995, and 2000. Results showed a trend across these periods suggestive of increasing work intensity. In 1990, the percentage of workers reporting that they worked at high speeds at least one-fourth of their working time was 48%, increasing to 54% in 1995 and to 56% in 2000. Similarly, 50% of workers reported they work against tight deadlines at least one-fourth of their working time in 1990, increasing to 56% in 1995 and 60 % in 2000. However, no change was noted in the period 1995-2000 (data not collected in 1990) in the percentage of workers reporting sufficient time to complete tasks.
- National Institute for Occupational Safety and Health (NIOSH)
- Centers for Disease Control and Prevention
TTY: (888) 232-6348
- New Hours of Operation
- Contact CDC-INFO