Research dealing with relationships between job stress and health and accident causation was reviewed, and the usefulness of worksite stress management training (SMT) for reducing stress symptoms and therefore lowering accident risk was discussed. Based on the review section, a heuristic model was presented wherein stress symptom activity produces decrements in worker capabilities, thereby increasing accident risk. The basic premise of the model was that a percentage of all accidents was a function of temporary, unsafe behavior brought about by stressor induced disorganization of the capacities of the worker. The function of the model was to organize diverse literatures, suggest testable hypotheses, and provide a vehicle for assessing the potential merits of stress management training. Buffer factors such as social support and stress coping skills function to weaken the stressor/acute reaction link and reduce the occurrence of ill health outcomes. Studies have linked several psychological and behavioral factors, either directly or indirectly, to performance decrements and increased accident risk. Among these were the factors of stress/anxiety, fatigue, and alcohol and drug use. Two case studies were presented, which illustrated the range of benefits that can be expected from company stress management training. The first was conducted at a midwestern public works department employing about 300 people, and the second was conducted by the St. Paul Insurance Companies in a midwestern hospital employing about 1,000 workers.
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