Introduction to Psychological Hazards at the Workplace

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Introduction to Psychological Hazards at the
Workplace

• Dr. Emilia Zainal Abidin
• Faculty of Medicine and Health Sciences, UPM

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Work When risk outweigh benefit

• Throughout the world, most adultsand many
  childrenspend much of their waking hours at work
• Work provides a number of economic and other
  benefits
• In recent decades significant changes, closely
  linked to the organisation and management of
  work, have taken place in the world of work and
  resulted in emerging risks and new challenges in
  the field of occupational health and safety
• Changing of pattern workers being introduced to
  pressures of increased production, faster
  machines, newer chemicals, continuous work, shift
  work at speeds determined by demand of production
• Example Hewlett-Packard inkjet-printer factory in
  Malaysia increase production up to 250 on some
  months

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• Psychological risks related but not limited to
• Work-related stress
• Workplace violence
• Bullying
• All types of harassment
• Work-life imbalance example death from overwork
  - karoshi
• Differences between
• Psychological risk is more related to
  individuals perspective while psychosocial
  refers to impact of work environment on health
• Psychosocial hazards are defined in terms of the
  interactions among job content, work
  organisation, environmental conditions and
  management, and the employees competencies and
  needs on the other (ILO)

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Psychosocial hazards Examples from Leka et al. 2003
Job content Lack of variety or short work cycles, fragmented or meaningless work, under use of skills, high uncertainty, continuous exp to people through work
Workload and work pace Work overload or underload, machine pacing, high level of time pressure, continually subject to deadlines
Work schedule Shift work, night shifts, inflexible work schedules, unpredictable hours and long or unsociable hours
Control Low participation in decision making, lack of control over workload
Environment and equipment Inadequate equipment, poor environmental conditions such as lack of space, poor lighting, noise
Organisational culture and function Poor communication, low level of support for problem solving and personal development, lack of definition of organisational objectives
Interpersonal relationship at work Social or physical isolation, poor relationships with superiors, interpersonal conflict, lack of support, bullying and harassment
Role in organisation Role ambiguity, role conflict and responsibility of people
Career development Career stagnation and uncertainty, under promotion or over promotion, poor pay, job insecurity, low social value to work
Home-work interface Conflicting demands of work and home, low support at home, dual career problems
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Psychosocial Impact or health indices

• Psychosocial impact in the workplace is linked
  to
• Increased absenteeism
• Poor work performance
• Health problems
• Staff turnover
• Depression, anxiety, sick leave and propensity to
  leave
• Reduced job satisfaction and motivation
• perceived difference between what is expected as
  a fair and reasonable return-job satisfaction

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Simplified Pyschosocial impact
STRESSORS

• 
  PRODUCTIVITY
• 
  
  PHYSIOLOGICAL
• 
  
  PSYCHOLOGICAL

WORKER
WORKER
ORGANIZATION SICKNESS TURNOVER PRODUCTION
INDIVIDUAL NEGLIGENCE REPUTATION
COUNTRY
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Definition of Stress

• The Emotional state which results from
  discrepancy between the level of demand and the
  persons ability to cope
• Job Demands
• Time Pressure
• Deadline stress
• Excessive workload
• Conflicting demands

Lazarus and Folkman 1980
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The Size of the Problem Globally

• 1 in 3 of Europe's workers report that they are
  affected by stress at work
• The Fourth European Working Conditions survey
  (2007) showed that 20 of workers from the first
  15 European Union (EU) member states (EU-15)
  believed that their health is at risk because of
  work-related stress
• In UK, 15 of all working individuals thought
  their job was very or extremely stressful
• ILO (2006) produced a list of occupations which
  equal or exceed the rate of 6 on a stress rating
  scale of 0 to 10 ?

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Stress Rating
Source ILO (2006)
Miner 8.3
Police officer 7.7
Prison officer 7.5
Construction worker 7.5
Airline pilot 7.5
Advertising executive 7.3
Doctor 6.8
Nurse 6.5
Ambulance personnel 6.3
Fire fighter 6.3
Teacher 6.2
Social worker 6.2
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Yerkes-Dodson Law Not all stress are bad
Performance arousal
High
Low
High (distress)
Optimum (eustress)
Low (distress)
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The Job Strain Model by Karasek
Psychosocial functioning at the workplace, based
on psychological demands and decision latitude  
Job strain hypothesis
fatigue, anxiety, depression and physical illness
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E.g. Causes of stress at work among young doctors

• Demands that work places on personal life,
  excessive workload, and long hours
• Covering for colleagues on sick leave and
  insufficient provision of locums is one of the
  most important factors contributing to excessive
  workload
• Fatigue which can result in decreased
  concentration, inadequate patient care and
  potentially serious clinical mistakes
• Bullying or harassment
• Feeling powerless and uninvolved in determining
  one's own responsibilities
• Continuous unreasonable performance demands
• Lack of effective communication and conflict
  resolution
• Excessive time away from home and family
• Office politics and conflicts among staff
• Feeling that reward is not commensurate with
  responsibility
• Work-related stress in terms of personal
  suffering, patient care and medico-legal
  liability
• High public expectation

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Work environment
Conceptual Frame Work of Stress
FAMILY SOCIO DEMOGRAPHIC STRESSORS
Home environment
OCCUPATIONAL STRESSORS
Work load
Work environment
Health status
Financial
Family Conflict
Time and System Management
ACUTE AND CHRONIC EFFECT 1. Physiological 2.
Psychological 3. Behavioral
OUTCOMES OF STRESS
Organizational relationship
Personality
Training
MODYFYING VARIABLES
SUPPORT
Knowledge
Skill
Social Interaction
Coping mechanism
Emotional support
PERCEIVED STRESS
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• Instrument - Personal Stress Inventory (ODonnell
  et al 1984)
• Consists of 52 items from 11 subscale
• Based on a four-point Likert scale
• Score of more than 40 or 36 (ROC curve) were
  considered stressed (Rokiah 1994, Mohd Ridzal
  2006)

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The chemistry of stress
E.g Fear of a car accident
E.g An argument
E.g Taking an examination
1. Chemical messages are carried to the
hypothalamus
2. The hypothalamus produces corticotropin
hormone releasing factor CRF
3.CRF goes to pituitary gland which releases
the hormone
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3. CRF goes to pituitary gland which releases
these hormones
4. TSH in thyroid gland increases metabolism
5. ACTH via Bloodstream to adrenal glands
7. Medulla produces Adrenalin and noradrenalin
6.Cortex produces cortisol
Increases heart beat raise blood pressure
Increases blood sugar
8. Chemicals return to the pituitary glands
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Signs and symptoms of stress

• backache,
• nausea,
• muscle tensions,
• shortness of breath,
• Malaise (general discomfort),
• weight loss,
• weight gain,
• Frequent flu/colds

• PHYSICAL
• Fatigue
• Sleep disturbances, difficulty
• getting up, stomach ailments,
• tension headache, migraine headache,
• GIT problems,

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Psychological

• Feeling
• Anger
• boredom
• frustration
• depression discouragement disillusionment
• anger, anxiety suspicious, irritability
  hopelessness

• Attitudes
• cynics
• indifference
• self-doubt
• Loss of empathy, difficulty concentrating
• low morale, moodiness, decrease sense of self -
  worth

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Behavioral

• fault finding
• blaming others
• defensiveness
• apply derogatory labels to people

• unnecessary risk taking
• workaholics
• conflict with co-workers
• Suicide, drug/ alcohol abuse etc
• absenteeism
• making mistake

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Sexual harassment

• The participation of women in the nation's labour
  force is significant - 44.2
• With increased participation of women in the
  workplace, there will inevitably be more
  incidences of sexual harassment
• Women who now hold more jobs which were
  traditionally dominated by men are also likely to
  face sexual harassment in the workplace
• There are also incidences of same sex harassment
  and men being harassed, but generally, it is a
  problem faced mostly by women

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What is sexual harassment?

• Sexual conduct which is
• Unwanted and Unwelcome to the recipient
• Imposed-on and Unsolicited or Unreciprocated by
  the recipient
• Any unwanted conduct of a sexual nature having
  the effect of verbal, non-verbal, visual,
  psychological or physical harassment
• Perceived by the recipient as a sexual nature,
  effect on her/his employment
• Perceived by the recipient as an offence or
  humiliation, or a threat to his/her well-being,
  but has no direct link to her/his employment

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5 Forms of Sexual Harassment

• Verbal Harassment
• e.g.. offensive or suggestive remarks, comments,
  jokes, jesting, kidding, sounds, questioning
• Non-verbal / Gestural Harassment
• e.g. leering or ogling with suggestive overtones,
  licking lips or holding or eating food
  provocatively, hand signal or sign language
  denoting sexual activity, persistent flirting
• Visual Harassment
• e.g. showing pornographic materials, drawing
  sex-based sketches or writing sex-based letters,
  sexual exposure
• Psychological Harassment
• e.g. repeated unwanted social invitations,
  relentless proposals for dates or physical
  intimacy
• Physical Harassment
• e.g. inappropriate touching, patting, pinching,
  stroking, brushing up against the body, hugging,
  kissing, fondling, sexual assault

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When and How Does Sexual Harassment Occur?

• The target of harassment as well as the harasser
  may be male or female
• Parties may be of the same sex

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Bullying

• What is workplace bullying?
• Workplace bullying is verbal, physical, social or
  psychological abuse by employer (or manager),
  another person or group of people at work
• Personal insults
• Invading ones personal territory
• Uninvited physical contact
• Threats and intimidation, both verbal and
  nonverbal
• Sarcastic jokes and teasing used as
• insult delivery systems
• Withering e-mail flames
• Status slaps intended to humiliate their victims

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What Is Workplace Violence?(Note the subjective
nature of 2--4)

1. Physical Assault
2. Threatening Behavior
3. Verbal Abuse
4. Harassment

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Four Categories of Workplace Violence

1. Violence by Strangers Committing Robbery
2. Violence by Customers, Clients, or Patients
3. Violence by Employees and Supervisors
4. Violence by Domestic Partners or Relatives of
   Employees (new category)

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How to measure Psychosocial Risk?

• Self reported questionnaires containing questions
  regarding presence of risk factors in the work
  environment cheap and easy
• Example Copenhagen Psychosocial questionnaire,
  burnout inventory, general nordic questionnaire
• Objective measures are based on observational
  approaches, including archival data (e.g.
  sickness leave, performance measures, accidents),
  and biological measures
• Since stress activates the pituitary-adrenal
  cortical system, biological markers are commonly
  used
• Measurements of heart rate (variability) and
  blood pressure, biochemical measures of uric
  acid, blood sugar, steroid hormones (i.e.,
  cortisol), serum cholesterol, catecholamines
  (i.e., adrenaline and noradrenalin, epinephrine
  or norepinephrine), are also considered robust
  and reliable ways to measure stress responses

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PSYCHOSOCIAL RISK MANAGEMENT - Organization
strategies

• Assessing job satisfaction
• Interview
• Observation
• Questionnaires
• Job enrichment program
• Direct feedback
• New learning
• Personal accountability
• Schedule their own work

• Improving the quality of work
• The work environment
• Task performed
• Reward structure

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Managerial approaches

• Reactive support
• Listening
• Referral
• Confrontation
• Control rewards

• Resolving of interpersonal conflict
• Issue conflict
• Role conflict
• Personality clash
• Support systems
• Staff support system

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Managerial approaches (cont.)

• Organization development program
• Increase level support and trust among individual
• Increase open confrontation
• Open and genuine in interpersonal communication

• Increase personal enthusiasm and self control
• Positive reinforcement
• Money
• Positive work environment
• Promotion

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Individual strategies managing psychosocial risk

• Control physical stress responses
• Breathing methods
• Muscle relaxation
• Mental method
• Manage actions
• Be assertive
• Use effective listening
• Maintain health buffers
• Exercise
• Nutrition
• Sleep
• Avoid maladaptive reaction to stress
• Alcohol drug abuse
• Smoking
• Overeating
• Blaming others

• Self monitoring
• Manage self talk
• Alter irrational beliefs
• Take it less seriously
• Take the treat into opportunity
• be okay no matter what
• Utilize available coping resources
• Social support
• Money
• Belief and Faith

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Types of health promotion programme

• Awareness programmes which aim to increase the
  workforces level of awareness in relation to
  specific health topics. Typical activities
  include health fairs posters, newsletters,
  educational classes and health screening
• Lifestyle change programmes directly aim at
  changing employees health behaviour through a
  variety of approaches such as skills training and
  self-help
• Supportive environment programmes aim to promote
  a sustainable healthy lifestyle through creating
  a workplace environment that supports and
  encourages healthy choices
• Peersman et al. 1998

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Are there people with no STRESS?

• Thank you for your attention