Part two: Is stress a health and safety hazard for you?

Stress is sometimes not regarded as an obvious health and safety hazard. The key is to identify the causes and symptoms (see part one [1]), and be prepared to act.

On the surface, stress may not seem as direct a threat as asbestos, infectious diseases, or needlestick injuries. With those hazards, the threat is clearly identifiable and the health impacts are commonly understood.

Stress is not as cut and dried. It is related to work organisation issues and their outcomes. For example, job insecurity is a cause of stress, which in turn can lead to WRULDs (work-related upper limb disorders), burnout, or anxiety.

These outcomes might be attributed to some cause other than job insecurity. Burnout or anxiety is often dismissed as being caused by an individual’s lifestyle or their ‘inability to cope’, which incorrectly shifts blame to the worker instead of their workplace – a classic employer manoeuvre.

Identify the problem

We readily recognize when stress is causing our health, job satisfaction, morale, family and personal relationships to deteriorate. It is not workers who need to be convinced that stress has become a significant health and safety hazard: it’s the employer.

Surveys and questionnaires

Surveys usually involve handing out a written questionnaire. They are a great tool for guaging the extent of a health and safety issue. Hackney TUC has produced a questionnaire which can be adapted for use in your workplace - download it here [1]. You can use it in full or in part. If it is too long, just use the questions that are relevant to your local or workplace.

Often, employers claim that there is no evidence for a problem like stress. When workers can show the results from a questionnaire, they take a major step towards addressing stress by gaining recognition for the hazard. It is a good idea to have either the union, through its health and safety committee, or any joint (union/management) health and safety committee involved.

Prior to distributing the survey, hold a membership information session. Ensure that members know the questionnaire is confidential and explain its purpose: to assess the stress problem in their workplace as a first step towards making necessary improvements to eliminate the hazard. It may be necessary to have the questionnaire translated, taking into account those workers whose first language is not English.

Once the survey is ready, it should be distributed throughout the workplace. Union representatives should be responsible for collecting completed questionnaires. There needs to be a plan and process in place for tabulating the questionnaires. Once the results are calculated, they should be presented and discussed at a union meeting, highlighting those issues that are central to stress in your workplace.

Use the information in our section ‘introduction to workplace stress’ to help explain the stress hazards in your workplace. The questionnaire results should then be presented at a joint negotiating meeting, preferably in a session or sessions dedicated only to dealing with stress hazards.

The results of the questionnaire need to be acted upon. It is not enough to just take the pulse of the membership. The questionnaire must form the basis for action to find solutions to workplace stress hazards.

If the employer or management representatives on the negotiating or health and safety committee do not want to co-operate with conducting a survey, the union should survey the membership on its own. However, the joint committee should be the staging ground to present the union’s survey results; the first lever for change on stress. The committee is a forum for concretely addressing health and safety hazards and union members must use it to push for change. If one does not exist in your workplace, make a formal request for one to be established. It is a right under the Health and Safety at Work Act.

Mapping

Mapping techniques can also be used in your workplace, to identify both the stress hazards and the health effects. By representing hazards and their effects visually, they can be more easily recognised and more clearly expressed than by written explanations.

Mapping is a form of collecting information that recognises workers as a source of valuable information and producers of knowledge. Health and safety improvements are more likely in workplaces where workers, with their union, are involved in identifying problems and developing solutions.

Three types of mapping are typically used to assess a health and safety hazard: body mapping, hazard mapping and your world mapping.

• Body mapping shows the physical and psychological effects of stress hazards.

• Hazard mapping looks at the layout of a workplace, charting where hazards exist.
• Your world mapping paints a wider picture by looking at how workplace hazards affect workers beyond the workplace, for example, how stress hazards affect family life.

These three forms of mapping provide a complete picture of health and safety hazards.

Taking action

This section covers specific actions for addressing stress in your workplace. Together with the solutions and strategies section that follows, it is a plan for dealing with workplace stress.

The law

It is basic law that employers should provide a safe place of work, safe plant and equipment, a safe system of work and reasonably competent fellow employees. Failure to do so may be used to prove fault – ‘negligence’ - by the employer.

The 1992 health and safety regulations

The first principle of all the regulations is that work should be adapted to the worker, not the worker adapted to the work.

The management of health and safety at work regulations 1992

These require every employer to carry out a risk assessment. This assessment should consider and specifically address the issue of stress and is meant to identify any ‘hazards’. The Code of Practice to the regulations describes a ‘hazard’ as: "Something with the potential to cause harm (this can include substances or machines, methods of work and other aspects of work organisation)".

The guidance to the regulations specify that a risk assessment should ensure that all relevant risks or hazards are addressed, ensuring all aspects of the work activity are reviewed.

The regulations themselves require the identification of groups of workers who might be particularly at risk: the examples given are the young or inexperienced, or those who work alone.

HSE guidance on stress at work

In May 1995 the HSE published guidance on stress at work. It is currently (Sept 2004) consulting on the implementation of new guidance.. Stress is recognised as a work place hazard that is both predictable and preventable. (Link to HSE website on stress [2])

Sources of stress identified by the HSE include providing a service to the public, poor health and safety, uncertainty, conflicts, high demands, inflexibility and lack of support.

The HSE says employers should:

• Ensure good management in terms of competence, consistency and two-way communication with staff.

• Ensure management have the right attitudes to stress.
• Ensure stress is understood and not seen as an individual's problem.
• Make sure the organisation is committed to addressing stress and that individuals are encouraged to seek relief and support.

Right to refuse

Under the provisions of the Health and Safety at Work Act, employers have a legal responsibility to provide a safe and healthy working environment. The employer is responsible for providing a working environment where stressors – like any other hazards – are eliminated, controlled or minimised. Workers have a duty to protect their health and have the right, and in some cases an obligation, to refuse unsafe work.

Traditionally, the right to refuse has been used in other areas, such as with possible exposure to toxic chemicals or cases where workers are required to work in confined spaces without proper engineering controls. However, the right to refuse is a legitimate way to address any health and safety hazard.

The same procedure for refusing unsafe work can be used with stress. Make sure you give a written explanation for your refusal and you consult with your trade union rep). The grounds for refusing unsafe work should be directly stated as being due to stress hazards, specifying some direct sign of stress (eg., time pressures, rushing unsafely through tasks to complete work, violence, harassment and bullying, etc.).

Stress is a health and safety hazard that can create unsafe working conditions. If all else fails, a work refusal is a valid and direct way to combat the problem.

Relax

Take your breaks. Slowing down and stopping your work on your break will help to relieve stress. It will also help you avoid the cumulative effects of toxic stress. If you are entitled to coffee and lunch breaks, make sure you are taking these breaks.

Similarly, if your collective agreement states that you have specific hours of work, then stick to those hours of work. Provisions that define breaks and the length of work days ensure that workers get a proper rest from work and that they are paid for all of the time they spend working.

You can also consider negotiating ‘flexible working’ which allows you to better fit your working life around your domestic and external commitments. Some workers have a legal right to have such requests properly considered by their employer (visit the DTI webpage on flexible working [2] for further details on the right to request flexible working).

The body and mind need to rest. A fifteen minute break can really help. Taking a break is also exercising some control over the job. Asserting control is central to eliminating workplace stress.

Taking a break also signals to employers and supervisors that union members know their rights at work and that they are able to exercise control where they have it. This is a vital point. If a supervisor sees a worker working through her/his break on a regular basis to complete tasks, that supervisor will assume that the worker does not need the break and will likely assign at least the equivalent of fifteen minutes more work. Taking breaks is a sign of solidarity among workers, as workers in the same job should be working the same hours, at the same pace.

Report stress health and safety hazards

There is a legal obligation on employers to provide a safe working environment. However, experience shows that it is only when workers and their trade unions actively challenge stressful working practices that change is achieved.

Proactive prevention at the source is the most effective way of solving any health and safety problem. The following organisational changes will help prevent and eliminate stress:

• Measures should be put in place to increase workers’ real control. Examples include giving workers more autonomy, more participation in decision-making, more opportunity for self-directed work, and more opportunity to use and develop their work skills.

• Workers should have the right to refuse overtime and overtime should be capped.
• Workloads must be decreased and made more manageable for workers and sufficient staff levels must be set.
• Sufficient rest times and breaks must be provided.
• Job designs must be reviewed to lower stress hazards, for example, working alone should be eliminated, and work tasks should be assigned in an appropriate manner according to experience and competence. Any job redesign must have meaningful worker input.
• Monotonous work should be avoided or eliminated where possible and more variety of work tasks should be incorporated into workers’ jobs.
• The physical features and arrangement of workspaces must be redesigned to reduce stress hazards (eg. minimise noise, introduce natural lighting, ensure proper ventilation is in place).
• Flexible work arrangements should be put in place to accommodate workers’ responsibilities (eg. between family and work).
• Communication needs to be improved to avoid workers suffering from stress in silence or isolation. Improved two-way communication will facilitate worker input on job design and other factors.
• Workplaces need to foster a supportive workplace climate to help eliminate stress, for example, by not tolerating bullying, harassment and violence in any form.
• Supervisors need to be supportive of workers, for example, by listening to workers’ ideas and concerns and acknowledging workers’ contributions to the workplace.
• Leave days should be provided to permit workers time for childcare, elder care and personal reasons.
• Employers should provide Employee Assistance Programs (EAPs) as a way to counter the effects of stress, keeping in mind that these programs do not replace the need for employers to prevent and eliminate workplace stressors.
• Governments need to increase public sector funding to counter staff shortages, overwork, and other stressors.
• Employers should reduce sudden changes (eg. new technologies, abrupt work shift rearrangements) in the workplace.
• Split shifts should be eliminated except where they form part of an agreed flexible working arrangement which fits the needs of the employee.
• Training to identify stress hazards should be instituted, preferably union-provided training.

Work that is reorganised following these recommendations will be less stressful. The changes and supports will help prevent stress by reorganising work to eliminate stress hazards.

Worker control

Workers need control for their jobs to be fulfilling. Work must be a meaningful part of our lives. Many of the recommendations in the previous section will provide greater worker control.

A more democratic workplace is a safer and healthier workplace. Workers also need to fully utilise existing controls to combat stress. For example, stress health and safety hazards must always be reported and where they exist they should be brought to a joint health and safety committee meetings.

Actions such as these are good examples whereby workers can exercise their existing control to help prevent stress.

Stress policy

Negotiating a stress policy is a good starting point for change. A policy should start from the premise that stress is an occupational health and safety hazard, and that all steps possible should be taken to prevent the hazard.

The policy should contain a definition of workplace stress. Further specifics could be added to the policy. For example, it could be linked to other policies such as grievance and equal opportunities.

The exact range of a stress policy in a given workplace may vary. What should be central is the universal principle of health and safety law in this country: the employer is obligated to protect workers’ health. The policy should reflect this, including a statement from management that stress is an organisational problem that it is committed to solve.

The policy should also outline a reporting procedure for workers experiencing stress. A good policy paves the way for further solutions and strategies, for example, by creating and determining the role and responsibilities of a joint health and safety committee. Any policy should be reviewed from time to time to assess its effectiveness. Policies can be updated and revised if necessary.

Collective bargaining

Collective agreements should always aim to improve workers’ health and safety. Because stress is largely caused by how work is organised, collective agreements can be used to reorganise work to eliminate stress hazards.

Any collective agreement on stress should have prevention of the hazard at its core. A definition of workplace stress should be spelled out in the collective agreement to frame stress hazards. The concept of normal versus toxic stress could be mentioned in the definition.

• Set minimum staffing levels.

• Establish flexi-time and job sharing initiatives.
• Create more favourable shift arrangements and permit workers to swap shifts with each other to accommodate family and other responsibilities.
• Set limits to overtime.
• Create shorter or compressed work weeks.
• Allow for voluntary reduced hours at work to accommodate personal or family needs. (Under recent legislation part time workers cannot be treated less favourably than their full-time colleagues).
• Establish sufficient rest breaks.
• Promote childcare provisions and parental leaves to address work-family imbalances.
• Provide time and resources for members to receive union health and safety training on stress and other health and safety issues.

As with other health and safety hazards, enforcement of the law is fundamental to ensure workers’ health and safety is protected. Workers can call in government health and safety inspectors (or local authority Environmental Health Officers) to investigate hazards and issue legally enforceable notices where workers make complaints that stress hazards are not being addressed by employers.

Compensation

Occasionally newspapers report cases where workers have won compensation after suing their employer for the damage to their health of stress at work. Occasionally these can sound like large sums of money, but such cases are difficult to win, and large compensation is only awarded when the worker has suffered serious damage and often is unable to work again.

Proving a stress case is not easy. ‘Stress’ covers a variety of conditions. Disputes over what it means will be used by employers to cloud and confuse issues.

There are a number of hurdles that a stress claim has to clear if it is to be successful:

Injury

It is fundamental to a personal injury claim that there is an injury. Injury does not have to be physical, but ‘stress’ is not enough. The courts look for evidence of a clinically recognisable psychological or psychiatric condition.

Duty of care

In the vast majority of stress claims where the case is brought by an employee against his or her employer, there automatically exists a legal duty of care and there has to be a breach of this duty of care.

Negligence

Establishing negligence - fault on the part of the employer - is a question of fact in each case. The employer should have been able to reasonably foresee a risk of injury due to the stress at work.

Medical causation

Medical causation - proving that the injury has been caused by work rather than personal circumstances or personal characteristics - is where stress cases often fail.

Prevention is always better than cure. If there is a stress problem at your work it is best handled in the workplace and not the court room. Speak to your union rep and ensure the issue is raised and steps taken to tackle it.