MODULE 7: PSYCHOSOCIAL ISSUES AND OTHER MISCELLANEOUS TOPICS IN OCCUPATIONAL AND ENVIRONMENTAL HEALTH - SECTION 5: WORK AND STRESS: 2: Health Effects Of Stress

2: HEALTH EFFECTS OF STRESS:

A variety of health problems are associated with stress, and in some instances, may be the first sign that an individual is stressed. These include gastric problems, headaches, mood and sleep disturbances, depression and deteriorating interpersonal relationships. At the same time, the worker becomes more vulnerable to infectious diseases. The mechanisms that an individual may use to address his stressful situation may, in themselves, result in greater ill health, eg. use of alcohol, psychotropic medication or even illicit drugs. This can eventually also lead to other negative consequences such as increased absenteeism and decreased efficiency.

A considerable amount of research has been conducted into the stressful conditions which result in musculoskeletal disorders. For example, Bongers et al (1993) postulated that the following factors played a role in such disorders:

1. Psychosocial factors at work:
   1. demand and control;
   2. social support.
2. Individual characteristics.
3. Stress symptoms.
4. Physical and behavioral health indicators.

Psychosocial factors at work directly influence mechanical load as for example in time pressure situations. Demands, job control and social support, together with individual capacity to cope may influence work related stress. Such stress may:

1. lead to increased muscle tone;
2. influence the relationship between load and symptoms due to enhanced perceptions of symptoms or reduced capacity to cope.

These researchers attempted to explain the interaction between the various factors resulting in a poor health outcome (in this instance, musculoskeletal disease) (Figure 2):

Previous research have indicated the following diseases to be associated with stress:

• Cardiovascular Disease: Many studies suggest that psychologically demanding jobs that allow employees little control over the work process, as well as prolonged job insecurity, increase the risk of cardiovascular disease, particularly hypertension.
• Musculo-skeletal Disorders: There is evidence that job stress increases the risk of back and upper-extremity musculoskeletal disorders.
• Psychological Disorders: Prevalence of mental health problems, such as depression and burnout, is associated with job stress levels. Economic and lifestyle differences between occupations and individuals may also contribute. There is, therefore, a need to identify those individuals prone for mental disorders within those individuals who are highly stressed.
• Work-related Injuries: There is growing concern that stressful working conditions interfere with safe work practices, thus contributing to the currently estimated global total of 250 million accidents at work each year, with around 300 000 fatalities.
• Suicide, Cancer and Ulcers: Some studies suggest an association between stressful working conditions and these health problems. However, more research is needed to draw firm conclusions.
• Burnout: Prolonged exposure to stress at work may lead to a psychological condition of burnout (feeling of being drained, reduced productivity and disinterest in one’s job.

Figure 2. From Bongers et al: Psychosocial factors at work and musculoskeletal disease. Possible associations of psychosocial factors at work with stress and musculoskeletal symptoms.