13 May, 2010
Lacking job security and decent working conditions creates a great deal of stress, particularly in people who are struggling to support a family. Medical researchers discovered, in the 1930s, that stress by itself could produce physical effects. Since then, there has been an ongoing effort to better understand the stress response.
The strict scientific definition of stress is "any stimulus, or group of stimuli, that provokes a physiological or psychological response." A more useful definition of stress in the work context might be "conditions that exceed a person's normal coping capacity." In occupational health, we are particularly concerned with the stressful effects on workers of conditions in the workplace.
What are the negative effects of excessive stress on health - and by health, we mean all aspects of physical, mental, and social well-being?
The symptoms of stress are generally thought to arise from the "fight or flight response." In our evolutionary history, human beings were adapted to respond to a threat by preparing to either fight, give chase, or run away. The body instinctively reacts in certain ways designed to prepare itself for a sudden, short-term, all-out effort to survive.
At first, the sense heightens, blood pressure goes up, heart rate accelerates, respiration increases, blood flow to the muscles is increase, muscles tense, and the digestive system shuts down. Your body temperature may change, provoking sweating. In our evolutionary past, these responses prepared you mentally and physically to meet a threat that would be resolved, for better or for worse, within a few minutes.
The problem in modern terms is that our bodies seem unable to distinguish between the "threat" posed by a cave-bear, a bullying boss, or perpetual fear of job loss. The fight-or-flight response, maintained or repeated too often, results in chronic or long-term damage. These can include hypertension and cardiovascular disease, ulcers, colitis, compromised immune systems, headaches, and psychological changes.
To further complicate things, different people respond to chronic stress in different ways and with different symptoms. Faced with the same workplace stressors, Jane may experience diseases of her digestive system while John may develop high blood pressure. These inconsistent symptoms have made it very difficult to get stress symptoms recognized as a legitimate occupational disease.
All working people experience some degree of career stress; but workers who toiled under Contract and Agency Labour (CAL), who lack even minimal job security and often work for lower wages and in poorer conditions than their full-time counterparts, experience much more. Career stress should be thought of as adding to all the other stresses caused by every aspect of a person's life.
To control stress in the workplace, the same hierarchy of controls that are considered in the control of any other hazard should be used. Control the hazard at the source, if possible; failing that, control the hazard before it reaches the worker (along the exposure path); and as a last resort, control the hazard at the worker.
CAL workers have less scope to seek these controls. They may be subjected to heavy work demands, a poor workplace environment, harassment or bullying, shift work, role uncertainty, a lack of training, unrealistic expectations, lack of input or control over the work, poor ergonomic factors, a high degree of scrutiny or monitoring, and of course job insecurity. Stress at work can have a synergistic effect on stress away from work, capable both of exacerbating and being exacerbated by: family problems, financial problems, sleep and fatigue problems, financial problems, and a feeling of powerlessness and low self worth.
Unlike full-time workers, who often experience a level of loyalty to their employer and their work, CAL workers can feel less commitment. In the long term, this can increase the risk of burn-out. Job performance will come to consist of doing just enough to get by, and this can spill over into personal life as the burned out worker fails to look after their own health, relationships, and families.
Stress is not a trivial condition that can be dealt with simply by willing it away. It is a serious problem, and a proven cause of a wide range of medical conditions
Control of the hazard at the source, would in this case mean the conversion of contract and agency jobs to secure, decent work.
Contract and Agency Labour can and does make workers sick.