Psychosocial job pressures are taking on increasing significance in Austria and across the rest of Europe due to recent developments in working life. The impact of the health outcomes of, for instance, high levels of stress and time pressure has become a key aspect of the development of working conditions. A recent study highlights these problems, and draws attention to the possible economic impact of ignoring stress-related issues at work.
Background
A study, The psychological stress of work and its consequences (in German, 2Mb PDF), was carried out in 2011 by the Austrian Institute of Economic Research (WIFO). It was based on complex empirical analysis, and shows a clear link between psychosocial job strains and health outcomes. In addition, it highlights the economic impact of psychosocial job strains in work-related sick leave and the employability of affected employees.
The study is based on the secondary analysis of a number of national and international surveys. The added value of the secondary analysis refers to the multivariate analysis of the primary data, which offers a more comprehensive picture of the coherence of certain data.
This text focuses on the results based on two national surveys: the Austrian Labour Force Survey, Special Module on Work accidents and work-related health problems (in German, 1.5Mb PDF), with a sample size of 19,600; and the Austrian Health Survey 2006/2007 (in German, 228Kb PDF), which had a representative sample of about 15,000.
Time pressures and excessive stress
Not surprisingly, the study showed that ‘time pressure and excessive stress’ was the most important work-related psychosocial factor affecting workers in Austria, and 30.2% of the respondents reported suffering from it at the time of the interview. This can be compared to 3.5% for workplace bullying and 1.3% for violence, the two other factors investigated.
Gender differences disappeared if working time volumes were taken into account. The prevalence of time pressure and excessive stress rose with the number of working hours per week both for male and female workers.
The subjective perception of being affected by time pressure also increased with the educational level of the worker, and was reported by more than 40% of workers with tertiary educational levels.
‘Time pressure and excessive stress’ was especially widespread in sectors with employment growth. In the health and social services sector it was reported by 45% of respondents, and in the transport, storage and communication group of occupations by 43%. This is an indicator of the particular significance for employment potential of psychosocial job strains in future-oriented sectors.
The multivariate analysis carried out for the study also indicated a clear correlation between age and the risk of being affected by time pressure and excessive stress.
Within the 50–54 age group, the risk was 42% (men) or 50% (women) higher than in the reference group (aged 15–19). Among female workers, the risk of being affected was 62% higher in large companies than in small ones with fewer than 10 employees. Company size did not make any difference to the risk levels of male workers.
Among both men and women, psychosocial and physical health risks at work often appeared together. Those who reported exposure to at least one psychosocial risk factor were, to a significantly higher extent, also exposed to at least one physical job strain.
Work-related health problems
All in all, 12% of female and 13% of male workers attributed health problems they had experienced during the preceding year to their workplace situation. In this respect, the study revealed a clear age correlation. Only about 20% of younger workers related their health problems to work, compared to 40% of workers aged between 35 and 39, and 50% of those aged between 55 and 59. This finding indicates the cumulative effect of job strains over the entire working life, reflected in the respondents’ subjective perception.
The study also attempted to look in more detail at the health impact of psychosocial job strains by correlating various health problems with the occurrence of psychosocial job strains.
The results, both overall and for individual diseases, showed that the proportion of workers who reported being affected by at least one psychosocial job strain was particularly high among those with health problems.
In the overall working population a third of workers were affected by at least one psychosocial job strain, but the lowest value among those who reported having health problems was 40%. While the correlation between psychosocial job strains and musculoskeletal diseases was relatively low (51.6% for female and 58.1% for male workers), it was high for stress, depression and anxiety (82.6% for women and 94.7% for men).
The study also found psychosocial job strains occurred to an above-average extent in conjunction with cardiovascular diseases, headaches, fatigue and infectious diseases.
By means of multivariate regression analysis, the study assessed the likelihood of the incidence of a disease or health problems due to job strains. With regard to male workers, the analysis indicated that the risk of suffering from a disease or health problem was 50% higher among workers affected by a physical job strain than among those who were not.
Similarly, psychosocial job strains – such as time pressure and bullying – also correlated with an elevated disease/health problem risk of between 49.3% and 66.5%.
All in all, exposure to a physical or psychosocial job strain raised the disease risk by 50% for men and by as much as 80% for female workers. For all psychosocial job strains together, there was an elevated disease risk of 45% for female and 54% for male workers.
The study concluded that the multivariate analysis showed a clear correlation between the occurrence of psychosocial and physical job strains and the likelihood of the incidence of disease or health problems.
Impact on different occupational groups
Based on the Austrian Health Survey, the study presented results on workers’ psychosocial health status indicated by:
- frequency of insomnia;
- chronic medical anxiety or depression;
- frequency of dejection and exhaustion;
- frequency of negative feelings.
It then related the health status to respondents’ occupational work patterns.
For insomnia, the study showed a higher incidence among workers in low-skilled jobs. This was true both for female workers, especially those in low-skilled service jobs, and for men working mainly in industrial sectors where night work and shift work played an important role. It also showed teachers were greatly affected by insomnia.
Chronic medical anxiety or depression only affected 5.5% of female and 2.4% of male workers. But, as the study pointed out, due to the extraordinarily long duration of sick leave for those with psychiatric diseases (37 days on average), the impact of these conditions went far beyond their prevalence.
Blue-collar workers were affected to an above average degree by depression, 3.3% of men and 10.2% of women. Also affected were female workers in ‘people-related’ services and management positions, as well as male workers in non-academic teaching occupations and administrative services.
A high percentage of workers in the teachers’ occupation group reported a critical level of alcohol use, which the study took as an indicator of stress in the workplace. The results showed interesting differences between genders and qualification. An over-use of alcohol was widespread among male teachers with an academic background (30%) and above average for female non-academic teachers (19%).
Economic impact of work-related health problems
The study drew particular attention to the economic impact of work-related health problems.
More than half (54%) of those who reported health problems caused or worsened by work had spent some time on sick leave during the year preceding the study. The study showed 16% had been on sick leave for between four and 13 days, 16 % for between two weeks and one month, 10% from one to three months, 4.5% from three to six months. Only 7% were absent for less than four days.
The study calculated a total number of nine million sick-leave days associated with work-related health problems, an average of 2.6 days per worker in Austria.
Workers not affected by job pressures had an average of 0.8 days’ sick leave, compared to 3.3 days for workers reporting at least one psychosocial job strain, 2.6 days for those with at least one physical job strain, and 5.9 days for workers who reported both physical and psychosocial job strains.
The multivariate analysis confirmed these findings. Even when the results were broken down by factors such as gender, age, educational level and sector, there was still a clear correlation between job strain and the probability of sick leave in the reference week.
For workers in both categories, having at least one physical and at least one psychosocial job strain, the probability of having been sick in the reference week was two and half times higher than those with no job strains.
Commentary
Even though the study acknowledges the difficulties in establishing a causal relationship between health problems and workplace factors, it presents impressive results with regard to psychosocial job strains and related health problems based on complex empirical analysis.
The findings of the study make it clear that the significance of psychosocial strains in working life is likely to increase in the future, and that the accompanying work-related health problems not only cause personal suffering but also have a serious economic impact. In the current economic climate, this is a key argument in favour of taking action.
Manfred Krenn, FORBA
